Smart Clinical Messaging within Pharmacy Workflows Improves Adult Immunization Rates

Empowering Retail Pharmacy Vaccination Programs Benefits Pharmacies, Patients, and Pharmaceutical Companies 

When it comes to reducing vaccine-preventable diseases in the United States, federal and state governments, local public health departments, medical associations, physicians, pharmaceutical companies, and retail pharmacies have several common goals, including improving adult vaccination rates. 

The Centers for Disease Control and Prevention estimates that just under half (49.4%) of U.S. adults received an influenza vaccine during the 2021 – 2022 “flu” season. Many of these vaccines were administered at retail pharmacies. Adult vaccination rates are substantially lower, however, for other vaccines, such as pneumococcal and shingles.  

So, how can we, as an industry, make a significant impact on adult vaccination rates? Smart clinical messaging is a promising technology to facilitate the time-sensitive and accuracy-dependent process of determining vaccination eligibility in the pharmacy. As consumers continue to demand more convenient and accessible healthcare, pharmacies are transforming the perception of a medical provider by offering basic healthcare services to their customers—including immunizations.  

The pharmacy’s unique position in the care continuum combined with its broad access to large numbers of patients make it an ideal care setting for improving vaccination rates. Pharmacists are trusted healthcare providers with regular access to more consumers than any other provider. Pharmacists want to operate at the top of their license and provide more clinical services but are challenged with staffing constraints and limited by technology that can neither identify which patients are clinically and financially eligible for vaccination nor provide a streamlined workflow. 

CareALERTS™ Smart Clinical Messages Deliver Value for Patients, Pharmacies and Pharmaceutical Companies

OmniSYS, XiFin Pharmacy Solutions, has created a purpose-built smart clinical messaging solution, CareALERTS™, specifically designed to send targeted messages that are both patient- and vaccine-specific. CareALERTS produces timely, actionable information for the pharmacist that can be integrated into the pharmacy management system (PMS) and manifest in the pharmacy staff workflow in near real time, allowing vaccination opportunities to be addressed at the point of care.

CareALERTS incorporates data from multiple sources to deliver a comprehensive solution to support smart clinical messaging for adult immunization, including:

  • OmniSYS proprietary medical and prescription claims data from more than 20,000 pharmacies 
  • Data from fifty-six state and jurisdictional immunization information systems (IIS) registries, through bi-directional integration 

CareALERTS leverages multiple data sources and a sophisticated opportunity rules engine that considers clinical eligibility, financial coverage, and business requirements to identify vaccination-eligible consumers in real time, at the point of service. Pharmacists no longer have to take extra workflow steps to query clinical or financial eligibility. With CareALERTS, the data is right at their fingertips. CareALERTS helps maximize clinical service delivery while streamlining the pharmacy workflow. It is also convenient for consumers, who can now be reminded at the point of care that they are eligible for a companion vaccine. 

Gaps in vaccination history and clinical and financial eligibility can be communicated to the pharmacist directly through the pharmacy’s PMS.

CareALERTS incorporates clinical rules based on the Advisory Committee on Immunization Practices (ACIP) guidelines and the Centers for Disease Control and Prevention (CDC) to ensure the vaccine is clinically necessary. CareALERTS also verifies medical benefits to ensure payor eligibility and plan coverage. Business rules are derived from payor data to ensure the vaccine is eligible for reimbursement. CareALERTS is also customizable to support operational workflow and national determination coverage (NDC)-specific programs such as influenza high dose vs. quadrivalent vaccines. 

CareALERTS messages can be delivered in seconds to the pharmacist within their existing workflow in the PMS. Upon receiving the message, the pharmacist can immediately counsel the patient on the benefits of immunization, right in the store. If the patient chooses to receive the vaccine during that encounter, the pharmacist can administer it at that time. 

CareALERTS enables all four essential areas of the immunization workflow: 

Patient Education

  • Pharmacists can view the patient’s immunization history as well as their clinical and financial eligibility for a companion vaccination and alerts can be sent to patients within any digital medium  

Scheduling and ordering 

  • Pharmacists can view pre-adjudication eligibility for both payor and vaccine 
  • Pharmacists receive alerts within the workflow for clinically and financially appropriate companion vaccines 

Billing 

  • The system automatically ensures benefit eligibility for both payor and vaccine 
  • Pharmacists receive alerts within the workflow for clinically and financially appropriate companion vaccines 

Clinical encounter 

  • Pharmacists can view the full patient immunization profile 
  • No disruption to pharmacist workflow or requirement to check a third-party system 
  • Immunization data is automatically shared with IIS registries

CareALERTS™ Delivers Demonstrable Benefits

Real World Results

  • OmniSYS customers combined $25.7 million in incremental revenue in a single year for participating pharmacies
  • One OmniSYS customer achieved a 31% conversion rate for companion pneumococcal immunizations, resulting in $11.9 Million in incremental revenue and improved vaccine protection the patient population served

This approach can be a big win for retail pharmacies and the communities they serve. It helps them better protect patients as well as increase the usage of profitable service lines. It also helps keep patients thinking about immunizations beyond the seasonality of the annual flu shot.

CareALERTS also enables applications such as the PMS, billing system, or EHR to pull actionable opportunity forecasts and complete patient immunization histories. Plus it enable public health and state registry clearinghouses to submit data to OmniSYS and pharmacies to update clearinghouses with completed immunization encounter data.

CareALERTS also enables applications to pull actionable opportunity forecasts and complete patient immunization histories. Plus it enable public health and state registry clearinghouses to submit data to OmniSYS and pharmacies to update clearinghouses with completed immunization encounter data.

As the important role of pharmacists as clinicians continues to grow, CareALERTS smart clinical messages will allow them to continue to build successful relationships and transform loyal customers into loyal patients. Plus, enhancing retail vaccination programs improves patient health outcomes and grows service line revenue. CareALERTS also helps pharmaceutical companies broaden the reach of their adult companion vaccinations.

Contact us for more information on CareALERTS for immunizations and other services.

Dean Braun

Dean Braun

As Senior Vice President of Business Development, Dean leads the rapid expansion of new business for OmniSYS. He is passionate about workflow solutions that help customers build brand while driving profitable growth. A healthcare information technology veteran, Dean has over two decades of sales and customer operations leadership experience.

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