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Throughout Denver Health’s pandemic vaccination efforts, the struggle was to effectively get people into the system who didn’t already have patient records with the health system without overwhelming call centers.

THE PROBLEM

As the safety net health system for metro Denver, Denver Health vaccinated many people who were not regular patients. Early on, the health system implemented a vaccine interest form created by IT teams on a separate database that allowed anyone in the public to put themselves on a waiting list for an appointment. you, when the health care system had vaccines.

“We then used this database to pull contact information and send scheduling tickets to people to get an immunization appointment online, without having a Denver Health Portal account,” Dr. Ann said. Boyer, chief medical information officer at Denver Health.

“It was a very manual process for our IT teams who used tableau on the database to pull thousands of names based on age and eligibility criteria and then enter them into a tool that we designed to send an email with a scheduling code.

“In order for our employees to plan online, they had to make sure we didn’t have duplicate accounts, usually going through an identity verification process with known information,” she continued. “In our older populations, it was often difficult for them to navigate the patient matching questions needed to create an account in our patient portal.”

As pediatric vaccinations arrived in the spring of 2021, staff knew that access to programming for thousands of children in Denver public schools was going to be a burden on call centers.

“Our MyChart pediatric rates were quite low compared to our adult populations, and we partnered with Denver Public Schools to make sure we could offer vaccines to tens of thousands of children 12 or older, who don’t ‘may not have a Denver Health account,’ Boyer explained. “We tackled 16+ with our old method, sending unique generated scheduling codes and instructions to the DPS emails of all students who were 16 or older in April 2021.

“However, it was a very laborious process,” she continued. “It was also complicated by DPS spam filters and relying on students to pass information/codes to their parents and have consents signed.”

PROPOSAL

EHR provider Epic’s open scheduling system would allow Denver Health to move to a less manual approach, allowing people who wanted an appointment to click a link on the health system’s website or from a community partner website, like the Denver Public Schools one, and finding the place and vaccine they wanted, without being patient already.

“Our patients can also use these tools or log into their MyChart patient portal account and plan directly from there,” Boyer noted. “Open programming for us came around the time when vaccine supply was less constrained and eligibility criteria were less stringent, hence the need for the waitlist and our pre-prioritization tools was no longer needed.

“This has allowed our clinics to have a number of vaccines available for Open Scheduling while reserving spots for our at-risk patients,” she added.

MARKET

There are a wide variety of electronic health record providers on the market today, including Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway Health, Medicomp Systems, Meditech, Medsphere Systems, and NextGen Healthcare.

TRY THE CHALLENGE

The Open Scheduling system provides the ability 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 early in the pandemic.

“We targeted Open Scheduling once we had an adequate supply of vaccines in late spring 2021, once the vaccines were open to the general public,” Boyer recalled. “We leveraged the ability to create special URLs for certain clinics – just our school health centers and school-based mass vaccination sites as a way to target children and their families.

“We sent these special URLs to Denver Public Schools to post on their website and send school communications to families, and sent directly to children in their DPS emails to allow them to register for vaccines in some health facilities in Denver that targeted Pfizer vaccines, which were approved for children,” she continued.

Community clinics were able to add open scheduling blocks to their schedules after offering Denver Health established patients, as a way to offer vaccines at Denver Health metro area clinics if there were vaccines available, but always give clinics a way to serve their patients first. Because the clinics are FQHC, Denver Health wanted to protect access to its at-risk patients.

Denver Health’s public website had Open Scheduling links for each vaccine maker or for the first ones available.

RESULTS

Without Open Scheduling and Direct Scheduling, call center volumes would have been difficult to absorb, especially in April/May 2021 and Nov/Dec. 2021, when new age groups were allowed.

About 20% of appointments for people 18 and under were scheduled through Open Scheduling, with more in the first weeks after these age groups were approved (25-35% through Open Scheduling in May and November 2021 ).

For initial vaccines in people aged 18 and under, in May 2021, 25% went through Open Scheduling (884 patients), 14% through MyChart (495 patients) and 62% through the call center (2,236 pts). ).

In November 2021, for patients 5-11, 37% went through Open Scheduling (2,412 patients), 22% through MyChart (1,467 patients) and 40% through the call center (2,668 patients).

TIPS FOR OTHERS

“Giving patients self-service options to schedule appointments is very important,” Boyer said. “Some people won’t be on hold for hours to get appointments. Self-service tools allow patients to have more control over when and where appointments are, but also to offload the need for additional staff in the event of an increase in enrolment.

“Think of flu shots as a great use case for that as well,” she concluded. “Seasonal increases in demand. Setting up scheduling capacity on your public website or even community partner links allows health systems to fill appointments in areas that have capacity with people new to your health system, while keeping other areas that do not have capacity reserved for certain patients. populations.”

Twitter: @SiwickiHealthIT
Email the author: [email protected]
Healthcare IT News is a HIMSS Media publication.