With the world awaiting a COVID-19 vaccine, many try to reduce their seasonal illness risk with the flu shot. Some local governments believe so strongly in public health benefits of the influenza vaccine they mandate it. For example, all students K-12 in Massachusetts are required to receive the seasonal influenza vaccine annually. New students entering between January 1-March 31, 2021 must receive a vaccine for the flu season before entry.1 With routine vaccinations down as COVID-19 concerns keep patients away from traditional office visits, health systems turned to creative solutions.
To help safely and efficiently improve vaccination rates, Boston Children's Hospital (BCH) went live with Cerner Mass Vaccination (Mass Vacc) in October 2020 — helping to improve the logistics and feasibility of drive-thru and other non-office based influenza vaccine clinics.
“We looked at our processes for flu clinics as a potential model for what we would do for COVID-19 vaccine clinics,” said Kathy Morgan-Gorman, MS, DNP, RN, NE-BC, senior nursing director, ambulatory medicine. “The mass vaccination module allowed us to use an ‘assembly line’ workflow. The first person in line could check-in the patient and enter the order, while the second could administer the vaccine and document. This also worked well for staff who may not have worked at a vaccine clinic before, as they could focus on just one or two steps of the process.”
The module allows a clinician to quickly verify if the vaccination is due, uploads records to the state vaccination system in near-real time, and helps trigger a bill for each vaccine.
While vaccinations on a large scale were previously possible, clinicians needed to search for and open each patient’s full electronic health record to review allergies, document a pre-vaccination screening, and then order and document the administration. A full chart workflow makes sense in a traditional office-based visit but is unnecessary and inefficient for a focused vaccination effort. Utilizing mass vaccination functionality helps expedite care delivery by presenting allergies and immunization history, providing the ability to do a pre-vaccination screening, and allowing ordering and documentation without opening the full patient record.
Starting in September, BCH began hosting and ramping up focused flu clinics to accommodate the expected rush of patients complying with the Massachusetts mandate for influenza vaccination prior school entry January 1, 2021. In the initial clinics, from September 6-October 6, 2020, BCH vaccinated 90 patients utilizing traditional full chart workflows. As BCH refined the clinic processes and began using mass vaccination functionality, during the period of October 7-November 6, 2020, BCH vaccinated 1,590 patients, representing a 16-fold increase.2
“With mass vaccination functionality, it takes only a few minutes to register and screen the patient, place the order, and administer and document the vaccine. When the setting is a drive-thru clinic, the patient and caregiver do not need to leave their car,” said Brenda Dodson, PharmD, clinical integration architect. “Compared to a traditional office visit there are operationally fewer steps for our patients and families which lessens their time investment while maintaining physical distancing during COVID-19 restrictions.”
“One of our clinicians approached us about trying this for other use cases, like standing up an immunization catch-up clinic for patients that missed routine vaccines, either because offices were closed, or they didn't feel comfortable coming in during COVID-19,” said Dodson.
Building on their success, BCH plans to use mass vaccination functionality to support the anticipated COVID-19 immunization effort.
For more information about best practices for COVID-19: Vaccine Preparedness, visit our Model Experience Page. For more information about best practices for COVID-19: Ambulatory, visit our Model Experience Page.
1 Cabrera, Omar, “Flu Vaccine Now Required for all Massachusetts School Students Enrolled in Child Care, Pre-School, K-12, and Post-Secondary Institutions,” Commonwealth of Massachusetts Department of Public Health, accessed November 10, 2020, https://www.mass.gov/news/flu-vaccine-now-required-for-all-massachusetts-school-students-enrolled-in-child-care-pre
2 Does not include vaccinations completed via a traditional office visit or inpatient care prior to discharge.