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5 min read

Susan Ibáñez: Technology challenges & impact on COVID vaccine

Susan Ibáñez: Technology challenges & impact on COVID vaccine

A Valley of Innovation—Rapid Adoption of Technological Solutions to Address COVID-19 Ibáñez, Lindley, and Jackson addressed how Vail Health uses technological innovations to address pandemic-related challenges.

About Susan Ibáñez Ibáñez is the chief information officer at Vail Health, a nonprofit community healthcare system in Colorado’s Eagle and Summit counties. Within the system are a 56-bed hospital, a 24/7 emergency care facility, and other specialty services and clinics.

About Julie Jackson Jackson is the director of applications & informatics for Vail Health. She has been with Vail Health for over four years and is also a registered nurse working with COVID-19 patients.

About Chris Lindley Lindley is the chief population health officer at Vail Health. He is also the Vail Health COVID-19 incident commander and the executive director of Eagle Valley Behavioral Health.  


Susan Ibáñez: You can see we are in a unique resort area kind of a medical destination if you will. So I wanted to share our formal problem statement that we created as we begin working through this journey. As every other healthcare organization in the country kind of facing the same thing. So our problem statement, we had more resources, patient registration scheduling, dedicated to registration and scheduling than any other aspect of our COVID testing process.

We had a need for patients to have the autonomy and entering demographic and insurance information in and to expedite the registration and scheduling process that was really our bottleneck. We wanted to provide patients with a link to enter all the necessary information. And to have this auto-populate ultimately into our two primary EMR systems, which are Cerner and all scripts Cerner and our inpatient side, and all scripts. In our ambulatory side.

Obviously, we had a very negative patient impact as we were going through this with the bottom the issues that we were facing. So some of our technology or technology challenges. Traditionally, we follow a very formal approach. We have robust project governance, we do a stringent financial and capital submission, and review and approval process.

And that can take several months, depending on the solution, then you may add an RFP process and requirements gathering, standard vendor vetting, and security assessment, like many of you, which you may have seen in the poll, typically, that’s a very long process. And we want to be very thorough, we want to do our due diligence to make sure that the loot solution we’re bringing into our organization is the right solution. Obviously, we were dealing with unprecedented times.

So we had to fast-track the solution. And some of the things that we did, where we involved our Incident Command, which is Chris had mentioned was established in January. So that team stayed together, we involved incident command and population health leaders, we looked through a different lens.

When we were selecting vendors, we needed a vendor, that might not be one of the large footprint traditional vendors that we had in-house typically, for our clinical IT solutions, we needed a vendor that was small and agile. And that would allow us to have rapid development, the finance review and approval process had to be fast-tracked.

One of the big benefits that we saw during this period of time, which I think everyone recognized was the Cares Act funding, which allowed us the luxury to take a lot of that financial discussion off the table. Still, we had to bet it. And still, we had to produce the business case, but things were able to move at a much faster clip. So we also decided to go with a phased approach for implementation really to get a life, get good, get better in this particular scenario, so that we could get our implementation up and running, hitting the highest priority and problem first, which was the severe backlog that we faced with our in our patient access space of getting the patient scheduled and registered for their testing and their vaccines.

So again, what we had to do differently in our Technology Roadmap with this scenario, we had to quickly do a rapid-fire analysis of the problem, we had to very quickly select a vendor, realizing that we probably wouldn’t be able to go with one of the typical standard vendors that we would have selected, we had to have an openness towards technology, we looked at technology and vendor selection, really through a different lens. We weren’t going with the very stringent due diligence, you know, process that we typically follow.

We had to partner with leadership and physician groups and community partners. And really, we focused on not letting perfect be the enemy of good. We knew that the solution we brought to market would not be the final product. But we had to get some relief for the staffing issues that we were facing. And we also had to accept that the product would still require some development, quite a bit of development actually. And then finally, we partnered with our IT community and Julio mentioned this in our success factors later.

It didn’t matter in healthcare it at this point in the game, if you were a competitor, a stranger, another colleague, it didn’t really matter. We were all out to achieve the same goal. And that was to provide a solution for healthcare providers to address the pandemic. So I saw the IT community come together in a way that I had never seen happen. So I wanted to share some information on our pre and post-solution implementation from testing and a vaccination perspective, pre solution, our process was to schedule and register patients via a manual entry and email process and phone call process.

It was extremely arduous. We had tons of people in there, we were hiring staff like crazy trying to just get and accommodate the volume of patients that were requesting tests initially, we could handle at pre solution about 70 appointments per day per clinic. We had multiple clinics established and expanded the number of clinics as we went that equated to about 280 appointments per day for testing at all our sites, and generated about $28,000 in billable revenue.

Now post the solution when we were having the patient’s schedule online, enter their insurance information, basically automating the process that was causing us all the grief, we were allowing patient self-scheduling, we could accommodate post solution about 119 appointments per day per clinic, which equates to about 476 appointments per day for all our sites, and resulted in about $47,600 in billable revenue. And this was actually a 70% increase in volume and billable revenue for our testing centers.

From a vaccine perspective, pre and post, again, pre our solution was very manual entry email phone calls. And these are vaccinations we could only process about 32 patients per hour. And that equated to about 256 patients per day. We handled our employee vaccinations a little bit differently. So these numbers don’t include that post solution.

We saw a 131% increase in volume, our patients were doing self-scheduling, entering their own insurance information that allows allowed us to bump up the numbers to 74 patients per hour, and equating to about 592 patients per day. Huge, huge increase. So in summary, the technology impact that we saw from being able to fast track and implement this solution doubled the volume of testing and vaccinations actually increase our volume by 105%.

On average, between both services testing and vaccination, it increased the access for testing and backs for both for our patients across the valley. It allowed us to fully integrate with our two primary EMR systems, which are Cerner in all scripts, reducing staffing cost by 85%. From our peak of what we had seen when we were doing all of our staffing and scheduling on a manual basis. And then finally, of course, it improved patient experience exponentially.

And we received so much positive feedback from our patients that were coming into our clinic. It was an amazing sight and we had opportunities even those like myself that are not in the clinical side of the house. Were able to participate in the vaccine vaccination clinics by helping people get checked in when they arrived, things like that. It was just a very moving experience. So it allowed all of us to be a part of the solution.

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