Vaccine preventable communicable respiratory illnesses are major causes of morbidity and mortality in USchildren and adults represent a major challenge to public health and clinician providers. From a public healthperspective challenges include assuring immunization, especially in groups where immunization is voluntary,surveillance for these pathogens, case and contact investigation, and the public health burden of antibioticresistance associated with treatment of viral respiratory infections. From a clinician perspective, timepressures limit their attention to the public health considerations associated with the prevention andtreatment of vaccine-preventable respiratory infections. Treating physicians may have difficulty locating andinterpreting public health guidelines, and these guidelines often lack specificity for treatment and do notinclude local surveillance data. We believe that these problems are fundamentally related to communicationbetween public health and clinician providers. The goal of this project is to align public health and clinicalpractice by taking advantage of information technology to make public health practice more efficient andeffective and to advance appropriate clinical management with respect to immunization, diagnostic testing,and prescribing of antiviral and antimicrobial medications. This project will focus on vaccine-preventable orpotentially preventable respiratory infections due to influenza, pertussis, Neiserria meningitidis,Streptococcus pneumoniae, and respiratory syncytial virus.
The specific aims are: 1) Extend a system foremail communication, distribution of surveillance reports, and retrieval of reference information to publichealth and clinician providers in Utah, 2) Measure the effect of electronic information exchange system onknowledge, awareness, efficiency, and communication on the part of clinicians and public health personnel,3) Conduct a nested trial, randomly allocating urgent care centers and primary care clinics to receivesurveillance reports for vaccine preventable respiratory illnesses with or without tailored clinical managementrecommendations, 4) Measure the effect of receiving surveillance reports coupled with tailored clinicalrecommendations on therapeutic management endpoints including antimicrobial and antiviral use and onsecondary endpoints of immunization rates in targeted populations. The project will be referred to as theInformation and New Technology Exchange for Rapid Action, Compliance, and Treatment (INTERACT).
