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Increasing pneumococcal immunizations among people with diabetes using patient reminders.

People with diabetes are at high risk for morbidity and mortality from influenza and pneumonia (1). Both the Centers for Disease Control and Prevention and the American Diabetes Association recommend that individuals with diabetes receive a pneumococcal and an annual influenza immunization regardless of age (2,3). Although the prevalence of pneumococcal immunizations among people with diabetes has increased, the level is still suboptimal, particularly among those aged <65 years (4). Efforts to increase the coverage level of immunizations in adults have largely been directed toward those ≥65 years of age who are Medicare beneficiaries (5,6). Thus clinicians and younger individuals with diabetes may be less likely to consider pneumococcal immunization. Several interventions have been shown to increase adult immunizations, including provider and patient reminder/recall, assessment and feedback to physicians, and standing orders for immunization (7). This report describes a quality improvement effort to increase pneumococcal immunizations in people with diabetes using a simple computerized diabetes monitoring system to facilitate patient reminders.

The Montana Department of Public Health and Human Services began to work in collaboration with three practices in Great Falls, MT, to monitor and improve diabetes care. The settings included a multispecialty practice, a community health center, and an Indian health center. Each of these practices used the Diabetes Care Monitoring System (DCMS), an electronic data system developed for primary care practices to …