Table 2.
Themes and exemplar quotes from pediatric healthcare providers interviewed about CDS reminders that targeted provider recommendation of the HPV vaccine to eligible patients
| Theme | Quotes |
|---|---|
| Awareness of CDS Reminders (Code: yes/no)a |
“I’ve seen…I think I’ve seen…yeah I’ve seen the Menactra and the TDAP. I don’t know that I’ve seen HPV.” (no) “I believe so.” (yes) “Was I supposed to notice [a prompt]?” (no) |
| Utilization or Acceptance of CDS Remindersa | “Usually it will just help me remember to talk to the parents about it.” “I may just kind of briefly look at their shot record, but HPV is not one that I necessarily will focus on. So if I don’t happen to notice… I might not notice as often as if there was a prompt and I’m not sure if… Is there a prompt?” “I wouldn’t say necessarily they influence my vaccination practice.” “I didn’t respond negatively. I don’t mind it. I’m glad to have it, because sometimes it’s actually helpful for me.” |
| Reasons for non-use of CDS remindersa | “I didn’t change my behavior, like because it’s already drilled into our heads to just do the vaccines.” “I don’t think I did (notice the script) but maybe it’s because I think I’m doing it so you know, as we move through, I look and I see – you don’t have your three HPVs” “I was much better about it when we were charting on the paper....during the patient encounter that that’s just not a priority, unfortunately… It would be great if it were on the computer.” “So I am hoping when we don’t have the paper anymore when it is all tablet and it magically gets transported into our note and I can do that right at the beginning, I will read over that and it will prompt me, because truthfully I think I have really done not so good of a job of noticing the scary prompts.” “I don’t feel that I need CHICA to tell me to vaccinate because I like to vaccinate.” “Some percentage is not necessarily override, it’s just the amount of time I have to be able to cover all the topics.” “If it’s absolutely false, meaning if I know the family, especially if I know that they don’t have guns or things or that nature and they print out the gun sheet, then I don’t introduce that information to them.” “I do (use the prompts) when it works in my workflow. It is not that I don’t think they are helpful. It is just that as you know, in the flow of the day and the craziness of the day to go back and forth and remember to look at all the prompts to review for the concerning ones, that’s been difficult for me going to all of the laptop work.” |
| Effect of suggested script | “Oh, no, I don’t need help with that. I know what I need to say.” “Okay. It may have been there, but I’m being honest with you. I probably did delete it because I sort of have my own little spiel that I give.” |
| Role of nurses in vaccination | “[O]ur clinic, my nurse is just, she’s a hawk when it comes to vaccines.” “To be honest with you, the reason I usually know (the patient needs vaccines) is my nurse tells me. So she reviews the chart before I even see the patient and she’ll tell me they’re overdue.” “My nurse will be like, hey, it looks like they need this one, too, based on what CHICA’s thrown out, printed out.” |
aOnly asked of the providers in the CDS reminder groups