Health systems have faced a litany of complex challenges to delivering patient care during the pandemic. Many are now developing vaccine distribution plans, but since vaccine supply tends to vary based on time, delivery and availability, it's not as easy to forecast how many doses might be available at a given time.
Hospitals and health systems have spent the past month rolling out the vaccine to front-line workers and their employees, as well as to older and at-risk individuals. They have refined their processes for scheduling and tracking both vaccine doses among clinicians and staff, but have grappled with how to scale up these efforts for the masses. Bringing in the general public introduces new obstacles for overburdened healthcare providers that can be eased, in part, by technology.
Intelligent automation company Notable Health recently hosted a webinar titled "How to optimize COVID-19 vaccine administration with AI and automation." The presentation featured an interview with Ezekiel Emanuel, MD, vice provost for global initiatives and co-director of the Health Transformation Institute at the University of Pennsylvania in Philadelphia, about the current state of COVID-19 vaccine distribution and how intelligent automation can solve the operational and clinical workflow challenges associated with a vaccination roll out of this scale.
Dr. Emanuel also serves as a special adviser to the director general of the World Health Organization and a member of President Joe Biden's Transition COVID-19 Advisory Board; he is also a strategic advisor to Notable Health.
Notable's platform automates any workflow throughout the care continuum, spanning administrative, clinical and revenue cycle domains. The technology deploys 'digital assistants' that are programmed to perform any repetitive, manual task — in this case, scanning the EHR to identify patients eligible for the vaccine, collecting informed consent, and scheduling necessary follow up appointments.
Muthu Alagappan, MD, medical director at Notable and an attending physician at UCSF Medical Center in San Francisco, said polls show as many as 15 percent to 40 percent of individuals don't want to receive the COVID-19 vaccine. Healthcare providers will need to craft personalized outreach campaigns to bring those individuals into the fold.
"We recognize there is a tremendous amount of heterogeneity between patient populations across different geographies, which results in varying degrees of skepticism about the vaccine," said Dr. Alagappan. "Every time a patient tells us they are not interested in receiving the vaccine, Notable's digital assistants can tailor follow up questions to diagnose why that is. If patients indicate they’d prefer to postpone the vaccine by seven or 14 days, we can trigger automated reminders at a later date, proactively and consistently providing vaccine education to keep them informed and up to date about their options."
"There is no doubt that the public's willingness to take the vaccine changes," said Dr. Emanuel. "It changes based on what is happening in the media; it changes based upon perception and who they are listening to and the messages they are getting."
A small percentage of the population is against vaccines of all kinds, said Dr. Emanuel, while others are eager to become early adopters. Then there is a large middle group of individuals who are hesitant to take the vaccine because of the rollout speed and limited testing.
"There has been an increase in people who are willing to take [the vaccine] after rollout. They see there are no major problems with it, and as more information becomes available about the vaccine, and if the alternative is getting COVID, in the end I think we'll get the vast majority of Americans [vaccinated]," said Dr. Emanuel.
Health systems are prepared for the early adopters but struggle with proactive outreach to populations less trustful of the healthcare system, including older Americans and minority groups. Dr. Emanuel suggested tailoring communications to those populations through multiple digital formats and leveraging trusted community healthcare workers to provide another touchpoint of personalized outreach.
"One thing we will have to change is, in general, our systems have been reactive to patients coming in, and now we have to be much more proactive in reaching out to patients at the appropriate time with information we can act on in ways they can trust," said Dr. Emanuel. "This is occurring in a milieu where there is a lot of mistrust in information and a lot of misinformation. There is a heightened level of skepticism, so being able to reach out, be authoritative and reassure people that what you are saying is something they can act on and trust, is important."
The pandemic exacerbated the need to get in touch with patients faster; support touchless environments for check-in and registration, and alleviate provider burnout from hefty administrative burdens. Since the start of the pandemic, health systems like Chicago-based CommonSpirit have used Notable to identify and triage patients at risk for, or showing symptoms of COVID-19, and reroute them to virtual visits when in-person visits were unsafe. The company recently expanded its platform capabilities to enable the next phase of this process, which is identifying eligible vaccine candidates, educating them on how, when and where to receive the vaccine, and scheduling their appointment.
"Undoubtedly, we are in a challenging phase of this pandemic, but also a hopeful phase over the next few months, as we look to getting the entire population, or majority of the population, vaccinated," said Dr. Alagappan. "As Dr. Emanuel and others have pointed out, there will no doubt be many challenges — operational, logistical and technical — that health systems will be faced with as they take on this enormous task. Notable, through intelligent automation, wants to be a partner throughout this process and provide technology that can extend the capabilities of your workforce, to enable them to vaccinate patients in a more effective and safe manner."
Notable is already partnered with leading health systems like Salt Lake City-based Intermountain, CommonSpirit and Renton, Wash.-based Providence to automate a variety of administrative and clinical workflows including patient intake, note taking, copay collection and more. As of January 14, Notable opened up an initial cohort of health systems to deploy its COVID-19 vaccine administration workflows. Click here for more information or to sign up.
Click here to view the webinar presentation.