SmartPhrase Integration, Education Sessions Improve Pneumococcal Vaccination Rates

Adding a SmartPhrase to provider clinical documentation along with consistent provider education significantly heightened rates of pneumococcal vaccination in a primary care center, according to results from a quality improvement initiative presented at IDWeek. The data were presented on Oct. 22, 2025, in Atlanta, Georgia.¹

What is a SmartPhrase, and How Can it Improve Vaccine Uptake?

SmartPhrases are shortcuts used within electronic health records (EHRs) that allow the insertion of prewritten texts into documentation. These can be customized based on specific patient information, allowing for more tailored and optimized treatment plans and efficient cross-disciplinary communication. By typing in a short code, a SmartPhrase can be populated within EHRs, saving time for providers.²

Tools like SmartPhrases allow for standardized prompts and reminders that can be strategically implemented in HER systems to increase vaccine uptake. SmartPhrases can automatically populate a brief reminder in a patient’s HER when they are due for a specific vaccine. SmartPhrases can also quickly expand into an order set for a vaccine, speeding up the process and reducing missed opportunities for vaccination.³

From a patient’s perspective, SmartPhrases can insert clear information into patient portals or visit summaries, which can help address common misconceptions about vaccines. In follow-up instructions, SmartPhrases can automatically populate vaccination care guidance or reminders for future appointments to complete their vaccine series. Ultimately, SmartPhrases free up time for both the patient and provider so they can, in turn, experience more thorough and personalized counseling.³

How Can a SmartPhrase Heighten Pneumococcal Vaccine Uptake?

Study Methods

Pneumococcal vaccination rates, specifically in primary care settings, remain low, despite established federal guidelines and affirmed risk, especially in older adults. Research suggests that the lack of uptake is in part due to patient refusal, the lack of ability to pay for vaccines, and the lack of provider recommendation, which can be hindered by low utilization of integrated reminders and provider uncertainty. More frequent encounters with the health care system and providers within it can increase vaccine uptake, but missed opportunities in physician offices continue to constitute a major concern.⁴

Use of a SmartPhrase could fill these gaps in care. In the current study, researchers initiated a quality improvement strategy to increase pneumococcal vaccination rates at the Gengras Adult Primary Care Clinic, Saint Francis Hospital. Their goal was to increase vaccination rates by 50% within 1 year of implementation.¹

Two components comprised the intervention. A SmartPhrase listing indications for the pneumococcal 20-valent conjugate vaccine (PCV20)—aligned with CDC guidelines—was incorporated into provider documentation templates, with regular updates. Next, quarterly education sessions led by the clinic director were held, incorporating reference reviews, case-based discussions, and interactive question-and-answer segments to help reinforce vaccination guidance.¹

Results

In the preintervention period in 2023, 164 PCV20 vaccinations were administered (quarterly counts: 19 in Q1, 16 in Q2, 27 in Q3, 102 in Q4). Pneumococcal vaccination rates increased significantly following the intervention. Quarterly vaccination counts in 2024 rose to 198 in Q1, 162 in Q2, 187 in Q3, and 214 in Q4. This represented a 364% overall increase compared with baseline, according to the investigators.¹

The patient populations before and after the intervention were comparable, with no major differences that could impact the validity of the results. The number of vaccinations in Q4 was higher compared with the previous quarters, which could be attributed to newly updated CDC guidelines released in that time that broadened pneumococcal vaccine eligibility to other age groups.^1,5

A SmartPhrase integrated into clinical documentation with ongoing provider education resulted in sustained increases in pneumococcal vaccine uptake and improved adherence to vaccination guidelines. The insights could help improve vaccine uptake in primary care settings and in areas across the health care system.¹

REFERENCES

1. Akiki M, Dagher C, Falcetti T, DeGennaro L, Stein A. (P-2036) A quality improvement project to increase pneumococcal vaccination rates in a primary care clinic. Presented: IDWeek; October 22, 2025; Atlanta, GA. Accessed Online via IDWeek Virtual Platform November 17, 2025.

2. Smart uses of Smart Phrases and pre populated templates. Professional Solutions. Published April 24, 2018. Accessed November 17, 2025. https://www.profsolutions.com/industries/dentists/insurance/risk-management/smart-uses-of-smart-phrases-and-pre-populated-templates/

3. Fichadia PA, Virmani M, Shah P, et al. Utilization and efficacy of DotPhrases in the electronic medical record for improving physician documentation. Proc (Bayl Univ Med Cent). 2024;37(4):692-696. doi:10.1080/08998280.2024.2352993

4. Missed opportunities keep pneumococcal vaccination rates lower. U.S. Pharmacist. Published August 19, 2019. Accessed November 17, 2025. https://www.uspharmacist.com/article/missed-opportunities-keep-pneumococcal-vaccination-rates-lower#:~:text=University%20of%20Florida%E2%80%93led%20researchers,and%2063.8%25%20in%20older%20adults.

5. Gallagher A. ACIP lowers pneumococcal vaccination recommendation to age 50. Pharmacy Times. Published October 24, 2024. Accessed November 17, 2025. https://www.pharmacytimes.com/view/acip-lowers-pneumococcal-vaccination-recommendation-to-age-50