How Creative EHR Optimization Streamlined COVID-19 Vaccination

At Mary Washington Hospital, getting a vaccine appointment is as easy as getting a table at your favorite restaurant, thanks to an innovative EHR optimization process.

CORRECTION: This article is updated to clarify Mary Washington Healthcare operates its COVID-19 vaccine clinic as a public service and it has not charged, billed, nor collected any payments for any vaccines administered at that clinic. 

Situated in the center of Virginia, the hospital is within driving distance of Washington DC, Maryland, Delaware, and Richmond, VA. Thus, the hospital was averaging roughly 2,500 COVID-19 vaccine shots per day, and its leaders knew EHR optimization was in the cards to streamline the vaccination process and mitigate potential clinician burnout.

First, Stephen Hughes, director of IS technology at Mary Washington, attempted to leverage the organization’s EHR vendor to adapt to the rapidly changing environment.

“We were able to get some use out of the clinic set up and create normalcy once individuals entered the clinic and how we get people through the system,” Hughes said in an interview with EHRIntelligence. “However, we needed to figure out how to get people quickly and easily into the vaccine clinic and to let them know that we had these options to sign up.”

In the early stages of vaccine rollout, Mary Washington Hospital, like every other healthcare facility, had to target specific audiences for the vaccine. 

“It seems like a hundred years ago now that we were worried about not having enough vaccines,” Hughes added. “Now we don't have enough people to come in, get the vaccine, but in those days it was, how do we reach target audiences?”

Once the targeted audiences started filing in, with upwards of 2,500 individuals coming through the hospital campus daily, the physical real estate to care for that high number of individuals became an issue.

“There is a certain amount of solutions within the EHR that were useful at the time,” Hughes said. “In the end, we knew we had to get patient X, and whatever that interaction was had to happen in the EHR. But we had to find ways to creatively go outside of the EHR vendor to supplement. We had to come up with creative ways to identify groups that we wanted to reach out to, to set up scheduling possibilities without being too wide open.”

Mary Washington Hospital felt the burden and impact of an overwhelming amount of individuals coming in for vaccinations into its medium-sized hospital. Faced with limited resources, leaders converted a conference center on campus into a walk-in COVID-19 vaccine clinic and constructed tents for check-in.

As a result, Hughes and his team decided to leverage a popular restaurant booking app on top of its EHR system to enhance its patient scheduling and streamline the vaccination process.

“The fact of the matter is, the EHR vendor has contactless scheduling and it was an option,” Hughes said. “In our case, given the little time we had to set it up, there was no way to get it set up fast enough for individuals who had never been to the EHR vendor-based hospital before. We had to find an alternate solution to quickly create a semi-integrated universe where this could fit together and get people through the system.”

In order to fix the issue, Hughes talked to multiple partners and consultants to find the perfect solution. After almost committing to a clinic management option, Hughes said it didn’t make sense due to time constraints.

Ultimately, Hughes decided on a popular restaurant app.

“For instance, someone drives up through the parking lot, they follow a series of parking signs to take them under a tent” Hughes described.

“We have an individual who utilizes the app, takes the information on the phone, and checks them into the waiting room, the parking lot,” he continued. “Then, there was someone who worked in the queue role, like a host or hostess in a restaurant. That person was then in communication with the clinical leads and the people who are handling registration from the EHR system.”

When an individual walked into the door, a Mary Washington Hospital employee connected them to the EHR for registration.

“We looked at possibilities and the restaurant app offers API capabilities into the EHR to pre-populate and carry over patient information to the EHR,” Hughes continued. “Although there were other options or solutions, integration was too slow compared to the fact that we had to ramp up quickly at 2,500 people and then get them through these tests.”

The restaurant app got the patient into the front door of Mary Washington Hospital and into registration.

“We knew throughout the scheduling, for instance, that we could build 15-minute increment blocks to get every scheduled individual vaccinated throughout the day,” Hughes added. “We would leverage the data that we got from the app for how quickly we saw people able to come in through the system.” 

Once the individual entered the “waiting area,” Hughes said it took roughly 25 minutes for the entire vaccine process. This time period was significantly less than it took pre-optimization.

In the end, Mary Washington Hospital leaders found a way to quickly leverage an outside app to streamline the overwhelming vaccination process.

“Based on the needs of the clinic and also how long we thought we were going to be operating it, it ultimately did not make sense to integrate a complicated scheduling solution,” Hughes concluded. “It made more sense to try and refine the clinic operations. We directed those resources inside operations and scheduling operations to try and draw the public in.”