St. Luke's Regional Healthcare System, based in Duluth, Minnesota, has been scheduling COVID-19 vaccine appointments through the patient portal from its electronic health record vendor Meditech. First it had to boost portal enrollments, which it did successfully. But then an issue arose.

THE PROBLEM

"Using the traditional documentation method for vaccines, each administration could take the vaccinator between one and two minutes to complete, since they needed to record the vaccine-tracking information, like lot numbers," said Clark Averill, director of information technology at St. Luke's Regional Healthcare System. "Given the volume of vaccines to be administered, the amount of manually entered information presents an opportunity for data entry mistakes.

"Portal enrollment wasn't our issue – scheduling vaccine appointments was our challenge," he continued. "Our patients could request appointments via the portal. Since these appointment requests went to a work list, staff would still need to 'schedule' the appointment on the physician's schedule. Due to the volume of vaccine appointments that needed to be scheduled, the current workflow just couldn't keep up with the requests."

PROPOSAL

Meditech offered a new system called Quick Vaccination, which was delivered through an update. With this new system, the vaccine information is preloaded by the pharmacy for each day's vaccine clinic. The vaccinator only needs to select the appropriate lot administered. This saves time and ensures that fewer data entry errors are recorded. The time to document an administration was reduced to about 15 seconds.

"To address the scheduling volume for vaccines, we gave patients the ability to directly book appointments into the vaccinator's schedule," Averill explained. "This allowed patients to select the day and time that was most convenient for them. We were able to control the number of appointments available by adjusting the vaccinator's resource."

MARKETPLACE

There are many vendors with electronic health records systems on the health IT market, including Allscripts, athenahealth, Cerner, DrChrono, eClinicalWorks, Epic, Greenway Health, HCS, Meditech and NextGen Healthcare.

MEETING THE CHALLENGE

"For vaccinators, the workflow of documenting is almost as fast as the process of administering the shot itself," Averill noted. "The process is much quicker and eliminates the potential for data entry errors.

"Using the quick vaccine documentation routine saves 45 seconds per administration. This saves staff a total of 62.5 hours per week spent documenting."

Clark Averill, St. Luke's Regional Healthcare System

"Allowing patients to see available appointments and directly book their appointment on a day and time of their choice is extremely satisfying for them," he added. "The process is simplified for internal staff, who no longer need to waste time scheduling and rescheduling for inconvenient appointment times."

RESULTS

When it came to its patient portal push, on March 8, 2020, St. Luke's Regional Healthcare System had 27,305 patients enrolled in its portal. This was 18.92% of the total number of patients.

"When COVID-19 ramped up, we made a major push to enroll our patients in the portal so they could access virtual visits, electronic messaging to providers, and medical reports like lab results and radiology reports," Averill recalled. "As of April 1, 2021, St. Luke's now has 61,426 patients enrolled, 33.81% of all patients."

The health system also measures how many patients use St. Luke's for primary care and the number of patients that have a primary care provider assigned. 54.45% of those patients are enrolled in the portal.

"We currently administer about 500 vaccines per day, five days per week," Averill noted of the vaccine effort. "Using the quick vaccine documentation routine saves 45 seconds per administration. This saves staff a total of 62.5 hours per week spent documenting.

"Scheduling a patient using the worklist takes a staff member approximately 90 seconds," he continued. "Since we allow 50% of our vaccines to be self-scheduled, it also saves staff 62.5 hours per week."

ADVICE FOR OTHERS

"Take a step back and evaluate what services work best for patient self-scheduling," Averill advised his peers. "For us, it was Medicare Wellness visits and COVID-19 vaccinations, but we continue to evaluate other use cases.

"If you have the opportunity to allow patients to self-schedule vaccinations, it is well worth the effort," he concluded. "Giving control to the patient to schedule their own vaccine appointment at a day and time of their choosing is a huge win for the patient and a great time-saver for the staff."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.