Enhancing vaccine uptake for pan-respiratory viruses [PODCAST]

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Pediatrician Christina Suh discusses the KevinMD article, “More than just the flu: Helping families and doctors prepare for pan-respiratory viruses.” In this episode, Christina addresses the challenges of the current pan-respiratory season, including RSV, COVID, and the flu, emphasizing the critical role of vaccines in saving lives. She explores the concept of closing the intention gap to support individuals who want to get vaccinated by making the process easier, rather than focusing solely on vaccine hesitancy. Christina highlights the overwhelming burden on health care providers to communicate complex vaccination guidelines and presents digital messaging strategies that effectively increase vaccine uptake without adding to provider workload. Additionally, she discusses the U.S. Department of Health and Human Services’ Risk Less. Do More. campaign and offers actionable strategies for health care systems to enhance patient engagement and improve vaccination rates.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at kevinmd.com/podcast. Today, we welcome Christina Suh. She’s a pediatrician, and she’s going to talk about the KevinMD article, “More than just the flu: Helping families and doctors prepare for pan-respiratory viruses.” Christina, welcome to the show.

Christina Suh: Thanks so much, Kevin. I’m really excited to be here.

Kevin Pho: All right. Let’s start by briefly sharing your story and journey.

Christina Suh: So currently, I’m a director of clinical affairs at a company called Phreesia. As you mentioned, I am a general pediatrician. So prior to coming to Phreesia, I saw patients in a pediatric primary care clinic for about fifteen years. We served a low-income population here in the Denver, Colorado, area. And then I joined Phreesia about five years ago as the clinical subject matter expert in kind of all things primary care, vulnerable populations, public health.

And today, outside of my work at Phreesia, the other hat I also wear, I sit on the Colorado State Board of Health. So I also have a foot in public health, serving the people of Colorado.

Kevin Pho: All right. And today’s article, of course, is relevant to public health: “More than just the flu: Helping families and doctors prepare for pan-respiratory viruses.” Tell us what this article is about.

Christina Suh: So let me talk a little bit about some of the work that Phreesia does, just to set some context for your audience. So at Phreesia, our mission is really to make care easier for everyone. And so we do that by giving patients the tools and information, education needed so they can really actively participate in their care and make informed decisions.

So one of the tools that we provide is we have the ability to show patients personalized messages related to a variety of kind of preventative health behaviors, vaccinations being one of them. We had the ability to analyze our data in terms of the vaccination messages that we had shown over the past few years to really understand: Were these messages effective in getting shots in arms?

And so we analyzed data for about twenty million vaccination messages. We were able to look at claims data to see the effect of immunizations, whether or not immunizations were received by the patients who had seen the messages versus a control group who had not seen the messages. And we found that across those twenty million messages, we found about a two-time increase in incremental vaccinations in that exposed group versus control. And for some of the vaccine messages, that number was almost ten times as many vaccinations.

So really excited about these results because, as a company, we really are very dedicated to keeping patients healthy and making sure that they receive the care that they need to receive, including getting those important immunizations.

Kevin Pho: So to give us context, what are some of the absolute numbers in terms of the vaccination rates before and after, of course, the text message reminders?

Christina Suh: So it was twenty million that we looked at. We also had the opportunity to ask patients kind of their thoughts on the messages that they had seen. So almost half of the patients that were exposed to the messages also had said that this was new information for them, which, as folks in the health care community, we just kind of assume that those messages are out there, that this shouldn’t be new news. But for a big part of those patients, they had said that that was new news.

But also, importantly, almost two-thirds of the patients had also said that they were planning to speak with their doctor about those vaccinations, which, for me as a provider, is a really important kind of next step, right? We want our patients that come into visits to be primed, have questions, want to have discussions, especially about things as important as immunizations.

Kevin Pho: So as a pediatrician, what were some of the obstacles that you face in terms of maximizing that vaccine uptake rate?

Christina Suh: So I think, for your audience, they probably know there’s a variety of reasons, right? So there’s the folks, the families who are vaccine-hesitant, and we know that there are a lot of different flavors of vaccine hesitancy and a lot of really good research going on in that space.

But there’s also kind of this group of families that I remember seeing that I think of as kind of that movable maybe. They haven’t flu vaccine for their child yet. Maybe they’re kind of late on getting the flu vaccine, but not because they don’t want to get the flu vaccine. It could be an issue of convenience. It could be an issue of they just have some questions.

And I remember having those encounters. I would see a child maybe later in that respiratory season; they haven’t gotten their flu vaccine yet. And really, all it took was a conversation to answer a few questions, and then the family would agree to start the flu vaccine series. And I remember those encounters just being a breath of fresh air, right? Because for primary care providers, it can really feel like a grind day to day, and especially when it comes to talking about immunizations and vaccinations.

But there are those families out there. There are those patients out there who are not against getting vaccinations but really just need a little bit more information, a little bit of a nudge. And providing that little bit of information before they go in to see their provider really could be one of those nudges that helps kind of tip them over.

Kevin Pho: Now, what about, of course, the political climate and a post-COVID-19 climate? How’s that affecting, over the last few years, the questions that you’re receiving about the flu vaccine and perhaps contributing to some of that hesitancy?

Christina Suh: There’s so much being talked about and written in this space, and it’s hard for me to say which way things are going to go. I mean, I think we have seen a decrease of immunizations, and so a lot of good research happening as to understanding the drivers for those.

But I think it’s important to remember that it’s still important and critical to really support patients, continue to support patients, to give them information, the tools and the information that they need that is accurate, that is evidence-based, so that they can have those conversations with their providers when they go to see them. So I think that doesn’t change for me. That is still going to be kind of the work that we’re very interested and dedicated to doing at Phreesia.

Kevin Pho: So talk to us about the text messages that patients are receiving. What kind of information are they receiving when they get texts?

Christina Suh: So the information really can be very simple in terms of, “You may be eligible to get your flu vaccine today. You may be eligible to get your RSV vaccine.” Kind of just really, again, putting that information in front of the patient in terms of, “You may be eligible. Here are some of the risks associated with the diseases that these immunizations protect against.”

But we also like to send a strong message: “Have a conversation with your provider.” In some cases, we may connect patients with doctor discussion guides so that, again, they can access another tool so that they can have that meaningful conversation with their provider during the encounter.

Kevin Pho: And then are these text messages to the public in general, or are they linked to specific practices who partner with Phreesia?

Christina Suh: Good question. So in general, they’re for patients who are using Phreesia to kind of check in for their visit. So the bread and butter of what Phreesia does is we support organizations for patient check-in. And so after patients have finished kind of their check-in process, they have the opportunity to kind of opt in or opt out to seeing further messages. And so it’s those patients who are kind of checking in that we have the opportunity to show that information to them.

Kevin Pho: And then are we talking about things like just the flu and RSV vaccines? What about some of the other vaccines, like pneumonia vaccines?

Christina Suh: So we can present messages kind of across the board for all of the respiratory vaccines. I’ll just share with you that just for this respiratory season, we’ve delivered over two million messages, and that’s a combination of kind of all the different respiratory vaccines.

Kevin Pho: All right. So the article also talks about the Risk Less. Do More. campaign. So talk to us more about that.

Christina Suh: So we were really proud to partner on that campaign, which, again, was really focused on getting those immunizations against the respiratory viruses, so influenza, RSV, and COVID-19, in the arms of folks who are high risk for severe disease from any of those bugs. So we’ve been delivering those messages, and it’s been just a really exciting partnership.

Kevin Pho: And in terms of next steps, where do you see, in terms of these text messages or patient reminders, going? And where are some potential opportunities going forward?

Christina Suh: So we’re going to continue to look into the effectiveness of our immunization messages just to make sure that, again, what we’re seeing is really driving shots into arms, or the messages that we’re presenting are really resulting in shots getting in arms. So as a past immunization delivery researcher, that is something that is really important and near and dear to my heart.

And we’ll just continue to support patients and providers, again, in just driving those health behaviors so that patients can stay healthy and really have optimal health.

Kevin Pho: Do you ever get pushback from patients that they’re getting overwhelmed with messages from their health care clinician? Because whenever patients go for a visit, for instance, they get text reminders for the visit. And then after the visit, they get multiple texts for things like patient satisfaction surveys. And now we have added text messages from even whenever they go to the pharmacy about getting their vaccines. And there are more text messages from companies like yourself. So do you ever get pushback from patients that this is just simply notification overload?

Christina Suh: That is such a great question, right, in today’s climate and in today’s environment. So I think what Phreesia has been really good at, Phreesia’s been around for almost twenty years, so we have really developed kind of some best practices in terms of what is enough messaging but not too much.

We really look at, “How do we make the messages relevant?” I think that also helps to the person that’s seeing the messages because I think part of it is, when you’re showing someone a message that is not relevant to them, that’s kind of where you can get some of that pushback. So we’ve got an excellent team, and we’ve got a really great kind of playbook of best practices that really helps us to kind of mitigate that fatigue that you can sometimes see from individuals.

Kevin Pho: We’re talking to Christina Suh. She’s a pediatrician, and today’s KevinMD article is “More than just the flu: Helping families and doctors prepare for pan-respiratory viruses.” Christina, let’s end with some take-home messages that you would like to leave with a KevinMD audience.

Christina Suh: So I would say the main take-home message is to remember the patients, that as you’re talking with them, they may not have all the information. It’s easy for us to assume that they’ve got all the information that they need to make a decision, but sometimes they don’t. So it’s important to maybe use all the tools in your toolbox to support patients with information so that they can make those decisions, that they can have those meaningful conversations with you as they’re making decisions about their health.

And also remember that there are, as you think about, “How do I support patients?” especially in the realm of immunizations, for me, I feel like this is kind of an all-hands-on-deck moment. So think about, again, think about all the tools in your toolbox. Maybe think about some of your business partners or vendors like Phreesia who may have solutions and also are dedicated to supporting patients in the same way that you may be dedicated to supporting your patients. And we’re here, and we are happy to partner to keep patients healthy.

Kevin Pho: All right, Christina. Thank you so much for sharing your perspective and insight, and thanks again for coming on the show.

Christina Suh: Thanks so much, Kevin. I appreciate it.

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