Improving HPV Vaccination Rates Across Rural South Dakota

Throughout the project period, which was one year, it was learned that the development of the data dashboard was more complex and challenging than anticipated. Immunization data was not easily generated by a clinic or primary care provider, and immunizations that were entered as historical data were more difficult to include in the reports.

Horizon Health Care developed a data dashboard that is updated monthly with HPV vaccination rates. The dashboard displays HPV immunization rates by clinic and provider. It can be filtered by appointment date, patient age, and gender. The dashboard also identifies patients who have not received an HPV vaccination and those who have not completed their HPV series so that outreach can occur.

In 2019, Horizon Health Care received funding from the SD Department of Health to develop several new strategies to increase Human Papillomavirus (HPV) vaccination rates across its network of 21 medical clinics in South Dakota. Horizon identified an immunization champion, implemented client reminders, provided community education, and developed a dashboard to report HPV vaccination rates for patients age 11-26.

The project was targeted to ensure that Horizon Health Care was able to readily identify their HPV vaccination rates as an organization and follow up with patients who had not received or not completed the immunization series.

Throughout the project period, Horizon teams collaborated to identify barriers to vaccination, received education, and developed a workflow to support improved HPV vaccination recommendation and follow-up.

Immunization rates increased among patients age 11-14 from a baseline of 53% who had received at least one HPV vaccination to 65% at the end of the project period. A rate increase was not observed among patients age 15-26 during the project period.

The development of the data dashboard took most of the reporting period to complete. As a result, the impact of the availability of that data on screening rates will be monitored throughout 2020.

• Client Reminders – Recommended Intervention (Strong Evidence)
• Provider Assessment and Feedback – Recommended Intervention (Strong Evidence)
• Community Education – Recommended Intervention (Strong Evidence)

The project involved the identification of an immunization champion who assisted in the development of client reminder letters and a workflow to support improved reminders and follow up. This new position allowed the nursing staff to have a central point of contact, improved communication, and created buy-in for the project.

The data dashboard developed throughout the project will provide data to support ongoing client reminders and improvement work undertaken by clinical teams.

Lastly, community education efforts identified in the project encouraged Horizon clinics to engage with schools and community events in a new way. Nine schools were identified as potential partner sites, and educational events were completed in three of those schools. Additional events are scheduled for the future.

Horizon Health Care will build on early successes of the project (client reminders, community education, and workflow development) throughout 2020 by leveraging the data dashboard to provide clinical teams with the information they need to close gaps in care related to HPV vaccination.