Can targeted flu vaccines lower hospitalization risk?

A Learning Health System project finds Kaiser Permanente Washington members who would benefit most from preventive services, writes Dr. Paula Lozano

By Paula Lozano, MD, MPH, senior investigator at Kaiser Permanente Washington Health Research Institute and associate medical director for research and translation at Kaiser Permanente Washington

“There’s still a lot more flu season to come,” according to an influenza expert at the Centers for Disease Control and Prevention (CDC), speaking earlier this month. The CDC and other national health agencies and organizations — including Kaiser Permanente — recommend a flu shot, even in February, to protect yourself and your family.

Last year in the United States, about 1 million people were hospitalized and 80,000 died from influenza. That’s why Kaiser Permanente takes flu prevention seriously. At Kaiser Permanente Washington Health Research Institute (KPWHRI), we help protect our community and others against influenza through our research as well as through a new initiative called the Learning Health System (LHS) Program. Now in its second year, the LHS Program aims to strengthen Kaiser Permanente Washington’s culture of continuous learning by supporting partnerships between researchers and clinical leaders. This flu season, the LHS Program found a way to put KPWHRI’s cutting-edge flu expertise to work for our members.

Preventing hospitalization of people most vulnerable to serious flu complications

Doctors have known for many years that conditions like chronic respiratory disease or heart failure make a person more likely to have serious flu complications (like pneumonia) or be hospitalized. Preventing influenza in people with these conditions relieves stress and reduces health care costs for patients and their families. It cuts down on avoidable use of health services. It can even reduce patients’ chance of dying.

KPWHRI’s influenza expert — Associate Investigator Michael L. Jackson, PhD, MPH — does epidemiologic research on the flu and flu vaccine. He recently published findings from Kaiser Permanente and five other large health systems across the country that strengthened the case for focusing influenza vaccinations on vulnerable groups such as people with chronic conditions. A few months ago, Mike joined forces with the LHS team and put his influenza expertise to use developing a new way to help Kaiser Permanente Washington health care staff get better at preventing flu in vulnerable populations.

Mike and the LHS team looked at data from Kaiser Permanente Washington members at five Puget Sound-area clinics and used a validated computer-based risk model to find the people who were most likely to be hospitalized in the coming year. The team gave each clinic a list of a few hundred patients with the highest risk of future hospitalization. These are the very people who are also most vulnerable to becoming seriously ill if they catch influenza. Nurses and medical assistants did personalized outreach, calling these members to remind them to get their free annual flu shot.

The LHS Program helped Mike partner more effectively with Kaiser Permanente Washington clinicians by providing predictive analytics, data programming and implementation support. This learning partnership made it possible to quickly design and launch an approach to reach out to members at high risk of influenza-related complications and encourage them to get vaccinated.

The LHS Program has a pipeline of projects like this one that are testing ways to use our Institute’s expertise and skills to support better clinical care at Kaiser Permanente Washington. Please watch for future stories about these efforts.

Dr. Lozano codirects Kaiser Permanente Washington’s Learning Health System Program.