EVERYONE WANTS TO GET MORE DOSES IN ARMS. HOWEVER, WE FIRST NEED TO GET MORE TECHNOLOGY IN VACCINE ADMINISTRATORS’ HANDS. THIS IS WHY.
I can’t remember another time in recent history in which our resilience and agility has been so rigorously tested on a global scale. In the past year, there have been countless events that have disrupted supply chains, filled healthcare facilities to capacity, stopped goods manufacturing, and pushed public safety professionals to their limits. Some were more localized than others, but all have had a significant impact on our ability to function – as governments, organizations, communities and individuals. Of course, our universal challenge continues to be the COVID-19 pandemic and, more specifically, our ability to achieve herd immunity.
In the U.S. alone, we must effectively and efficiently administer hundreds of millions of doses of COVID-19 vaccines across almost four million square miles of land to help stop the spread of the virus. That’s not going to be easy, even with the federal government’s assistance, because the distribution and administration process is highly fragmented.
Right now, millions of vaccine vials are being sent to privately-run retail pharmacies, grocery stores, and healthcare facilities, each of which has its own processes and procedures in place for dispensing and reporting – and none of which use the same systems to execute operations. There are also inconsistencies in how government-run sites are conducting vaccine campaigns within jurisdictions and across borders.
That’s why we must work together to develop a vaccine administration process that is efficient, predictable, repeatable and scalable. It must also prioritize the health and safety of all involved, not exclusive to social distancing considerations. For example, every vaccine administrator should be able to quickly, accurately and securely capture and report patient and vaccine vial data. However, it will be excruciatingly difficult to accomplish this without greater utilization of technology.
Perhaps the best way to illustrate this is to consider what each step of the vaccination process entails, the current challenges at each point, and the ways in which technology can help improve outcomes:
STEP 1: REGISTRATION
The first and perhaps most important step in the process is registration. Capturing each patient’s information is vital to the successful administration of the vaccine. The registration process also provides you with the information required to properly staff the vaccination facility. Ideally, scheduling of administrators, facilitators, medical professionals, and security should be executed using a workforce management solution that can effectively project traffic demand and task requirements. Look for a system such as the one that Reflexis offers, as it will help you optimize labor scheduling (and spend) down to 15-minute intervals based on the input criteria. This is especially important in environments like grocery stores and retail pharmacies where vaccinations aren’t your team’s only responsibility. It also helps to ensure that all scheduling decisions are compliant with labor laws and regulations, union rules and organization policies, and gives front-line workers more control over their schedules.
(Editor’s Note: Reflexis is hosting a webinar with CVS Health on March 30 to talk about how it’s transforming the consumer health experience in its clinics and pharmacies with streamlined labor scheduling. You can learn more and register here.)
The registration system will also provide you with the information you need to physically set up your facility, assuring that you have adequate space for the patient volume and required social distancing. If properly synced with your registration and inventory management systems, a task management solution can send instructions to team members about how to arrange (or remove) seating and complete inventory and safety checklists to confirm sufficient vaccine doses and supplies are on hand to accommodate the day’s appointments.
STEP 2: CHECK IN
You made a promise to patients during the registration process that you will:
– have the vaccine dose you promised them at the time you confirmed.
– provide a safe environment.
– have staff to guide them through the physical facility (remember this may be the patient’s first time in your facility).
– have adequate healthcare professionals to administer the vaccine and monitor for side effects immediately after.
You must follow through if you want to build trust and confidence in the vaccination process and, specifically, your site’s capabilities. The best way to ensure the process goes smoothly from the moment they approach the greeter to the moment they say goodbye is to eliminate paper from the equation.
Every staff member should be mobilized with a handheld computer, barcode scanner, tablet and/or printer that is synced with your registration, healthcare information, and administrative systems. This will enable them to quickly complete the following actions upon patients’ arrival:
– scan a driver’s license or other ID card to confirm identities and as well as a barcode or QR code on the smartphone to confirm the appointment. (This could help prevent fraud, too. Vaccines are a hot ticket item right now and some people will go to great lengths to get theirs.)
– retrieve patient records.
– auto-populate wristband data, if used to streamline positive patient ID (PPID) and monitor traffic flow throughout the process.
– alert other staff that patients are ready to be taken back for their appointments.
Kiosks could also be used to offer reduced contact or completely contactless check ins. Though you will still need a staff member available to assist patients with questions and ensure proper cleaning of the kiosk display between uses.
If the patient filled out medical history, insurance, privacy and consent forms in a separate app prior to arrival, a barcode or QR scan on their smartphones could help you quickly transfer the data to electronic health record (EHR), vaccination reporting and/or billing systems.
Just be sure that the mobile technologies you give staff will keep them fully connected to workflow systems and one another through their shifts. They must be able to effectively communicate and collaborate, whether inside the building or outside in a parking lot. A wireless push-to-talk (PTT) solution can enable them to coordinate patient movements from station to station, starting with the handoff from the check-in clerk to the vaccine administrator. A solution such as Q-Comm could be used for instantaneous communication to field locations. And alerts from a mobile task management app can help everyone stay appraised of procedural changes needed at the check-in desk to prevent crowding from occurring at any station.
STEP 3: VACCINATION
The patient’s wristband should once again be scanned as she/he enters the administration station – or identity otherwise verified, preferably with a government ID barcode scan that reduces the risk of fraud. Vaccine temperatures should also be double checked before the dose is extracted, ideally with a temperature-sensing indicator that has been affixed to the vial from the first mile through the last. The vaccine vial must then be associated with the patient to ensure the proper manufacturer, lot/batch number, and dosing is reported in the EHR and on the vaccination certificate. Scanning the barcode on the patient’s wristband and the vaccine vial barcode is the fastest and most accurate way to link the two, if a wristband is used. If not, scanning another barcoded identifier, such as a driver’s license, is recommended.
Scanning the vaccine vial at the time of administration will also help you keep track of vaccine inventory which is extremely important when dealing with such a valuable product. When the vaccine is administered and the patient is ready to move to the next station, the patient’s wristband or ID should be scanned again. The healthcare provider will then safely dispose of the syringe (medical waste) and the vial according to disposal regulations and disinfect the station (to include any mobile devices or scanners used) in preparation for the next patient.
STEP 4: POST-VACCINATION OBSERVATION
After the patient is vaccinated, he or she will probably need to remain in an observation area for a specified period. Of course, it’s important to maintain social distancing. So, the patient’s wristband or ID must be scanned upon entering and leaving this station to confirm location and help monitor room capacity. Establishing a policy and process for a patient who has an adverse reaction to the vaccine is also mandatory. A patient having an adverse reaction requires immediate attention. The first step is to diagnose the severity of the reaction and determine what medical attention the patient requires. Equipping observation staff with handheld mobile computers and tablets will enable them to send alerts and get the proper healthcare professional to the patient as quickly as possible. Upon arrival, the healthcare professional should be able to identify or verify the patient by scanning the wristband or other ID. It is possible the patient will be too distressed to speak. Scanning the wristband will also match the patient with the exact vial his/her vaccine dosage came from, which is why it’s strongly recommended. Capturing this information quickly and accurately is critical. Once a decision has been reached about the patient’s treatment, all the information related to the adverse reaction must be captured and recorded. (Again, a simple wristband scan can expedite and simplify this process.)
Patients without any adverse effects will be notified when their “waiting” time is up and they can leave. Scanning a wristband or other barcoded documentation establishes a timestamp and assures all parties that each patient has remained in the post-vaccination observation station for the required time. If the data is fed into a prescriptive analytics solution, site managers will be alerted quite quickly if a pattern of non-compliance is detected and automatically sent corrective actions for follow up. Patient safety must be a top priority.
STEP 5: CHECK OUT WITH A UNIVERSALLY TRUSTED CERTIFICATE
Once the patient has successfully made it through the vaccination journey and is ready to go home, the next best action is receiving a certificate or card verifying vaccination (and the final scan and removal of the wristband, if used). Proof of vaccination will be required to travel, return to work and resume social activities in many parts of the world.
Therefore, it’s going to be important that all vaccine administrators have a way to produce such documentation before the patient walks away. This could be done via a digital app; however, it’s important to also generate a physical certificate or card as not all people will have smartphones and not all places will accept a digital certificate (yet).
It’s best to issue cards that are sturdy, as they will be required for many activities and carried constantly. The card should be difficult or impossible to duplicate by anyone other than the original issuer. This is critical to building trust in the authenticity of the document. As my colleague Alex Fryer explained in his recent blog post, any certificate, card or label intended to prove vaccination should have a barcode or QR code unique to that individual. This really is the best way to capture, store and share sensitive data, such as the patient’s personal information and the vaccination details.
You will also want to have printers that can print these cards immediately for the newly vaccinated patients. Make sure you have the right type of printers, supplies and media for this unique application, and keep plenty of card stock on hand. Being forced to leave the vaccination facility without a card will disappoint the patient, and creating handwritten documents increases the risk of errors. Considering that most vaccines require two doses, it’s important that the first dose information be conveyed accurately when the patient shows up for the next appointment.