For those few of you who have been hiding under a rock since the beginning of the year, let me catch you up with an executive overview of 2020: global pandemic, not going well. Now that we’ve level set, there is some good news: vaccines that have been developed in a fraction of the typical time are soon to be made available to certain populations in the United States. In fact, the United Kingdom just approved a COVID-19 vaccine and will begin administering shots within days. Assuming the experimental data from the pharmaceutical companies passes the Food and Drug Administration’s muster, the U.S. will have two new vaccines by year’s end.
While the enormous work of scientists across the globe will be celebrated for years to come, the difficult part for healthcare organizations that will be administering these vaccines is just beginning. We need to administer one or two doses to 330 million people in the next six to nine months. At the onset, there will likely be two different vaccines (Pfizer/BioNTech and Moderna) each of which requires two doses, but separated by different time periods. There are other manufacturers who aren’t far behind, and their number of doses and timing will likely differ as well. Each will have unique storage requirements, and it’s unlikely that any of them will be interchangeable. (Translation: if the first dose is from Pfizer, the next dose must also be from Pfizer.)
The Centers for Disease Control and Prevention (CDC) has received recommendations from the Advisory Committee on Immunization Practice about how to prioritize and allocate the initial supplies of vaccine. The CDC will soon publish their own recommendations about who gets immunizations first, but ultimately each state gets to decide how its portion of vaccine is delivered. Healthcare personnel are likely first in line, with long-term care facility residents and essential workers not far behind.
What must healthcare IT experts be doing right now in order to prepare to administer all these vaccines? Here are some things to focus on:
- Dust off and re-examine your immunization clinic build in the electronic health record (EHR). Most organizations have created these tools to support the annual influenza vaccine push each fall and winter. These sorts of tools and clinics will be required to support COVID-19 vaccination. Is your build ready to sustain your organization’s needs? For example, can your immunization clinics be configured for non-flu vaccines? Do you have hard stops that make sense for immunizations that cost a lot of money, but that serve no purpose for a COVID-19 vaccine that is pre-paid by the government?
- Start preparing your immunization and inventory modules for some of the peculiarities of COVID-19. The initial vaccines will be released under an Emergency Use Authorization (EUA) which means there won’t be a standard Vaccine Information Statement (VIS). There will be something similar published by the FDA; where will your users document the date of this mandatory FDA Fact Sheet? In the VIS field or somewhere else? Initial vaccines won’t have an expiration date so the CDC recommends using 12/31/2069 as a placeholder date. Can your systems support that? Start thinking about loading NDC and CPT codes. Oh, and the CVX and MVX codes while you’re at it.
- Ensure that your billing module is ready for the unusual COVID-19 requirements. Hospitals and clinics won’t be paying for vaccines as it will be supplied by the federal government. Hence, expect to drop a zero-dollar CPT code that may vary based on manufacturer and dose. Providers should be able to recoup administration fees (also likely new CPT codes) but only from insurers, never from the patient. If you’re thinking the logic in your charge router and claim scrubber will be tested, you’re correct!
- Think about how you’ll track employees’ COVID-19 vaccination status. Will your organization require patient-facing staff to be vaccinated? If so, how will you record and report on progress? Many hospitals and clinics don’t put employee health information in their EHR. If your group has a separate health record for employees, can it support multiple vaccines each with different recall intervals?
- Plan for how you’ll schedule and recall your patients for their COVID-19 vaccines. Do you anticipate that patients will call or use your EHR patient portal to schedule for a shot? Or will you reach out to them proactively based on which priority group they fall in? If the latter, how will you identify patients with chronic diseases who need to be vaccinated early? If you have specific EHR registries for these folks, you’re one step ahead. If not, expect some tricky reporting needs, likely based on ICD-10 diagnoses or SNOMED concepts.
Of course, there are many other details to contemplate, but these are among the most important. Time is of the essence. If you wait until all the specifics are ironed out by the manufacturers, governmental agencies, and payors, you’ll find yourself under a crush of patients. Plan now and remain flexible as things invariably change.
Do you need support getting your organization up to warp speed for vaccine distribution? Please fill out the form below and we’ll be in touch with more information about how Nordic can help.