During Denver Health’s pandemic vaccination efforts, the struggle was to efficiently get people who did not already have patient records with the healthcare system into the system without burdening call centers.
THE PROBLEM
As the safety net health system for the Denver metro, Denver Health vaccinated many people who were not regular patients. Initially, the healthcare system submitted a vaccine interest form created by IT teams on a separate database that allowed anyone in the public to put their name on a waiting list for an appointment, when the healthcare system had the vaccines available.
“We then used that database to extract contact information and send scheduling tickets to people to get a vaccine appointment online, without having an account on the Denver Health Portal,” said Dr Ann Boyer, lead medical information at Denver Health.
“This was a very manual process for our IT teams who used tableau on the database to extract thousands of names based on age and eligibility criteria and then put them into a tool we created to send an email with a planning code.
“In order for our people to code online, they had to make sure we didn’t have duplicate accounts, typically going through a process of verifying identity with known information,” he continued. “In our older populations, it was often difficult for them to navigate the patient correspondence questions required to create an account on our patient portal.”
As pediatric vaccinations would arrive in the spring of 2021, staff knew that access to programming for thousands of children in Denver’s public schools would be a drag on call centers.
“Our pediatric MyChart rates were quite low compared to our adult populations, and we partnered with Denver public schools to make sure we can offer vaccines to tens of thousands of children 12 years of age and older who may not have an account. Denver Health, “Boyer explained. “We approached age 16 and over with our old method, sending unique generated programming codes and instructions to the DPS emails of all students who were 16 or older in April 2021.
“However, this was a very laborious process,” he continued. “It was also complicated by DPS spam filters and relying on students to get the information / code from their parents and get signed consents.”
PROPOSAL
Epic’s EHR provider’s Open Scheduling system would allow Denver Health to move to a less manual approach, allowing people who want an appointment to click a link on the healthcare system website or from a community partner’s website (like Denver public schools) and find the location and vaccine they wanted, without already being patient.
“Our patients could also use these tools or log into their MyChart patient portal account and plan directly from there,” Boyer noted. “Open scheduling for us came at a time when vaccine supplies were less limited and eligibility criteria were less stringent, so the need for the waiting list and our prioritization tools were no longer needed.
“It has enabled our clinics to have a number of vaccines available for Open Scheduling, reserving some seats for our patients at risk,” he 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.
FACING THE CHALLENGE
The Open Scheduling system offers people who have never been seen at Denver Health the ability to make an appointment. This is an important tool for vaccinations as the provider seeks to reach a larger community that may not have access to vaccines elsewhere (particularly at the start of 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 public,” Boyer recalled. “We used the ability to create special URLs for certain clinics, just our school health centers and school mass vaccination sites as a way to target children and their families.
“We have 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 enroll for vaccines at some Denver Health locations they have taken. they are targeting Pfizer vaccines, which have been approved for children, “he continued.
Community clinics were able to add Open Scheduling blocks to their schedules after offering established Denver Health patients, as a way to offer vaccines in clinics across the Denver Health metropolitan area if vaccines were available, but however, we offer clinics a way to serve their patients first. Since the clinics are FQHCs, Denver Health wanted to protect access for its patients at risk.
Denver Health’s public website had Open Scheduling links for each vaccine manufacturer or earliest available.
RESULTS
Without Open Scheduling and direct scheduling, call volumes for the call center would have been difficult to absorb, particularly in April / May 2021 and November / December 2021, when the new age groups were authorized.
Approximately 20% of appointments for people aged 18 and under were scheduled through Open Scheduling, especially in the first few weeks after the approval of those age groups (25-35% through Open Scheduling in May and November 2021).
For initial vaccines in people aged 18 and under, as of May 2021, 25% arrived via Open Scheduling (884 patients), 14% via MyChart (495 patients), and 62% via the call center (2,236 points).
In November 2021 for patients aged 5 to 11, 37% arrived via Open Scheduling (2,412 patients), 22% via MyChart (1,467 patients) and 40% via the call center (2,668 pt).
TIPS FOR OTHERS
“Giving patients self-service options for scheduling appointments is very important,” Boyer said. “Some people won’t wait for hours to make appointments. Self-service tools give patients more control over time and location of appointments, but also reduce the need for additional staff when spikes occur. of registrations.
“Think of flu shots as a great use case for that too,” he concluded. “Seasonal surges in demand. Putting scheduling features on your public website or even links from community partners allows healthcare systems to fill appointments in areas that have capacity with people new to your healthcare system while retaining other areas which have no capacity reserved for selected patient populations “.
Twitter: @SiwickiHealthIT
Email the writer: [email protected]
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