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Vaccinating the entire U.S population: Health information technologies are positioned to help

Betty Rabinowitz, MD
Conditions
December 13, 2020
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The mammoth task of vaccinating most of the world’s human population against COVID-19 is before us. Several viable, highly effective vaccines have been developed at record speed. The pharmaceutical industry will now be called upon to meet the next challenge of producing the vaccine at scale by manufacturing the billions of required doses. A distribution and logistics challenge follows: how to equitably coordinate and execute the widespread distribution and administration of these vaccines, some of which require extremely cold temperatures to maintain viability. Scientists, logistics experts, ethicists, clinicians, epidemiologists, government agencies, private sector, and the public will have to collaborate for this vaccination effort to be successful. Many new technologies and new modalities have already been invented in the process of solving this urgent need, and many more innovations will be coming in the months ahead as this colossal project is undertaken.

Health information technology (HIT) has a role to play in the success of this endeavor. Multiple vaccine-related tasks will be facilitated with the assistance of evolved HIT systems.

Identifying who needs to be vaccinated with what priority

Mature population health platforms are designed first and foremost to create and manage cohorts of patients who share clinical or demographic common denominators. In this regard, they are extremely well-suited to identify patients at high risk for COVID complications based on clinical or comorbidity characteristics. Patients who decline vaccination can be excluded and flagged, as can patients who already tested positive for COVID in recent months or those already vaccinated. This process is highly dynamic and will require practices to manage shifting ever-changing populations efficiently and accurately.

Patient outreach and communication

Automated outreach to patients identified as high risk and requiring early vaccination can be facilitated by EHR and population health outreach programs utilizing multiple communication modalities based on the patient’s communication and language preferences. These systems also meticulously log and document outreach messages. It will be essential for practices to engage their patients early to increase awareness and acceptance of this new vaccine.

Documentation and tracking of immunization status

EHRs and population health tools have the toolset to allow documentation of each patient’s particular vaccine. Once the reporting requirements at the state and federal level become available, the mode of transfer of this data and the specific data elements can be determined. It is encouraging that at this time, there are multiple state vaccination registries for routine non-COVID vaccinations already receiving interfaced data from EHR systems across the country.

Identification of gaps in care for COVID vaccinated patients

Many patients deferred routine preventive care during the COVID pandemic. As patients become vaccinated and therefore at lower risk for contracting COVID, it will be important for population health systems to actively identify gaps in care among patients who have been vaccinated and actively outreach to these patients to complete the required and recommended preventive services. Similarly, reaching out to already vaccinated patients to attend to ongoing care for chronic conditions will be important to return patient confidence and engagement to pre-pandemic levels.

It is reassuring to know that once the details of the process by which the American public is going to be vaccinated is known, HIT platforms are ready to take on the required tasks.  Clearly, some adaptation to the specific requirements that the COVID vaccination project will impose will be necessary. Still, the required tasks are ones that these systems were built to address and have been utilized and honed with other vaccines and will serve this critically important mission well.

Betty Rabinowitz is chief medical officer, NextGen Healthcare. She can be reached on Twitter @DrBettyR.

Image credit: Shutterstock.com

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