The Community Organized Relief Effort in Georgia, better known as CORE, had a major operational challenge to coordinate all the logistical issues of setting up mobile vaccinations for COVID-19 across an entire state and managing dozens of field teams at more than 100 different locations.

THE PROBLEM

Prior to the pandemic there were no platforms designed for mass patient registration, complex scheduling and communication, let alone platforms that managed all the specific information required for COVID-19 vaccinations, said Jonathan Golden, Georgia deputy area director of CORE.

"CORE and Sick Clinic were awarded a statewide contract to provide mobile vaccination sites for COVID-19 across all 18 health districts in Georgia," he said. "This meant setting up multiple pop-up vaccination sites in each health district.

"CORE received all three vaccine types – Moderna, Pfizer and J&J," he continued. "Each vaccine had different scheduling requirements, which meant CORE would have to reopen pop-up sites at different time intervals for first dose and second dose appointments, depending on the vaccine used at a given site."

The plan was to vaccinate tens of thousands of patients in a short period of time, so there was a challenge of collecting and processing large amounts of patient registration data, consents and more, which often was done via paper at other sites.

Another challenge with mass registrations and online appointment bookings is overlapping bookings. When one has thousands of patients trying to register simultaneously for a limited number of appointment slots, it can cause double-bookings and other scheduling problems.

"Given this is a very high-volume project with many small-dollar claims, there also was the challenge of billing such a high volume of claims in a short period of time," Golden noted. "Finding a practice management system that could streamline high-volume billing and integrate with an online patient registration and appointment booking system was nearly impossible."

PROPOSAL

To handle a high volume of patients, CORE needed a custom scalable system that could streamline the registration and scheduling process, Golden explained.

"As a cloud-based solution, Curogram is scalable and can handle thousands of registrations and online appointment bookings simultaneously," he said. "Like an airline booking system, Curogram temporarily reserves slots when patients select a time slot, so appointment slots do not get double-booked.

"With site locations and availability changing weekly and even daily, CORE needed a flexible patient registration and scheduling tool that could adapt and communicate with patients on the fly," he continued.

"Curogram's customizable availability configurations enabled CORE to create custom availability on the fly, by location, and solve logistics issues such as multivisit scheduling tied to specific vaccine types and scheduling of ever-changing mobile sites."

CORE also needed a system that could track and report COVID-19 vaccine-specific data such as vaccine lot numbers and immunization-registry reporting. Curogram's patient registration, scheduling and COVID-19 reporting tools were critical to streamlining the operations, he added.

CORE also is managing hundreds of patients across dozens of sites daily. This requires constant communication with patients throughout the day to coordinate schedules and answer patient inquiries. Curogram's two-way texting features streamline high-volume patient communication and drastically reduce patient phone calls, he noted.

"Sick Clinic is the clinical entity that provides the clinical oversight for the project and is ultimately responsible for handling the medical billing for the project," he said. "The challenge of billing thousands of visits per week was solved with vendor DrChrono's easy-to-use billing dashboard.

"The fact that it was tightly integrated with Curogram was critical as all the patient registration and appointment data was automatically populated in the DrChrono mobile health platform," he said. "This drastically reduces data errors generally introduced with the manual entry of patient data by front desk staff."

MEETING THE CHALLENGE

CORE schedulers use Curogram to create and modify online availability for new and existing locations on a regular basis. CORE site staff use the system to check patients in, and onsite scribes document vaccine-related information such as Lot Number administered in the system.

Sick Clinic patient services staff use Curogram to two-way text with patients daily to answer patient questions, provide driving directions and facilitate scheduling changes. Sick Clinic billing staff use DrChrono to identify the proper insurance payers, submit claims and manage collections.

RESULTS

CORE currently operates 36 field teams, five days a week, at 180 sites in Georgia. CORE set up hundreds of unique sites and thousands of vaccine events across the state. CORE surpassed 50,000 COVID-19 vaccine doses over 60 days via mobile vaccination sites across all 18 health districts in Georgia.

CORE was able to go from zero field teams to 36 teams in a 60-day time period. Each team has approximately 14 people in various roles that handle site management, logistics and injector.

"CORE was able to scale massively, thanks to Curogram's custom solution," Golden said. "We chose Curogram and DrChrono because of the ease of use; and they could both scale so quickly and keep up with the ever-changing demands of the program.

"The robust technology solution built for CORE allows staff to travel to remote sites to easily vaccinate out-of-reach people throughout the state," he continued. "For example, CORE went to a chicken farm in Georgia at 4 a.m. and vaccinated 200 migrant workers who mainly spoke Spanish and Pacific Islander languages."

In addition, ships docked at the Port Authority in Savannah from India, China and Japan with workers who had not been off the boat in 14 months were able to easily get vaccinated (J&J one-dose) from the CORE team.

ADVICE FOR OTHERS

"[The} state government approach is still a bit disjointed, and each state is different when it comes to administering the COVID-19 vaccinations," Golden said. "It would be beneficial to replicate a system like this and have one statewide mobile vaccination program.

"The COVID-19 vaccination statewide process can be daunting. States are in need of a more streamlined process," he concluded. "A lot of states still aren't doing enough to set up mobile vaccination programs. An agile technology solution, combined with teams that can travel to remote sites that state health departments can't reach, can bring COVID-19 vaccinations to more people."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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