P118 Leveraging Electronic Medical Records for Produce Prescription Program Referral for Improved Enrollment and Participation


      Low program enrollment and participation is an issue across many produce prescription programs aiming to improve access to fruits and vegetables. The Keiki (child) produce prescription (KPRx) study provides Waianae Coast Comprehensive Health Center (WCCHC) patients with vouchers to purchase fresh fruits and vegetables. The KPRx feasibility study found the program to be popular and desired, but enrollment and retention to be quite low.


      The objective of this research is to quantify the impact of integrated and electronic referral processing on produce prescription program enrollment and participation.

      Study Design, Setting, Participants

      This quasi-experimental study compares enrollment and participation among KPRx participants by referral mechanism. Study participants were pediatric patients of the WCCHC. In the feasibility study a paper prescription was provided with instructions to visit the farmers market to enroll and the clinic called to remind patients. In the pilot study, a unique referral mechanism was developed by the WCCHC electronic medical record (EMR) team, which allowed pediatricians to screen patients for eligibility and click a button to refer the patient to the KPRx study. KPRx staff were alerted of the referral via the EMR and subsequently contacted participants to enroll at the farmers market.

      Measurable Outcome/Analysis

      Enrollment and participation at 3 months are the primary study outcomes. Enrollment, quantified as the number of enrolled participants in comparison to the number referred, will be compared between the two methods. Program participation, quantified as the number of active program participants at three months from enrollment, will also be compared. Independent t-tests will be used to test for significance.


      There were significant improvements in enrollment and participation with the EMR innovations (manual referrals=193, 49.7% enrollment, 23.8% participation vs EMR referrals = 121, 90.9% enrollment, and 54.5% participation) P < 0.05.


      EMR innovations can be leveraged to enhance enrollment and participation in fruit and vegetable prescription and other healthy food incentive programs.


      NIH, Hawaii Medical Services Association Foundation


      Supplementary data related to this article can be found at