Government agencies have held vaccinations since the days of paper, pens and file. Countries around the globe have successfully implemented large-scale immunization programs.
In countries like India, with the second most populous population, a vaccination campaign to eliminate polio has been carried out in specific centers and conducted in-house. India was officially declared polio free in March 2014. All without technology!
The routine vaccination is always done by appointment or visit. Immunization of populations with polio, smallpox or similar diseases has always been part of a government’s multi-year plan.
However, COVID-19 vaccinations are planned to coordinate with public health officials to prioritize management by age group, to identify vulnerable spots among population groups, and supply-demand gap, track vaccinated groups, and more.
Managing large-scale immunization programs in any country is an extraordinary task in which technology can streamline these processes. Governments around the world have been equipping their IT systems in the background to support the vaccine delivery process. The right technology applications can turn the COVID-19 vaccination program into a game changer for the healthcare industry.
IT supports the COVID-19 vaccination programs
Health information technology can only be a helper in immunizations. To effectively digitize the vaccination process, it is important to map all workflows and the stakeholders of the vaccination platform or application being used.
Key stakeholders in the vaccination program include patients, physicians, immunization administrators and public oversight agencies, who monitor vaccine use and effectiveness, especially in an outbreak.
Some of the interventions for which technology could be a driver of vaccine administration include:
Keep track of vaccines. Cold chain maintenance for vaccines is an important practice, especially when vaccines are transported over long distances and need to be stored under specified conditions. Tracking technologies include sensors to monitor the temperature of the jars and a control panel for monitoring the logistics of the supply chain across various distribution channels.
Find a vaccine supplier. Vaccine finder is a simple web portal for conveniently locating suitable suppliers in the vicinity. For COVID-19, the CDC currently administers this portal and lists vaccine centers and suppliers nationwide.
Check for eligibility. Most countries use a comparative approach to vaccine administration, with those more vulnerable to receiving doses earlier. A simple checklist or portal questionnaire can help people learn about their eligibility based on public health service guidelines. The CDC has made eligibility-based recommendations Immunization Practice Advisory Committee, an independent panel of health and public health professionals.
Schedule a vaccination. This works like any other scheduling protocol, such as scheduling an appointment, and can help avoid overload at immunization centers.
Communication. There is some vaccine hesitation globally, and every government is making significant efforts to alleviate public fears through social media campaigns, chatbots, phone helper numbers, and so on. different things. Educational programs, both for health workers and the general public, are underway. Certification of vaccinations and notification of adverse events to the center are also part of the communication program. Notifying an individual’s vaccination status with a digital report is an important part of the COVID vaccination series. Some countries are arguing about using digital health certificates with inoculation QR codes to allow admission into their countries. Inoculation certificates based on QR codes can be stored on cell phones and allow public health agencies to track dispensers of vaccines, validate vials of vaccines and from there on inventory. The certificate does not disclose any personal health information. However, the World Health Organization has yet to advocate for the use of the vaccine passport for travel, as it is unfair to countries that cannot be mass vaccinated.
Reporting and data analysis. Large-scale immunization programs are monitored by automated reports to public health regulators. Washington’s Public Health Program uses data compiled from a variety of sources such as claims, EHRs, laboratories, and health determinants to stratify risks for their members. and use the information to plan their vaccine access and distribution preferences.
HL7 Integration Standards and Terminology for Immunization
No record-keeping agency maintains immunization record history. The best place to find adult immunization history is in the childhood health record, if available, or to get information from parents and caregivers if they recall the details.
In the post-COVID world, immunization records in stand-alone systems can be transferred to the EMR system if healthcare data standards are used. In HL7 2.x, a VXU message is used to record immunization history, communicate subsequent doses, record observations, and generate reports on synthetic individuals and populations.
Similar goals can be achieved in the HL7 FHIR, with the Immunization resource, to record current and historical vaccine use. HL7 and FHIR are used to pass immunization information from one system to another. With large-scale immunization programs, immunizations can be documented in the Immunization Information system or state registry. They can be shared with the EMR system electronically using standard HL7 2.x or FHIR messages.
USCDI data standards consistent with final judgment regarding patient interoperability and access and requirements for use of HL7 CVX’s standard code set to document administered vaccines and API standards for the exchange of patient electronic health information.
There are currently four CVX codes listed for COVID-19 vaccine. These are the four generic variants of the vaccine available. NDC codes are used to capture specific pharmaceutical variants.
The foundation for immunization digitization
Many technology companies recently rolled out their platforms dedicated to the process of delivering vaccines. Microsoft, Salesforce, Accenture, and Infosys have developed a vaccine management platform for end-to-end management of vaccination processes.
Centralized vaccine management platform designed to provide real-time access to vaccine management data, check eligibility, enable scheduling, support outreach campaigns, and public reporting and decision-making.
Healthcare providers, vaccine recipients, and public health organizations are the main users of these platforms. Whether these platforms are reducing the administrative burden or adding a layer of work to people on the ground will probably only be known after a few months of use.
Technology revolves around the vaccination process, especially in today’s context when large numbers of the population are vaccinated, which can be a hindrance if not done properly. The following steps must be taken to ensure technology is the backbone of this vaccination:
Create a simple, intuitive interface that can be used across all age groups and demographics. For example, seniors face technological challenges such as scheduling online appointments. Setting up an IVR call center with human interfaces in multiple languages can be helpful in such cases.
Review all work processes and map the touchpoints of all stakeholders, including vaccinators, users and public health officials, to real-world interactions. For example, automatic confirmation of every scheduled vaccination appointment, including one booked through the IVR call center in the example above.
Support should be easily integrated into EMR to allow the enrichment of patient data with vaccination profiles. The QR code in the vaccination manifest allows scanning of codes into EMRs, immunization information systems or other electronic devices.
Some glitches may be in the early stages but resolve them quickly to keep up with the learning path. Technology should not be an obstacle in such a large global vaccination site. Technology is not an option, but rather the aid of getting populations vaccinated as quickly as possible.
Dr. Joyoti Goswami is a Lead Consultant at Damo Consulting.