Summary：
This study, published in the Journal for Healthcare Quality, evaluates a systemwide implementation strategy to improve Human papillomavirus (HPV) vaccination rates within an integrated health system in Maine, USA. Although HPV vaccination is routinely recommended for adolescents, coverage has historically remained lower than that of other adolescent vaccines. From 2019 to 2024, this healthcare group increased HPV vaccination completion rates from 46.2% to 55.4%, whereas national rates declined over the same period.
The intervention consisted of four coordinated components: quality improvement (QI), electronic medical record (EMR) optimization, provider education, and multi-level communication. HPV vaccination was established as a formal QI target and incorporated into performance evaluation frameworks, supported by regular feedback of clinic-level data to promote accountability and targeted outreach. A designated physician champion played a central role in facilitating implementation, engaging clinical teams, and advancing system-level changes.
EMR enhancements included performance tracking tools, clinical decision support prompts, and workflow improvements such as automatic scheduling for subsequent doses and expanded patient self-scheduling. These changes reduced missed opportunities and supported earlier vaccine initiation, particularly among children aged 9–10. Education and training initiatives equipped providers with evidence-based communication strategies to address parental hesitancy, while external partnerships provided technical support and opportunities for shared learning.
A comprehensive communication strategy targeted both providers and patients. Messaging emphasized HPV vaccination as cancer prevention, and patient-facing interventions, such as simplified immunization schedules, surveys, and SMS reminders, were implemented to improve awareness and facilitate timely vaccination. These efforts were closely aligned with EMR-based tools to streamline the pathway from recommendation to uptake.
The intervention resulted in sustained and statistically significant improvements in vaccination rates over time. This case demonstrates that a coordinated and multi-component strategy, which integrates performance management, digital health tools, provider engagement, and patient-centered communication, could work effectively for improving the HPV vaccine coverage within the healthcare group’s facilities. Further research is needed to assess the scalability of this approach and the relative contribution of its individual components across diverse healthcare settings.
Source:
Zimmerman, C. B., Ramos, J., Parker, M. G., Hasan, O., Atkinson, L., Tavakolikashi, M., Welch, G., & Keeport, M. (2025). An Integrated Health System’s approach to improving human papillomavirus vaccination rates through a systemwide implementation strategy. Journal for Healthcare Quality. https://doi.org/10.1097/jhq.0000000000000510
Content Editor: Xinyue Zhou
Proofreader: Zhangyang Pan, Xinyu Zhang
Page Editor: Ruitong Li
Translator: Tianyi Deng
