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Vaccination Information and Reminder System - because babies do not come with instructions

Engaging parents in vaccinating their babies through an early education and reminder system that helps them remember to vaccinate

Photo of Jo Pirie
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Describe what you intend to do and how you'll do it in one to two sentences (required 350 Characters)

The Alliance aims to increase immunization rates of toddlers in Merced, California by providing a vaccine reminder device and smart phone application to pregnant women during their prenatal visits and providing an opportunity for the provider to educate and reinforce the benefits of vaccinating their baby.

Explain the innovation (2,500 characters)

In Merced County, California, one of three counties served by our MCO, vaccination coverage rates have consistently lagged behind the other two by a wide margin. A trend of decreasing immunization rates in Merced has emerged over the last few years. In 2018, the percentage of 0-2 year-olds in Merced who were fully vaccinated was just over 63%, compared to 79.8% in the other two service area counties. As a result of this trend, we undertook activities to better understand the barriers to immunization experienced by members living in this rural county and to develop a creative solution to help address the needs of our most vulnerable members. Results of patient surveys indicate that mothers are not receiving vaccine information/education and lack awareness of when vaccines are due or that they forget to attend their child’s routine appointments during which vaccinations are typically received. With this in mind, we focused our efforts on creating a solution to improve awareness and practical knowledge around vaccination to increase immunization rates in Merced County. Using the information gathered through member outreach, we devised a solution that employs a comprehensive system starting with prenatal providers educating expecting parents on the importance of vaccinations. Evidence suggests that provider recommendation is the strongest predictor of getting vaccinated; therefore, allowing this time for dispelling misinformation/addressing concerns or to gain a better understanding of what to expect after birth may improve immunization rates for 0-2 year-olds. At home, parents will also have a magnetic device that may be attached to a refrigerator or other metal surface and will provide a visual cue by changing color whenever the child is due for vaccines and/or routine well-child visits. The concept was piloted and we received feedback from 19 individuals. A majority of mothers claimed they did not receive information or education about vaccinating their baby. During our conversations they discussed wanting more education about vaccines, why they are needed, and when and how frequently they need to be given. Although many of the new moms had their first visit to the pediatrician scheduled at the hospital, about 30% of them had to schedule these visits on their own. A majority of moms said reminders for when vaccines are due would be helpful and about half of them said the visual cue provided by the magnet would motivate them to schedule an appointment.

Which part(s) of the world does this innovation target?

  • Northern America

Geographic Focus

North America, United States, California, Merced County - Our Rural Neighbors

Stage of Innovation

  • Prototype

Who will work alongside your organization in the project idea? (1,000 characters)

We have relationships with Merced county hospitals, public health department, local immunization coalition, and local immunization registry organization, whose partnerships will be integral in executing this idea. Except for the hospital, these entities have all been actively engaged as part of the local immunization coalition to improve immunizations in Merced. We do not foresee challenges in facilitating these relationships further. Identification of an engineering and product development group to design and create our simple, low-tech notification device will be dependent on appropriate funding. Given our proximity to innovative technology organizations in the Silicon Valley, barriers are not anticipated.

How is your idea unique? (750 characters)

Our solution is simple. We encourage prenatal care providers to start the conversation about the importance of vaccinations early so our parents can make an informed decision. Our idea also addresses social determinants of health challenges faced by our members that education alone may not always resolve. We utilize a variety of resources (e.g., notification technology, targeted solutions to personal barriers, and access to local resources) to minimize missed vaccination opportunities. Finally, we have a unique advantage in the existing relationships with other providers and organizations in the healthcare system and community to coordinate the care of our members. If successful, this program can be spread to other Medicaid health plans.

What is the name of your organization

Central California Alliance for Health

Explain your organization (250 characters)

The Alliance is a non-profit Medicaid managed care health plan established to improve care for the members we serve. We continue to uphold our mission by improving the immunization rates of our members and protecting them against harmful diseases.

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Women’s health/rights focused organization
  • Disabled Persons Organization (DPO)
  • medicaid managed care health plan

Gender and Diversity (500 characters)

The Alliance is committed to delivering culturally and linguistically appropriate health care services to our diverse membership. Our goal is to ensure that all members regardless of race, color, religion, national origin, creed, ancestry, ethnic backgrounds, language, marital status, English proficiency, age, health status, physical or mental disability, gender, sexual orientation or gender identity, or identification with any other persons/groups all have equal access to quality healthcare.

Organization Location (less than 250 Characters)

Our team is stationed at our headquarters located in Scotts Valley, California, with the exception of one team member who works out of the office in Merced.

Size of organization (number of employees):

  • 101-1,000 people

Website URL

http://www.ccah-alliance.org/

Scale of organizational work

  • Regional (reach within 1 geographic region)

Tell us more about you

Our team includes our Quality Improvement (QI) Director, two QI Managers, four QI Nurses, and four QI Analysts. We are the right team to work on this problem because: 1) Our organization and department is focused on improving immunizations within the 3 counties we serve; 2) We are active within our health care community and local immunization coalitions; 3) We are familiar with and connected to the community of practitioners that will be integral in supporting this new innovation; 4) We will play an active role in piloting and spreading the device/app/education; and above all, 5) We are passionate about improving the health of our members.

Applying to Gavi INFUSE

  • OpenIDEO Website
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Attachments (2)

Magnet.png

Another picture of our magnet that changes color

App 1.png

Initial pages of our application

2 comments

Join the conversation:

Comment
Spam
Photo of Matthew Taylor
Team

What type of low tech prototype have you designed that will effectively deliver timely information to parents, whilst also being cost effective, non-invasive but also not forgotten in such a busy time of their lives. Additionally how much coordination will occur with the healthcare systems and will a partnership be able to be constructed with the relevant healthcare authority?

Spam
Photo of Jo Pirie
Team

Hi Matthew,

The prototype that was most popular among our users was the refrigerator magnet with a corresponding smartphone app. The magnet was the most favorable device as it is non intrusive, inexpensive to manufacture, child proof, and positioned in a visible location that is frequented by the caregiver. The screen on the magnet will light up and change color when the child's immunizations become due as a visual cue that action needs to be taken. This feature can be tied to the application or could be programed into the device itself (it's basically a fancy kitchen timer). The app will be very simple and can help to identify barriers to accessing care, scheduling that first visit to the pediatrician, or be a resource to credible vaccine websites.

Education and distribution of the product will require the assistance of the Comprehensive Perinatal Services Program (CPSP) or Healthy Families America (HFA) home-visiting program that is managed by the Health Department, which we already have an existing relationship. However, further conversation with those managing the CPSP or HFA is needed if IDEO and Gavi are interested in further working with us to assist in making our product and services a reality.

From the literature, there is evidence that supports starting the conversation about the importance of child vaccinations early during pregnancy. In a CDC longitudinal study, they found that 85% of first time expectant moms made a plan for vaccinating their baby by their 2nd trimester. This result supports programs that provide early education to pregnant woman as impacting immunization rates. There also are currently legislative forces that are supporting our efforts as Governor Gavin Newsom has proposed spending $100 million to expand a home-visiting program — in which nurses and social workers visit young, low-income parents to give health and parenting advice such as the Nurse-Family Partnership (NFP) Program. NFP works by having specially trained nurses regularly visit young, first-time moms-to-be, starting early in the pregnancy, and continuing through the child’s second birthday. As an estimation of the kinds of outcomes we may be able to expect, the NFP in particular, has shown a 19% improvement in children being up to date on their vaccinations by 6 months old.

Finally, it is always cheaper to prevent disease than to treat it. There are direct costs associated with illness such as hospitalization costs. There are also indirect costs such as costs to contain an outbreak, lost wages by the caregiver, long-term effects of disease complications - deleterious costs to the child, family, and community. However, the cost to manufacture a bluetooth digital refrigerator timer/magnet is less than $16. There will be additional costs in managing the application, training staff on the product and services. But overall, it seems the money spent on prevention is justified in the potential cost savings if diseases and outbreaks can be prevented.

Thank you for your question.