Improving vaccination of pregnant women against seasonal influenza through use of a mandatory field in the obstetric electronic medical record

Background: The aim of the present study was to determine whether using a mandatory data field in an electronic health record would increase compliance with the recommendation to vaccinate pregnant women against influenza. Methods: Two cohorts of women who delivered at the Centenary Hospital for Women and Children between 1-31 July 2015 and 1-31 July 2017 were compared for compliance with the national public health recommendation to vaccinate all pregnant women against influenza. The single change between audit periods was programming the electronic health record to include a mandatory field preventing clinicians from closing patient files unless they selected an answer to the question asking whether influenza vaccination had been performed. Data were audited and compliance rates were compared. Results: A total of 275 and 299 women delivered in the two audit periods. There were no significant differences in maternal or neonatal characteristics between the two cohorts except for maternal age, which was younger in the second period (33.3 versus 31.5 years; P = 0.001). Vaccination rates doubled between audit periods (35.0% versus 79.8%, P < 0.0001). Conclusion: Introducing a mandatory data field into an electronic health record system may increase compliance with public health interventions, such as influenza vaccination in pregnant women.