Improving the pace of vaccine distribution through technology
The COVID-19 pandemic has negatively impacted our health, economy, and psychosocial well-being. Public health mitigation measures such as wearing masks, social distancing, avoiding large gatherings, and washing hands have demonstrated benefit in curbing the spread of infection, but have been implemented inconsistently and unevenly throughout the world, which has limited their effectiveness. Unfortunately, as we start a new year, we have seen the same daunting challenges that marked the end of last year, with the virus continuing to spread, hospitals in many places are becoming overwhelmed. Fortunately, the new year ushers in the arrival of recently approved vaccines, providing hope of light at the end of the tunnel. This hope, however, comes with a new challenge—accelerating the secure, safe, and equitable distribution of vaccines that can immunize the community and help restore a sense of normalcy in our lives.
The steps may be daunting, but vaccinations provide the safest and most effective path forward. The goal needs to be to vaccinate as many persons as possible, starting with the highest risk populations, and as quickly as possible. Technology plays an essential role in accelerating the distribution of the vaccine and evaluating, using global real-world data, how long the immunity lasts after vaccination to assess reinfection risks and determine if and when revaccination is necessary. It can also help facilitate cross-agency collaboration, enable remote work, improve data insights, and deliver trusted services without interruption.
The Microsoft Vaccination Management platform includes a growing collection of vaccination specific solutions from Microsoft and our partner ecosystem. They are designed to enable and extend an organization’s vaccination management capabilities and create end-to-end experiences for citizens, front-line vaccine administrators, and healthcare providers. Those offers can enable registration and prioritized scheduling of appointments, optimize material management by streamlining automatic replenishment of supplies, track-and-trace monitoring of prescriptions and medical supply deliveries, and streamline reporting to help public health systems stay focused on getting the vaccines, resources, and services where and when they’re needed. Using data and artificial intelligence (AI) solutions can provide actionable insights that enable public health and government officials to make informed policy decisions, improve vaccination education, and help avoid supply disruption. Most recently, The National Covid Vaccination Registration Platform for the 45 million eligible citizens in the U.K. is built via an Azure web form and hosted on Azure. As part of the overall service, System C, hosted and managed the National Immunisation Management System (NIMS) on Azure, also integrating with Primary Care and National Health Systems (NHS) nationally, using Power BI for reporting.
Embracing the power of digital, along with the power of human innovation and strategic partnerships, can help support the continuity and stability of public health and safety in every country as we work to stop the pandemic and prepare for any future public health risks.
Vaccination campaign management
The promising news is that COVID-19 vaccinations have started. Many of the cold-chain logistical issues of delivering the vaccine to hospitals and clinics have been addressed. One example of this kind of problem-solving is FedEx and Microsoft’s collaboration on FedEx Surround, a platform that uses data to manage and track inventory in real-time originally built for businesses, now being used to help support vaccine distribution.
However, as public health and healthcare organizations plan ahead, we should expect a new set of challenges. One of those is how to educate, inform, and encourage vaccinations for the broader population, several of whom may be unaware, unsure, or unconvinced about the safety and merits of the vaccine. Just as we have seen with prior vaccination campaigns, the active involvement of respected healthcare providers and community leaders will be central to the success of this effort. Technology can amplify these messages and also help deliver individualized recommendations.
As states and local communities begin to vaccinate their populations, keeping the public informed about the status of the vaccine distribution will be important for maintaining trust. Public organizations are launching public-facing dashboards that track available doses, the number of residents vaccinated, both first and second doses, among other key data points. The state of Minnesota, for example, is leveraging Microsoft Power BI in its comprehensive public vaccine data dashboard.
Early in the pandemic, we observed how AI-based chatbot technology could deliver personalized responses for individuals seeking answers to their questions about COVID-19. Individuals who screened at-risk based on their responses were then directed to a telehealth visit and/or to receive a COVID-19 test. This enabled streamlined screening and triage for large populations, which increased the availability of healthcare professionals and other resources to focus on the delivery of care. Azure Health Bot recently released new capabilities and templates for vaccinations to enable checking eligibility for COVID-19 vaccines and providing answers to related questions. Trinity Health, one of the largest healthcare systems in the nation, caring for more than 30 million people across 22 states, has effectively utilized AI chatbots to make it easier for patients to quickly connect to the care they need. From answering questions to routing patients to the appropriate avenue of care or service, the technology provided an improved experience.
As health organizations and public health services explore how to answer specific questions and provide individualized recommendations about the COVID-19 vaccine to large diverse populations, AI chatbot technology may again serve as a powerful tool. It can be used to help answer questions based on specific concerns that the person has and at the same time facilitate the registration for the vaccination.
Pre-registration and phased scheduling
Unlike the flu shot where individuals can simply request and receive one, the COVID-19 vaccine is in limited supply. COVID-19 vaccinations need to be prioritized. While several prioritization models have been proposed, such as the Fair Priority Model and recommendations from the Advisory Committee on Immunization Practices, adoption of these and other guidelines has been highly variable and subject to local interpretation.
However, one thing that remains constant is the need for all organizations to move quickly and not lose valuable time. Now is the time to embark on large scale campaigns to educate the public about the vaccine, address individual concerns, identify pockets of those who require targeted interventions, and most notably pre-register people for the vaccine. Individuals can be notified in an automated manner at a later time when they are eligible to schedule the vaccination. For example, the Oklahoma State Department of Health is partnering with Microsoft to develop a mobile app to help residents confirm vaccine eligibility and help schedule vaccination appointments.
Pre-registration is not a new concept. It involves registering individuals prior to them fulfilling eligibility criteria. The same principle can be applied to COVID-19 vaccinations. Currently, registration and scheduling of individuals for vaccinations occur at the same time. By separating these two processes and enabling pre-registration to take place in advance of scheduling analytics and AI can then be applied to the pre-registration results to help predict which populations require further attention, where they are located, and the types of outreach most likely to increase vaccine registration rates in those communities.
Throughput efficiency
To increase the vaccination rates, we also need to consider how many individuals can be vaccinated per clinic per day. This is influenced by several factors, including the number of vaccines available in the clinic, vaccine storage capabilities, the number of staff available for patient intake and vaccine administration, access to personal protective equipment, and the size and configuration of the clinic. Each of these factors needs to be tracked and managed. Moreover, given that we are in the midst of a pandemic, we need to ensure that patient lines are short and socially distant, and rooms are uncrowded. To do this, scheduling and throughput need to be highly efficient. Scheduling blocks, automated reminders with appointment confirmations, rescheduling options when necessary, standby lists in case of no-shows and cancellations, and reporting of wait times are helpful approaches that can be enabled through technology. Cities like El Paso, TX have leveraged Microsoft’s Vaccine Registration and Administration Solution capabilities to support this effort establishing a public site for residents to register for a COVID-19 vaccine and schedule appointments and to enable effective management of vaccine dosages, vaccination phases, and other key logistical tasks.
As COVID-19 vaccinations are extended to the broader population beyond healthcare providers and nursing home residents, health organizations need an efficient and reliable process to verify age, occupation, and presence of high-risk conditions. Verification of vaccine eligibility presents a major bottleneck in the vaccination process unless it is performed in advance of the visit. Pre-verification can be performed through automated or semi-automated matching of credentials using established databases. Secure, authorized access to these databases will need to be established in advance. Partnerships with health insurers and public health agencies, who have access to these types of data sets for large populations, may help facilitate auto-verification.
Vaccination sites
Increasing the physical size, total number, and accessibility of the venues where consumers can receive COVID-19 vaccines is essential. Large-scale vaccinations require large-scale venues such as stadiums and conference centers. Ideally, these sites should be operating around the clock, 24 hours per day, 7 days per week. However, staffing these sites with trained individuals and setting up processes and infrastructure to deliver COVID-19 vaccines efficiently will be a challenge.
Today, public health departments, hospitals, pharmacies, and grocery chains are authorized to administer the vaccine. Now is the time to expand this to medium and smaller-sized provider sites. These may include physician practices, dentist offices, urgent care centers, and other allied healthcare provider practices. Organizations should consider setting up mobile clinics and mobile units, which can be stationed at community centers, churches, schools, and other local sites, to bring the vaccine to neighborhoods where the most vulnerable and highest risk individuals reside. Expanding vaccination capabilities to large, medium, and smaller-sized venues will require technology infrastructure that enables efficient delivery of the vaccine, timely reporting of vaccinations and adverse events, and effective management of the process.
Vaccine credentials
Going beyond the vaccination process, some individuals may want to have a convenient electronic verification such as a QR code that they received the vaccine, instead of carrying, and potentially misplacing, the paper records usually received with vaccinations. Any such electronic verification must preserve patient privacy and be universally accepted to be successful. To achieve this, any electronic health card should be built on international open standards (e.g., HL7 FHIR) with a decentralized infrastructure (see SMART Health Cards Framework). Already, there are a number of efforts aligning to bring broad-scale consensus around such an approach.
One such effort is the recently announced Vaccine Credential Initiative (VCI), which is a coalition of public and private partners committed to empowering individuals with digital access to their vaccination records based on interoperable, privacy-preserving standards. Such a credential, based on the open industry standards of a distributed digital identity requires a secure, scalable foundation for vetting identity. Microsoft is helping organizations and governments around the world create a citizen decentralized-digital identity hub, which can be used not only for the pre-registration process but can form a component of the future digital identity wallet, while still giving citizens control over data access, and preserving privacy.
Now there is a need to continue to re-evaluate the current processes for distributing and administering the vaccine. By exploring innovative approaches and leveraging technology health organizations can impact the timelines for delivering vaccines securely, equitably, and with speed which will ultimately save lives and help end the pandemic. Microsoft and its partners are committed to doing our part to help the global community deliver vaccinations in a safe, efficient, and prioritized manner.
We want to help enable your COVID-19 recovery through platform tools that support your vaccination management and administration. Contact your Microsoft representative or email [email protected] to learn more.
