Among many other things, Covid-19 has illustrated just how fragmented the U.S. healthcare system is and the lack of meaningful health information exchange capabilities at-scale between and among different stakeholders. The pandemic has also exposed the egregious lack of investment in the country’s public health infrastructure to date, the challenge of private and public institutions having to innovate at breakneck speeds, and the way in which technology platforms are bridging the gap.
While not all fragmentation in healthcare is ‘bad’ — more independent physicians practices are a good thing when it comes to improving healthcare access and bringing down costs, for example — healthcare’s disparate, siloed nature is incredibly problematic when trying to coordinate activities, information and logistics related to Covid-19. These efforts include vaccine appointment scheduling, public health reporting, standards development and compliance, and helping providers reach and better engage vulnerable and at-risk populations.
Platforms playing an important role in the Covid-19 vaccination effort
At the early stages of the pandemic, the focus was largely on Covid-19 testing eligibility, scheduling, and results delivery. Today, with vaccination efforts well underway, the focus has shifted to implementing solutions and standing up networks that make important connections between healthcare agencies and other sources that need Covid-related information, goods or services, and those with the technology to supply it.
Because platforms are uniquely suited to address critical issues in healthcare — like better matching supply and demand, increasing information sharing and access, better facilitating and reducing the costs of transactions, and unlocking innovation at scale — it’s no surprise that the public and private sectors continue to leverage platforms in the country’s Covid-19 vaccination efforts.
Here are a four ways in which healthcare organizations have been — or should be — utilizing platforms to solve some of healthcare’s most pressing vaccination-related challenges.
1) Platforms Are Central To Vaccination Outreach, Education and Communication
Nearly half the country has now received a Covid-19 vaccination shot, with 46% of U.S. residents having received at least one shot and 34% being fully vaccinated (data as of May 9). President Biden’s goal is to have 70% of the nation’s adults vaccinated with at least one dose by Independence Day, where the latest Centers for Disease control data shows that figure at 58%, as of this writing.
Central to reaching these vaccination goals? Effective, targeted patient communication and engagement strategies. As Jennifer Kates, senior vice president at the Kaiser Family Foundation (KFF), noted to MSNBC, “We feel like we’re getting to the point where the people that are left are very hard to reach and need assistance and more education, or those that are resistant and don’t want it.”
“For healthcare systems to achieve a true digital transformation, they must consider solving for patient communications on a platform-level,” said Guillaume de Zwirek, CEO of patient engagement and communication platform WELLTM Health. “Just like what the EHR/EMR did for healthcare patient records data, we think a platform-level solution for patient communication is required to act as the connective tissue between all communication touch points across the entire patient journey,” he said, which seems to be working, well, WELL.
The company reports that more than 150 health systems are using WELL Health to manage communications and scheduling for Covid-19 vaccinations, including industry giants like Cedars-Sinai in Los Angeles and Houston Methodist in Texas. Since the Covid vaccine became available in the United States, health systems using WELL Health facilitated more than 6 million vaccine appointments1 and sent more than 30 million Covid-related messages through the digital health platform.
“For vaccine distribution, providers needed a way to communicate with millions of people at many different moments including informing of eligibility, answering questions, scheduling appointments, tracking adverse events and more,” said de Zwirek. “This digital agility has been incredibly important during COVID, as vaccine availability has shifted frequently. Providers could engage their patients in real-time about new/open vaccine appointments to avoid losing supply.”
This kind of agility and ability to quickly scale is another reason why platforms are increasingly being relied on for healthcare delivery, especially during a public health pandemic.
At Blue Shield of California, which is working with the State of California on its vaccination program, the company leveraged its partner analytics platform, Cogitativo, to help with vaccination-related outreach to members. Using the platform’s database to sift through available member data and employer codes, Blue Shield of California was able to send emails and push notifications through its member portal. This alerted members who might be eligible for the vaccine according to the tiering system that the state government implemented.
And their efforts worked. “While communication was sent out via direct mail and email, the open rates for high-risk members were the highest engagement among all member communications in the past year,” said Jamie Chan, vice president for clinical quality at Blue Shield of California.
Beyond using demographics, claims history, and engagement data from its general membership, Blue Shield of California also used claims data to build a comprehensive profile of an individual’s clinical risk, COVID exposure, and risk of adverse outcomes. Additionally, “Member engagement data has been used to assess our communication plans and to identify the optimal modalities to reach our diverse populations,” said Chan.
The organization also applied an added layer of employer codes to help identify frontline workers, and supplemented internal data with community-level census data and social determinants of health (SDoH) data. As Chan noted, “This has allowed us to further extend the depth of our member profile and measure disparities in access, outcomes, and along multiple dimensions including race/ethnicity, income, transportation barriers and social support.”
Taking into account SDoH is critical, given there have been higher rates of illness and death from Covid-19 among people of color, which a recent KFF Brief describes as a reflection of “increased risk of exposure to the virus due to living, working, and transportation situations, increased risk of experiencing serious illness if infected due to underlying health conditions, and increased barriers to testing and treatment due to existing disparities in access to health care.”
While data and analytics platforms can enable better population targeting, there are also the generational gaps in terms of communication and engagement channel preferences, which are leaving some young people feeling ill-informed and not accounted for. As detailed recently by STAT News, Generation Z-ers around the country may not be opposed to Covid-19 vaccinations, but they’re not finding information that’s relevant to them. What’s more is a recent STAT-Harris Poll found that 21% of Gen Z (young adults aged 18-24, as defined in the survey) said they will not get vaccinated against Covid-19; another 34% said they would take a “wait awhile and see” approach.
To address their hesitancy and help young consumers make informed decisions, tailored to them, healthcare organizations and agencies at the local, state and federal levels must have targeted education and communication strategies in place. These strategies must take into account how different generations — Gen Z and millennials specifically — engage with technology platforms and social media channels, and include creating content that’s best suited to their consumption and syndication preferences.
2) Platforms Can Help Pediatricians In Vaccine Distribution Efforts
The Kaiser Family Foundation recently dug into American Community Survey data from 2019 in an effort to better inform the organization’s process of vaccinating the adolescent population. KFF found that there are almost 17 million adolescents (ages 12-15) in the United States, accounting for 5.3% of the U.S. population and 26.6% of the U.S. population under the age of 16. KFF also found that nearly half of adolescents ages 12 to 15 are people of color, including one in four who are Hispanic, 13.4% who are Black, and 4.8% who are Asian.
With the Federal Drug Administration (FDA) recently authorizing use of Pfizer’s Covid-19 vaccination, kids ages 12 to 15 years old now qualify for the Covid vaccination, with at least 15,000 pharmacies nationwide — and even some high school campuses — set to offer doses.
This doesn’t automatically mean parents will be rushing out to get their children vaccinated, however. While a new study shows that roughly 30% of parents plan to get children vaccinated as soon as possible, more than 25% say they will not. These figures warrant attention, given recently released data from the American Academy of Pediatrics showing that children now make up 22% of Covid-19 infections in the country.
Independent pediatricians may be well positioned to help communicate and influence parents and children.
“We should seek to use pediatricians as vaccine administrators for young populations. They are trusted members of the community, they are experts in children’s health and can answer questions, and they tend to practice in convenient locations for their patients,” says Pedro Sanchez de Lozada, CEO of digital health startup Canid, a platform company seeking to simplify vaccine management for pediatric practices.
Canid seeks to help elevate the role of independent pediatricians in the Covid-19 vaccination effort in two ways: first, by helping with operational and administrative complexities; and second, by helping state agencies understand how they can efficiently work with pediatric practices on the vaccine distribution effort.
On the first point, Canid has identified that vaccine supply chain management was not part of most pediatrician’s medical training. “Dealing with the vaccine supply chain is complex for pediatricians,” said Sanchez de Lozada, who explained that they deal with a multitude of products with different specifications of care and strict inventory management rules to keep government-provided inventory separate from inventory intended for children covered by commercial insurance. Billing and reimbursement adds further complexity. Canid seeks to automate as many elements as possible, to allow pediatricians to focus more time on administering vaccines and less time on backend paperwork.
On the second point, Sanchez de Lozada noted that pediatrician independence unfortunately makes it challenging for states to think about working with them about vaccination efforts. “It’s difficult for a state to think about communicating and coordinating distribution with hundreds or thousands of smaller practices,” said Sanchez de Lozada. Canid “is trying to help by serving as an aggregation point, providing scalable technology and services to help smaller practices be a part of the solution.”
3) Platforms Help Scale Covid-19 Public Health Reporting And Compliance For Thousands Of Providers
As the world slowly begins to open up, state and federal health departments are increasingly relying on technology platforms to help with public reporting needs. One company that is focused on simplifying public reporting efforts is Redox, a digital health platform that provides a single source through which healthcare providers, labs and diagnostic testing companies can submit lab results electronically to each state health department.
“Our customers use a single integration point with Redox and our nationwide network of State and Public Health Departments to implement Electronic Lab Reporting integrations in 14 days or less, allowing them to focus on their core offering – resulting Covid-19 tests and/or administering vaccinations,” said Andy Pung of Redox. Making test results and vaccination administration data available in real-time, he said, “is critical to the public health decisions being considered and made on a daily and weekly basis. We saw our platform as a way to play our part in the national response to the pandemic.” Redox uses Electronic Lab Reporting, or ELR, which allows companies to automatically send results and avoid manual reporting processes, such as faxing, online lab portals, secure emails, and spreadsheets.
The ability to connect so many disparate technology systems is no small feat, with no small purpose; it’s also the role that platform companies are increasingly being called on to play, as Pung says was the case with Redox. “Our customers and the market came to us with the need. We had existing laboratory/diagnostic testing customers and new clients who developed Covid-19 tests who needed to report results to all 50 states per CDC requirements. It started with just Covid-19 tests but has grown to reporting vaccination administrations as well.”
Because the CDC standards are very fluid, the structure and format of the data elements Redox sends on behalf of its clients requires frequent updating within the company’s technology configurations — which in the absence of a connected platform, would be a time-intensive, resource-draining process. “The volume of Covid-19 tests and laboratories reporting test results has created unprecedented demand on the Health Departments’ infrastructure and IT staffing,” said Pung, “which has exposed some infrastructure challenges as well as staff capacity issues to build and maintain an increasing number of ELR integrations.”
4) Platforms Help Consumer And Public Health Needs, While Protecting Privacy
With travel restrictions still in place but travel ramping up, consumers will continue to be called on to present proof of their Covid-19 test results and vaccination status; The Commons Project and its CommonTrust Network was designed to help consumers do just that.
The Commons Project is an independent non-profit organization that develops digital solutions for public good. Its most recent efforts are designed to give individuals access to their Covid-19 testing and vaccination data, while also letting them control who has access to their data and when. At the heart of the Commons Project is the CommonTrust Network, a group of public and private partners that have come together to facilitate consumer health data access.The network aims to make it easier for consumers to return to travel, work, school and life, while also protecting their data privacy.
“The CommonTrust Network is fundamentally a registry of data sources, testing providers, vaccination providers and public health registries that want to use open, interoperable standards to give either test results or vaccination records to patients, clients, and citizens,” said Paul Meyer, CEO of the Commons Project. Through the network’s digital app, CommonPass, individuals can digitally access their lab results and vaccination records, and surface their Covid-19 health status at a country’s point of entry without revealing any other underlying personal health information.
Not surprisingly, trust is what has helped drive network usage and scalability to date. “What we’ve eventually realized, and what led to the CommonTrust Network, is that this ultimately is all about trust,” said Meyer, who added that “the main problem with many other health apps is that they fundamentally don’t work, unless they’re built on a trust network.” The trust network is becoming more critical because of issues around fake vaccine passports.
Meyer describes CommonTrust as “a network of public organizations, committed to empowering people using the public standards.”
Standards development and compliance may be “easier” in other countries with national health systems and databases, notes Meyer, but in the U.S., “we have this very fragmented healthcare system. And to be able to kind of implement a standard means you have to develop a broad network of both healthcare institutions and their technology partners, in order to move at a lightning pace around the solution and the standard from the get-go.”
Meyer credits this agility as being key to bringing together platform organizations like Microsoft, Oracle and Salesforce, and electronic health records (EHR) vendors like Epic and Cerner, to converge around a given standard. “Usually, that takes a decade to get that amount and be able to corral that many.”
Pandemics And Platforms In The Future
Our healthcare system is highly fragmented, which has created significant challenges during the pandemic around coordination, information asymmetry, matching demand and supply, and information exchange.
Businesses that are building technology platforms that serve to bring different stakeholders together to transact in standardized ways can create tremendous value. In this pandemic, platforms have been used to:
- Make appointment scheduling more efficient by providing matching between consumer schedule and provider availability
- Help pediatricians manage their vaccine supply chain and ensure states understand how they can leverage the strength of independent practices for vaccine distribution to children
- Simplify required public health reporting for thousands of healthcare providers to hundreds of public health and state agencies
- Provide a trusted and privacy-preserving way for consumers to show Covid-19 status for travel purposes
While we are beginning to emerge from the long Covid-19 winter and have every reason for an optimistic future, experts also are warning against likely future pandemics. With more platforms in healthcare connecting disparate stakeholders for more purposes and facilitating information exchange in real-time, we should be better prepared.