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With the possibility of a COVID-19 vaccine becoming more real, challenges such as vaccination distribution tracking and data sharing are also coming into focus.
Just this week, drugmaker Moderna Inc. announced promising early results for a COVID-19 vaccine, demonstrating 94.5% efficacy. Pfizer Inc. and BioNTech SE also announced their vaccine candidate was found to be 95% effective -- and 94% effective for those over 65 -- in preventing the disease in patients.
While drugmakers race to develop and release a COVID-19 vaccine and federal regulators plan for wide-scale distribution, healthcare CIOs are preparing for a race of a different kind: ensuring the infrastructure is in place for capturing data and tracking the distribution of COVID-19 vaccinations.
Challenges such as vaccine storage and distribution are top of mind, but experts like Aaron Miri, CIO at UT Health Austin in Texas, said healthcare CIOs should make data their No. 1 focus. That means ensuring patient immunization records are in a usable format, that EHR systems can capture COVID-19 vaccination data, and that vaccination data such as who has been given a vaccine can be transmitted to regional public health authorities as well as the Centers for Disease Control and Prevention (CDC).
Miri suggested healthcare CIOs lean on the lessons they learned at the start of the pandemic, namely figuring out early how to capture and transmit COVID-19 testing data to public health authorities. The COVID-19 vaccine distribution process will likely present a similarly fast-paced situation -- yet with a set of data challenges all its own, he said.
Data availability will enable vaccine distribution
"The problem with vaccine tracking is that each state has its own level of what it requires for immunization records," Miri said. "Some require it by law to be in a paper format signed in black ink … some states allow a digital tracking mechanism. The regulations on the IT side have never been established or modernized in 20-plus years. So, CIOs are having to navigate all these things."
Miri said the first step CIOs should take is to locate patient immunization records and make sure they are in a format suitable for modern healthcare systems.
"If I have the data, is it in a manner that's going to be readable and ingestible to a modern electronic medical record, or do I need to take that data and modernize it?" Miri said. "AKA, is it in a PDF scanned somewhere from an old record and I have to now make it into a digital, usable copy? That's effort No. 1, locating and making the data usable."
A digital immunization record in the EHR will go a long way toward assisting COVID-19 vaccine distribution efforts, Miri said. With COVID-19 testing, clinicians across the nation had to adapt to a new order of things, as testing commonly occurred outside of the traditional hospital setting. The vaccine distribution process could take a similar approach. If CIOs can make vaccination data easily accessible to clinicians, they'll help make the distribution process more efficient and effective, according to Miri.
Indeed, Steve Wretling, chief technology and innovation officer at the Healthcare Information and Management Systems Society (HIMSS), said CIOs need to plan how they'll support technology access at alternate vaccination sites, as well as provide the healthcare organization with the tools they need to prioritize patients for vaccine distribution so as not to overwhelm distribution.
"Communication internally within the organization is going to be essential for focusing on priorities and tackling the initiatives that need to get done to support the vaccine distribution," Wretling said. "And on the patient front, communicating clearly to patients by proactively reaching out to them and letting them know what the plan is for distribution."
Getting EHRs ready for the vaccine
Wretling said CIOs will have to understand what data needs to be captured during the COVID-19 vaccine distribution process, not only for internal purposes but also to meet reporting requirements for regional public health entities as well as the CDC.
"That is paramount to get right to help facilitate the process," Wretling said.
Miri also stressed the importance of data capture and encouraged healthcare CIOs to sit down with clinical staff to understand what data clinicians will need and what systems clinicians will need access to if the vaccine distribution process happens away from the direct hospital campus. Then, CIOs will need to evaluate EHR vendor progress on how they're preparing their products for COVID-19 vaccination distribution and whether they have vaccination modules with the appropriate fields ready to go.
CIOs should also prep a contingency plan in case they need to move forward without support from EHR vendors, a lesson Miri learned from COVID-19 testing. Most EHR vendors were "slow to the draw" in the early days of COVID-19 when it came to creating modules for keeping track of patients who had been tested and test results, according to Miri. That prompted him to turn to startups like Sentinel Healthcare in Seattle for assistance with remote patient monitoring and contact tracing.
"We had to do that because I couldn't wait on my EHR vendor to act," Miri said. "I do give them credit because they did come through eventually and they've done some phenomenal work. But they're going to have to be quicker on the draw for this one because there is going to be even more pressure from the public once there is a cure."
Wretling said CIOs need to work with vendors to make adjustments within the EHR to distribute the COVID-19 vaccine, track who has received the vaccine, especially if more than one dose is required, and make sure follow-up reminders for patients are adhered to.
"If there is a two-part protocol for taking this vaccine -- if a patient shows up one day in a clinic at a health system and then three weeks later at a retail pharmacy -- how do you make sure this is now their second dose?" Wretling said. "There is going to have to be a lot of focus on being able to share and access data about patient vaccines and immunization records from a patient safety perspective but also to safeguard the supply, especially if the vaccine supply is limited."