How to optimize a healthy IT system for immune drive

From the days of paper, pen and folder, government agencies have organized vaccination campaigns. Countries around the world have successfully implemented vaccination programs on a large scale.

In countries such as India, which has the second largest population, vaccination campaigns to eradicate polio have been carried out in designated centers and carried out door-to-door. In March 2014, India was declared polio-free. No technology at all!

Routine vaccination management is always carried out through regular appointments or appointment appointments. Vaccination for polio, smallpox or similar diseases has been part of the government’s multi-year plan.

However, COVID-19 vaccination campaigns are being planned in cooperation with public health officials to prioritize management by age group, identify vulnerabilities in the population, manage the gap between supply and demand, track the population who vaccinated, and so on.

Managing mass vaccination programs in any country is an extraordinary task, where technology can simplify these processes. Governments around the world have been stepping up IT departments in the background to assist in the vaccination process. The right application of technology can transform the COVID-19 vaccination program into a game changer in the medical industry.

IT assists COVID-19 vaccination plan

Health IT can only be the promoter of the vaccine drive. In order to effectively digitize the immunization process, it is important to map all the workflows and stakeholders of the immunization platform or the application being used.

The main stakeholders of the vaccination program include patients, physicians, vaccination managers, and public monitoring agencies that track vaccine administration and effects (especially during outbreaks).

Some of the intervention points where technology can facilitate vaccine management include:

  1. Vaccine tracking. Maintaining the cold chain of vaccines is an important task, especially when vaccines are transported over long distances and need to be stored under designated conditions. Tracking technology includes sensors used to monitor the temperature of sample bottles and dashboards to track supply chain logistics across various distribution channels.

  2. Find a vaccine provider. Vaccine Finder is a simple web portal, and suitable providers can be easily found nearby. For COVID-19, the CDC is currently managing the portal and lists vaccination centers and providers across the country.

  3. Check eligibility. Most countries use a staggered approach to administer vaccines, with weaker people receiving the vaccine earlier. A simple checklist or questionnaire on the web portal can help people understand their eligibility based on public health service guidelines.According to the US Centers for Disease Control and Prevention (CDC) Immunization Practice Advisory Committee, An independent group of medical and public health experts.

  4. Plan vaccination. This is as effective as any other scheduling protocol (such as scheduling appointments) and can help avoid overcrowding in vaccination centers.

  5. communication. Global vaccines are hesitant, and every government is using social media campaigns, chatbots, helplines and other means to alleviate people’s fears. Educational programs for medical staff and the public are gradually being implemented. Proof of vaccination and communication of adverse events to the center are also part of the communication plan.

    Using digital reports to communicate an individual’s vaccination status is an important part of the COVID vaccination driver. Several countries are debating the use of digital health certificates with vaccine anti-counterfeiting QR codes to allow them to enter their countries. The QR code-based vaccination certificate can be saved on the mobile phone, and the public health agency can track the vaccine drive and verify the vaccine vial for inventory counting.

    The certificate will not disclose any personal health information. However, the World Health Organization still does not support the use of vaccine passports for travel because it is considered unfair to countries that cannot achieve mass vaccination.

  6. Data reporting and analysis. Large-scale vaccination programs are monitored by automatic reports for use by public health administrators. The Washington Community Health Plan uses data aggregated from multiple sources (such as claims, EHRs, laboratories, and social determinants of health) to stratify the risks of its members, and uses this information to plan the scope of its vaccination and distribution priorities .

Uniformity and terminology standard of HL7 vaccination

There is no record keeping institution that stores the history of vaccination records. The best place to find adult immunization history is in the child’s health record (if any), or to obtain information from parents and caregivers (if they recollect detailed information).

In the post-COVID world, if medical care data standards are used, vaccination records in a separate system can be transferred to the EMR system. In HL7 2.x, VXU messages are used to record immunization history, communicate follow-up doses, record observation results, and generate reports about individuals and groups of people.

Using immunization resources, the same goal can be achieved in HL7 FHIR to record the current and historical use of vaccines. HL7 and FHIR are used to transfer vaccination information from one system to another. Through large-scale vaccination programs, vaccines can be captured in the immunization information system or state registry. They can be shared electronically with the EMR system using standard HL7 2.x or FHIR messages.

The USCDI data standard complies with interoperability and patient access to the final ruling, and requires the use of HL7 CVX standard code set Record the administered vaccines and API standards for exchanging patient electronic health information.

Currently, four CVX codes used for the COVID-19 vaccine are listed. These are the four universal variants for the currently available vaccines. NDC codes are used to capture specific drug variants.

Immune Digital Platform

Many technology companies have recently launched their platforms specifically for the vaccination workflow. Microsoft, Salesforce, Accenture and Infosys have developed a vaccine management platform for end-to-end management of the vaccination process.

The centralized vaccine management platform aims to provide real-time access to vaccine management data, check eligibility, allow scheduling and support of outreach activities, public reporting and decision-making.

Healthcare providers, vaccinators and public health organizations are the main users of these platforms. Whether these platforms reduce the management burden or add extra workload to the field platforms can only be known after several months of use.

If improperly implemented, the technology surrounding the vaccination workflow (especially in the current situation where large numbers of people must be vaccinated) may act as a deterrent. The following steps must be taken to ensure that technology is the enabler of this immune drive:

  • Create a simple, intuitive interface, suitable for all age groups and demographics. For example, older people always face technical challenges, such as arranging online appointments. In this case, it helps to set up an IVR call center using a man-machine interface with multiple languages.

  • Consider all work processes and map the touch points of all stakeholders (including vaccinators, users, and public health officials) to actual interactions. For example, sending an automatic confirmation message for each planned vaccine appointment, including the appointment booked through the IVR call center in the above example.

  • Supports easy integration into EMR, so that immunization records are more enriched with patient data. The QR code in the vaccination information statement can be scanned into EMR, vaccination information system or other electronic devices.

There may be some failures in the initial stage, but they must be resolved as soon as possible to maintain the learning progress. In such a huge global vaccine drive, technology should not become an obstacle. Technology is not about choice, but about getting people vaccinated as soon as possible.

Dr. Joyoti Goswami is the principal consultant of Damo Consulting.

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