Intermountain CIO on Need to Innovate Around Pandemic’s Twists and Turns

What are your priorities in this current moment?

It’s still about high throughput for testing patients who may be COVID-positive. We’re about one month into the vaccination [process] and that's required a lot of teams across our organization to make sure we have a vaccine tracking and management plan that can scale. And then you have all the complexities of the dual-dose vaccination process where timing is really important. There’s a lot of importance around tracking which vaccination comes from which manufacturers that patients are receiving, and looking at contraindications.

In the meantime, all the other strategies by and large still need to move forward. So we're putting a lot of focus on what our workforce of the future will look like. We envision making accommodations for having a lot of our caregivers working more permanently from home than what we had before the pandemic. That creates new challenges; it’s one thing when we're all remote, but what about when we're half remote and half back in the office? So there’s a lot of effort going around understanding what the configuration of our physical workspaces needs to look like, what the technologies need to be able to do, and how we can help ensure the team members are staying engaged and being productive. The pandemic has certainly had a toll on organizations’ revenue structures, so we've been very expense-focused as well, working to help make sure we have an appropriate cost structure for those services that we're providing.

From the health system perspective, what are the tools that will need to be developed and implemented to support the entire vaccination rollout process? How is that going for Intermountain so far?

Fortunately, we've had a few months to really be thinking about it, with some advanced warning of rough timing for when the first doses would be made available. But it still has required a lot of rapid thinking and innovations, as well as incremental improvements on existing processes. So we were able to leverage some amount of the actual testing work that we've done, even though there are lot of differences, too. One thing that I would call out would be around our electronic data interfacing with our state's immunization registry.

We have helped with the state to engineer a bidirectional data interface that's required a lot of creative interface engineering, and it's helped to provide that foundation for good vaccine stewardship in the state of Utah, which is exciting. What this bidirectional interface allows us to do is rather than just a unidirectional interface whereby we send vaccination data to the state, or just doing a lookup from the state, we now have the ability to make sure that a patient who presents for a vaccine hasn't already received the vaccine from somewhere else—either within our system, or across other healthcare systems or clinics in the state. So we have this ability to in near real-time see an accurate status for each patient.

What’s the technology behind this interface?

It was developed in conjunction between Intermountain and the state of Utah; it’s basically an interface that we built along with the state for having that bidirectional feed. So it's not required by the state for other healthcare organizations, but we saw the need early on that this would be a much better way to be able to make sure that we're sharing all the data that we have back with the state, and likewise, the easy ability to bring data in that the state has from other healthcare organizations that are submitting immunization data. And we also have that available inside our EHR. We can see all the [data] around the COVID vaccine manufacturer, the date the first dose was given, when the second dose is scheduled, all those kinds of things. And our Department of Health at the state level controls the distribution of vaccines across the state, so that partnership has been really key.

What other tools are being leveraged related to the vaccination process?

Another area that I would call out would be some of the tools we use around outreach. In these initial phases, we're leveraging outreach texts and emails to let people know they need to get their second dose as applicable. For the first dose, we haven't needed to do outreach per se, since there's been enough interest. But that will change over time, and then we will be leveraging our partnership with Cerner and some tools that they have to be able to do outreach through My Health+, which is our consumer digital front door tool to help inform people around vaccines, and for ourselves to be able to see care gaps.

We've also developed, in partnership with Qualtrics, what we call the Intermountain VaxPass, that goes to the patient via email or text, and if patients have no access to the internet or texting, they can also call our call center to get a Vax Pass. This Vax Pass has a QR code that can be scanned, and it links up all the [vaccine] information, which can then be linked to the actual file and stored in our EHR, and subsequently sent to the state's immunization registry. [Intermountain officials say the VaxPass is available for patients as of Monday, Feb. 8].

Is the VaxPass specific to the patient and health system, or can it be used in the future in public spaces like for getting on a plane?

It’s really for both purposes. It’s for doing your scheduling process that is all automated online, but then once you've had that vaccination, it’s also part of that process that gives you that result that can be accessed both in our My Health+ digital front door tool, as well as with our partnership with Apple, through their Health Kit. So it’s the same outcome, in essence: you have proof of vaccination as you're traveling, and you would need to be able to prove or demonstrate you've been vaccinated. The Vax Pass would be part of the proof.