By Kris Joshi, Ph.D.,
EVP & President, Change Healthcare Network Solutions
Ramesh Raskar, PhD
Founder PathCheck Foundation
Kasia Jakimowicz, MPA
Innovation in Government Fellow, Ash Centre for Democratic Governance and Innovation
As availability of vaccines is set to grow quickly in coming months, our public health infrastructure to administer them has emerged as a bottleneck. That is partly because most healthcare IT systems in place today were designed to collect data for billing, insurance and logistics, rather than to engage directly with millions of consumers. Much can be learnt from the way rideshare companies like Uber and Lyft engage with consumers, improve from constant consumer feedback, and efficiently match supply with demand.
Vaccine distribution and administration is a consumer logistics challenge. It need not be burdened by the complexities of a typical medical appointment with a busy physician. The healthcare data requirements for vaccination are actually quite minimal, and do not require a full medical record. Instead, community engagement, local logistics and communication should be the focus. This is where effective consumer technology, characterized by a relentless focus on simplicity and consumer experience, can make a difference.
In ridesharing, registration is separated from scheduling and delivery, reducing the scramble for information during the ride and improving the experience. A similar approach can help vaccine registration occur separately from scheduling, allowing demand to be measured by site and geography, which can then inform distribution of vaccine supplies. For vaccination related community outreach, digital and paper based processes using vouchers and coupons can be deployed seamlessly with digital technology, just as airlines allow both printed and digital boarding passes. For hard-toreach populations, a ‘paper-first’ approach with sophisticated tamper-proof features can provide a convenient interface to digital solutions. For instance, PathCheck Foundation is developing a paper-based Encrypted COVID-19 Vaccination Card to provide vaccination journey credentials to individuals, tech-savvy or not.
In 1947, New York managed to vaccinate six million people for smallpox in less than a month as there was no need for complex pre-registration and postvaccination tracking. Today, we do need to collect more data for each consumer, but that can be done in a way that does not slow down the overall process. If the initial registration information is kept to a minimum, more detailed information along with consumer feedback, can be captured during the post-vaccination observation period.
For those who prefer electronic registration, it can be done easily on a mobile phone. Those who cannot, can do so over the phone, still following the same process for registration followed by scheduling. As vaccine supplies become more available, those registered can be quickly notified, even for sameday appointments. Sites can invite the appropriate number of preregistered people to sign up for appointments within rough time windows of one or two hours. Just as riders are notified when their rideshare is arriving, consumers waiting can be notified when it is their turn, so they can head inside. Until then, they can text to confirm their arrival at the site but wait in their cars or in a waiting area until called. This can ease the burden of long lines and cold weather and also accommodate last-minute cancellations.
Post-vaccination follow-up includes the need to verify vaccination status, scheduling for the second shot (if required), and ensuring the second shot matches the first shot in situations where it is administered at a different site. Like the automatic payment and receipt at the end of a ride share, it should not require any effort on part of the consumer or the vaccination site - it should be automatic. This can be accomplished with a “vaccine passport” that includes a lightweight verifiable credential. It looks like an airline boarding pass which can be printed if needed and is easily verified via a unique QR code, providing proof of vaccination when necessary. A consortium of non-profit organizations and healthcare technology companies have created an open standard to ensure vaccine passports issued by different entities are consistent and interoperable. An example that uses simple text messaging has been developed by Change Healthcare. A lightweight, secure, and easily shareable vaccination credential can build trust through transparency. It is also safer in the event of a data breach as it does not contain the entire medical record.
What was state-of-the-art when rideshare services launched years ago is now widely available in the consumer world. It should be in healthcare as well. Starting with vaccination, perhaps all healthcare visits can become easier to manage.