As the slower-than-expected COVID-19 vaccine rollout continues around the United States, experts have noted the importance of the "last mile" – getting dosages into the arms of patients.

Some industry leaders say that although the logistics are certainly important, using existing patient engagement technology to complement vaccination outreach could be key to ensuring that every American who needs protection from COVID-19 can get it.

Guillaume de Zwirek, CEO of Well Health, told Healthcare IT News that he believes the best strategy is to "meet patients where they are."

"I don't think healthcare really understands what true patient engagement is," said de Zwirek, whose company offers patient communication tools. "There is no single common standard. They're all communicating with patients in different ways."

"Healthcare is the third-worst industry when it comes to customer service," de Zwirek continued. "It should be number one."

De Zwirek noted that labyrinthine messaging systems and unclear pipelines can contribute to patient frustration and health risks. 

For instance, at the time of his interview with Healthcare IT News, de Zwirek noted that it had taken him a full hour to book an appointment to get himself and his family tested for COVID-19 after an exposure, "with 12 different phone calls."

When the pandemic first began to sweep across the United States this spring, "the first thing our company did is, we thought about our platform and how we could help our customers handle the influx of patients," de Zwirek said. "We built out a bunch of workflows."

Now that the vaccine is becoming more widely available, Well plans to scale up in a similar fashion, he said, noting that 13 integrated delivery networks are using the platform to deliver vaccine-related communications via text message.

Since the beginning of December, the company says it has helped providers schedule more than 8,000 "dose 1" vaccine appointments.

"We took a customer live in four days last week specifically because of the COVID vaccine," de Zwirek said.

Many electronic health records have been preparing their systems to record COVID-19 vaccinations and report back to health departments, with some using patient portals for vaccine-related communications. 

"I'm not here to compete with or replace the patient portal," said de Zwirek. But he said bundling workflows into the portal inevitably creates friction. 

"I got my COVID results yesterday. I got an email with the link to my MyChart and couldn't remember my password," he said. 

By contrast, there are HIPAA-compliant ways to use texting to convey information to patients.

"If there is an opportunity to eliminate friction, take it," he said. "There are many use cases that don't include [protected health information] that will get way higher compliance."

Greg Johnsen, CEO of LifeLink, points to chatbots as a way to address patient demand and confusion around the vaccine.

"Additional complexities around new documentation, specific follow-up vaccination windows, and an influx of people that are new patients could overwhelm current intake and scheduling processes," said Johnsen. 

"Building a handful of digital assistants versus training thousands of individuals is also a key consideration when it comes to efficiency and cost," he added.

Johnsen pointed out that conversational AI can engage people on their phones or other devices to help with scheduling, form completion, reminders, directions, screening and follow-up. 

He noted that EHR integration is "critical," saying that EHRs can trigger bots to reach out to patients and help to make the process more personal.

"It makes a difference if the bot knows your name, or knows your doctor, or knows the date you are due to get your second dose of the vaccination," said Johnsen.

"Conversely, when a digital assistant collects information from patients, that data must be written back to the patient record in the EHR. Conversational AI is at its best when deployed as an engagement layer that 'wraps' and extends the big systems of record," he added.

Like de Zwirek, Johnsen emphasized the importance of smoothing friction wherever possible. He says browser-based programs with a wide range of supported languages can boost access, enabling patient trust and ease of use.

"The human dimension to healthcare is vital and should not be diminished in any way. But the administrative overhead is ripe for automation," he said.

LifeLink, which enables providers to deliver patient workflows as chatbot conversations, measures engagement as a key performance indicator. 

"In light of the expected COVID-19 vaccination volume projections, saving just a few minutes on each case adds up to massive time and efficiency savings," Johnsen said.

"It could be the difference between achieving herd immunity in 2021, or not," he predicted.

Pouria Sanae, founder and CEO of ixLayer, said another way to smooth out friction could be streamlining as much pre-vaccination communication as possible. 

ixLayer, which offers tools for health testing technology, can be integrated with EHRs to offer physician-ordered, patient-ordered or direct-to-consumer testing. 

"When COVID happened, we had everything in place to start COVID testing," said Sanae, who says ixLayer "sits in the background" for hundreds of COVID testing programs, including the U.S. Coast Guard's.

Now, with individuals beginning to clamor for access to the COVID-19 vaccine, Sanae says ixLayer can be used for patients' electronic consent forms and health history in order to make the process smoother. 

One advantage, he says, is the platform's ability to offer solutions "in as many languages as [the providers] want" – which will be increasingly important as the vaccine becomes available to the wider population.

"Once you've done the vaccine, there are patient CRMs in place so you can keep a closed loop," Sanae continues, which will allow providers to more easily track any severe symptoms or adverse reactions.

As far as accessibility goes, Sanae says the company went through an audit to try and ensure the platform does not present hurdles for users with disabilities. 

"But this is something the entire industry needs to improve," Sanae said.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.