The effort to achieve mass vaccination in the U.S. has gotten off to a slower-than-predicted start, plagued by supply shortages, disorganization and inadequate IT systems.
Below, five CIOs from hospitals and health systems across the country share what IT infrastructure improvements they think are necessary to improve the efficiency of the vaccine rollout process.
Editor's note: Responses have been lightly edited for clarity and style.
Brian Herrick, MD, CIO, Cambridge (Mass.) Health Alliance: Improvements include a clinical tracking system, open access to scheduling, and ensuring that our process does not increase inequity.
These improvements require 1) analytics to identify the correct population at the correct time of the phased vaccine timeline, 2) the ability for patients who qualify for the vaccine to easily schedule themselves without needing to interact with a person at a time that works for them, 3) ensuring that patients are able to schedule and commit to the second dose at the correct interval, 4) automated reminders and an outreach system to ensure the maximum number of patients return for their second dose at the correct interval, and 5) automated education opportunities in all languages and multiple forms.
Michael Restuccia, senior vice president and CIO for corporate information services, Penn Medicine (Philadelphia): The vaccine rollout process is a classic case study for successful projects requiring "people, process and technology." In this equation, the technology infrastructure of an electronic health record and network connectivity seem to be sufficient at most health systems and communities to support the cause. As a result, the most crucial elements to enable success is the project leadership and teamwork amongst all segments of the healthcare delivery system (people and process).
The efforts by many to coordinate the vaccine supply, timing, storage and manufacturing of the vaccine, along with patient scheduling, administration and tracking of the vaccine are critical to the process. A break in the chain of any one of the critical path segments will result in vaccine rollout delays, continued spread of the virus and overall dissatisfaction.
Zafar Chaudry, MD, senior vice president and CIO, Seattle Children's: At Seattle Children's we looked at initially supporting the workforce (employees and providers), then planning for community members, parents, caregivers and patients.
The crucial IT components are: functionality to define phases, sub-phases and criteria to prioritize the list of individuals for vaccination management; functionality to provide the ability to self-serve and schedule an appointment for single or multiple doses of vaccine; the capability to manage the administration and tracking of vaccines; and functionality to run reports and export data to the state based on state reporting requirements.
We’ve built out two capabilities: a solution within our Epic EHR, and using MazikCare (built on Microsoft Dynamics 365 and utilizes its Health Accelerator) that enables an online portal for eligibility determination, real-time appointment scheduling with encrypted QR code touchless check-in, and second appointment reminders.
Mark Amey, CIO, Alameda Health System (Oakland, Calif.): Historically we have vaccinated our employees for the flu through our employee health department, utilizing an employee medical record system. However, like many others, we found it lacked important functionality such as scheduling and a robust portal to aid in the vaccination process. Thus, we are migrating some of these functions into our EMR, which is a growing trend among healthcare systems.
Vaccinating our patients especially in the emergency department and inpatient setting has the challenge of the patients' need to receive a second dose, possibly after they have been discharged from the hospital three to four weeks later. As patients move through services, departments, and potentially other organizations or care providers, the IT infrastructure needs to be able to communicate and support the vaccine type, dose timing and location of the patient.
Lastly, public health vaccine clinics require supporting such things as scheduling vs. walk-up clinics, tracking and reminders of follow-up appointments, gathering of appropriate demographics, and reporting. This all must be done in a very rapid manner.
However, this does not begin to address the shortages of clinical staff to administer the vaccines or keeping abreast of ever-changing data requirements, priority groups to receive the vaccine, and guidance from the government. In short, I believe that the issues we’re facing across the country and certainly in California are less technology and much more operational, procedural, and people power.
Steve Garske, PhD, CIO, Children’s Hospital Los Angeles: At Children’s Hospital Los Angeles, efforts to design, build and implement a functional system with robust reporting over just a few weeks in order to quickly vaccinate staff were made possible by combining equal parts predictive readiness across the organization — existing infrastructure and connections with the county, CDC, etc. — with technically savvy and nimble teams for IT informatics, integration, development, technical analytics and training, with robust support IT infrastructure, and tight coordination throughout, both with clinical staff and our quality partners.
In the absence of some or any of these things, the most crucial element to maintain is a capable, committed technical team and strong leaders. These folks were able to take what we had, fill in the gaps, and make something truly inspiring happen in a very short period of time.