How to improve health IT systems for immunization drives

Government agencies have organized vaccination campaigns since the days of paper, pens and files. Countries around the world have successfully administered vaccination programs on a large scale.

In countries like India, which has the second largest population, a polio vaccination campaign has been delivered in designated centers and moving from home. India was officially declared polio free in March 2014. All without technology!

Routine administration of vaccination has always been either by setting a specific date or by prior appointment. Immunizing populations against polio, smallpox, or similar diseases has long been part of governments’ multi-year plan.

However, COVID-19 vaccination campaigns are being planned in cooperation with public health officials to determine department priorities according to age groups, identify weaknesses between population groups, manage the supply and demand gap, track the vaccinated groups, and more.

Managing large-scale vaccination programs in any country is an extraordinary task as technology can simplify these processes. Around the world governments are working to equip their IT arm in the background to help with the vaccination delivery process. The right technology applications can turn the COVID-19 vaccination program into a game-changer for the healthcare sector.

Information technology helps with coronavirus vaccination programs

Health information technology can only be a catalyst in vaccination campaigns. To effectively digitize the immunization process, it is important to map all workflows and stakeholders of the vaccination platform or app used.

The primary stakeholders in the vaccination program include the patient, the doctor, the vaccination official, and the public monitoring authorities that track the administration and effectiveness of the vaccine, especially in the event of an outbreak.

Some points of intervention where technology can be an aid to administering the vaccine include:

1. Trace the vaccine. Maintaining the vaccine cold chain is an important activity, especially when vaccines are transported over long distances and require storage under specific conditions. Tracking technologies include sensors to monitor bottle temperature and dashboards to track supply chain logistics across various distribution channels.

2. Find vaccine providers. Vaccine finders are simple web portals for locating suitable vaccine providers in the vicinity. For COVID-19, the CDC currently manages this web portal and lists vaccination centers and providers across the country.

3. Check eligibility. Most countries use a stepwise approach to administering vaccines, with the most vulnerable people receiving the doses earlier. A simple checklist or questionnaire on the web portal can help people find out their eligibility based on public health services guidelines. The CDC makes recommendations on eligibility based on Immunization Practices Advisory CommitteeIt is an independent panel of medical experts and public health experts.

4. Schedule a vaccination. This works like any other scheduling protocol, like scheduling an appointment, and can help avoid overcrowding at vaccination centers.

5. Telecommunications. There is a certain amount of hesitation about vaccines around the world, and every government has gone to great lengths to assuage public fears through social media campaigns, chatbots, helpline numbers, and other means. Education programs, for both health care workers and the public, are rolling out. Certificates of vaccination and transfer of adverse events to the center are also part of the outreach program.

   Reporting an individual’s vaccination status with a digital report is an important part of the Coronavirus vaccination campaign. Many countries are discussing using digital health certificates with QR codes for immunization to allow entry into their countries. QR code-based vaccination certificates can be saved on cell phones and allow public health authorities to track vaccine drives and validate vaccine vials, and thus inventories.

   The certificate does not disclose any personal health information. However, the World Health Organization does not support the use of vaccine passports for travel yet, given that it is considered unfair to countries unable to achieve mass vaccinations.

6. Reports and data analyzes. Large-scale vaccination programs are monitored through automated reports of public health administrators. The Washington Community Health Plan uses data gathered from multiple sources such as claims, electronic health records, laboratories, and social determinants of health to classify risks for its members and use the information to plan vaccination education and distribution priorities.

HL7 terminology and integration criteria for vaccinations

There is no record-keeping agency that stores the history of vaccination records. The best place to look for adult immunization history is in the Children’s Health Records, if available, or to get information from parents and caregivers if they remember the details.

In a post-COVID world, vaccination records in autonomous systems can be transferred to EMR systems if healthcare data standards are used. In HL7 2.x, the VXU message is used to record immunization history, report subsequent doses, record observations, and generate reports on individuals and grouped subpopulations.

The same goals can be achieved in HL7 FHIR, with the immunization resource, to record current and historical administration of vaccines. HL7 and FHIR are used to transfer grafting information from one system to another. With large-scale vaccination programs, vaccines can be captured in immunization information systems or state records. Can be shared with EMR systems electronically using standard HL7 2.x or FHIR messages.

USCDI data standards comply with interoperability and ultimate judgment of patient access and require the use of HL7 CVX standard code set For registering managed vaccines and API standards for sharing patient electronic health information.

There are currently four CVX codes listed for COVID-19 vaccines. These are of the four generic types of vaccines currently available. NDC codes are used to capture specific pharmaceutical variants.

Immunization digitization platforms

Several tech companies have recently launched their platforms exclusively for streaming vaccinations. Microsoft, Salesforce, Accenture, and Infosys have developed a vaccine management platform for the overall management of immunization operations.

The centralized vaccine management platform is designed to provide real-time access to vaccine management data, validate eligibility, allow for scheduling and support awareness campaigns, and public reporting and decision-making.

Healthcare providers, vaccine recipients, and public health organizations are the primary users of these platforms. Whether these platforms lighten the burden of management or add an extra layer of work to those on the ground, they will likely only be recognized after a few months of use.

The technology around the workflow of vaccination, especially in the current scenario, where a large population must be vaccinated, may be a deterrent if not properly implemented. The following steps must be taken to ensure that technology is an enabler for this vaccination campaign:

• Create simple, easy-to-use interfaces that can be used across all age groups and demographics. For example, older adults always face technical challenges such as making appointments online. Establishing an IVR call center with a human interface in multiple languages ​​can help in such cases.

• Consider all workflows and a map of contact points for all stakeholders, including vaccinators, users, and public health officials, for the actual interaction. For example, send automated confirmation letters for each scheduled vaccine appointment, including the appointment booked through an IVR call center in the example above.

• Support for ease of integration into the electronic medical record to allow patient data to be enriched with vaccination records. QR codes in the vaccination information data allow the code to be scanned into electronic medical record records, immunization information systems, or other electronic devices.

There may be some gaps in the initial stages, but you need to address them quickly to maintain the learning curve. Technology shouldn’t be a hindrance in such a large global vaccine campaign. Technology is not about selection, but rather empowerment, to vaccinate the population as quickly as possible.

Dr. Joyote Goswami is a Principal Consultant at Damo Consulting.