During Denver Health’s pandemic vaccination efforts, the struggle was to attract people who do not yet have health system patients into the system effectively without overburdening call centers.
As a health safety system for the Denver subway, Denver Health vaccinates many people who have not been regular patients. Initially, the health system introduced a vaccine interest form created by IT teams in a separate database that allowed anyone in the public to put their name on the waiting list when the health system had vaccines available.
“We then used this database to retrieve contact information and send tickets to schedule people to get a vaccination appointment online without having an account with the Denver Health Portal,” said Dr. Ann Boyer, chief executive. on medical information at Denver Health.
“It was a very manual process for our IT teams to use a table above the database to retrieve thousands of names based on age and eligibility criteria and then incorporate them into a tool we built to send an email with a planning code .
“In order for our people to plan online, they had to make sure we didn’t have duplicate accounts, usually going through an authentication process with some information,” she continued. “In our older populations, this often made it difficult for them to navigate the patient matching issues needed to create an account on our patient portal.”
As pediatric vaccinations came in the spring of 2021, staff knew that gaining access to a schedule for thousands of children in public schools in Denver would be a burden on call centers.
“Our pediatric MyChart rates were relatively low compared to our adult populations, and we partnered with public schools in Denver to make sure we could offer vaccines to tens of thousands of children 12 years of age or older who may not have an account in Denver Health, ”Boyer explained. We have managed our old method for 16 years or more, sending unique generated planning codes and instructions to DPS emails to all students who were 16 or older in April 2021.
“However, it was a very laborious process,” she continued. “It was also difficult for DPS spam filters and reliance on students to provide information / code to their parents and obtain signed consents.”
EHR Epic’s open planning system will allow Denver Health to focus on a less manual approach, allowing people who want an appointment to click on a link on the health system’s website or from a community partner’s website (such as Denver Public Schools) and to find the location and vaccine they wanted without being a patient anymore.
“Our patients can also use these tools or log in to their MyChart patient portal account and plan directly from there,” Boyer said. “The open schedule for us came at a time when the supply of vaccines was less limited and the eligibility criteria were less stringent, so the need for a waiting list and our pre-prioritization tools were no longer needed.
“This has allowed our clinics to have a number of open-schedule vaccines, while reserving some seats for our high-risk patients,” she added.
There are a wide variety of eHealth providers on the market today, including Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway Health, Medicomp Systems, Meditech, Medsphere Systems and NextGen Healthcare.
MEETING THE CHALLENGE
The Open Scheduling system offers an opportunity for people who have never been seen at Denver Health to schedule an appointment. This is an important tool for vaccinations, as the provider is trying to reach a wider community that may not have access to vaccines elsewhere (especially earlier in the pandemic).
“We turned to Open Scheduling after we had an adequate supply of vaccines in the late spring of 2021, after the vaccines were open to the general public,” Boyer recalled. “We used the opportunity to create special URLs for specific clinics – just our school health centers and school vaccine sites – as a way to target children and their families.
“We sent these special URLs to Denver Public Schools to publish on their website and send school messages to families, and sent them directly to children in their DPS emails to allow them to register for vaccines in certain locations. Denver Health is targeting Pfizer vaccines that have been approved for children, “she continued.
Public clinics have been able to add open-schedule blocks to their schedules after offering them to established Denver healthcare patients as a way to offer vaccines in clinics across the Denver Health Subway area if we had vaccines available, but we still give clinics a way to serve their patients first. Given that the clinics are FQHC, Denver Health wanted to protect access to its high-risk patients.
Denver Health’s public website had open planning links for each vaccine manufacturer or for the first time available.
Without an open schedule and direct planning, call center call volumes would be difficult to absorb, especially in April / May 2021 and November / December 2021, when new age groups were allowed.
About 20% of meetings for people under 18 were scheduled on an open schedule, especially in the first few weeks after the approval of these age groups (25-35% on an open schedule in May and November 2021).
For the initial vaccines in people aged 18 and under, in May 2021, 25% came through Open Scheduling (884 patients), 14% through MyChart (495 patients) and 62% through the call center (2236 points).
In November 2021, for patients 5-11, 37% came through Open Scheduling (2412 patients), 22% through MyChart (1467 patients) and 40% through the call center (2668 points).
ADVICE FOR OTHERS
“It’s very important to give patients self-care opportunities to schedule appointments,” Boyer said. “Some people will not wait for hours to get appointments. Self-care tools allow patients to have more control over the time and location of appointments, but also relieve the need for additional staff when jumps in registrations occur.
“Think of flu shots as a great use,” she concluded. “Seasonal jumps in demand. Allowing planning on your public website or even links from community partners allows health systems to fill meetings in areas that have capacity with people new to your health system, while retaining other areas that do not have the capacity reserved. for selected patient populations. “