Integrating a State Vaccine Scheduling System into the EHR

Employees at Keck Medicine of USC, a health system that includes three hospitals and over 40 outpatient facilities in the Los Angeles area, were forced to handle the COVID-19 vaccination wave through the healthcare facility’s access center and phone calls.

Due to the massive administrative burden, TJ Malseed, the health system’s chief information officer, knew Keck Medicine needed to centralize and improve its vaccine administration and tracking as quickly as possible for individuals located in the Los Angeles area.

Engineered by the California Department of Public Health, My Turn Vaccine Scheduling System became the state’s preferred method of vaccine scheduling. And for the folks over at Keck, that meant an EHR integration. 

“Our administration was highly supportive of the My Turn initiative and the premise behind it, which is health equity,” Malseed said in an interview with EHRIntelligence. “In the beginning, it took numerous resources to identify a vaccination solution or website that had available appointments. This way via the My Turn website, users saw the vast majority of sites that were available to do vaccinations in one consolidated location.”

Armed with the specific application programming interface (API), Malseed, along with the mixture of Keck and Cerner health IT professionals, got to work to integrate the solution as soon as possible to alleviate administrative and patient burden.

“We worked through the integration to be able to show when we have vaccination availability with the My Turn website because the state developed an actual API to show when providers have availability,” Malseed explained.

“Our EHR vendor did not have the state’s scheduling solution pre-built in, that would have been impossible, so as the liaison between the state and the EHR vendor, we managed to get the state's representatives, as well as the EHR vendor on the phone.”

Within two weeks, Keck Medicine and the EHR vendor connected to My Turn to enhance how its patient community could schedule vaccinations and its clinicians could administer vaccinations. Keck was one of the first health systems in the state to fully integrate the My Turn Vaccine Scheduling System.

While Malseed and his team scaled for the anticipated volume, the user volume soared to unexpected heights once USC connected to My Turn. Keck initially had a limit of 10,000 concurrent connections, but Malseed saw nearly 40,000 connections to the portal within the first few hours of integration. Keck worked with the vendor to further optimize the EHR’s self-scheduling platform.

“We were reserving appointments at the very beginning when someone started to initiate a transaction,” Malseed explained. “When an individual logged in, the person could hold a time slot and never book the actual time slot. We had to tweak that because until someone actually booked that time slot and confirmed it, it wasn't reserved. It could artificially look booked when in reality it wasn't, so we had to optimize that.”

After ironing out those issues, Malseed said the integration broadened Keck’s previous population base. It also allowed Kek to extend further out into the community than ever before.

What’s more, the EHR integration helped Keck with patient matching, an essential factor in vaccine rollout.

“By using our own native EHR, it allowed us to have more information on the patient when we're vaccinating them, rather than some of the traditional super sites that do not have access to patient data,” Malseed added. “Whereas by executing this process through our own EHR, we participate in health information exchanges, so there is more information available to our physicians when they're vaccinating the patients.”

When an individual schedules her appointment, the system automatically determines if she will receive the Moderna or Pfizer vaccines. Then, the solution automatically sets up a new appointment, whether it is 28 or 21 days out for that patient, respectively. It also facilitates a follow-up solution to gauge whether the individual is having any side effects.

“From a provider point of view, it sends the patient data to the California database and it automatically logs whether or not that individual received the vaccine on the state’s database,” Malseed said. “That way there's no manual entry for the clinician and the patient doesn't need to follow up to indicate that they received the vaccination.”

This specific integration was strictly for COVID-19 vaccinations, but with the groundwork set and the integration mapped out, Keck could leverage the code for future widespread vaccinations.  

“Relative to the My Turn facet, that integration was largely just custom work, but relative to other vaccinations, yes it has been optimized due to the interactions,” Malseed concluded. “The code that we built on a scale for the future could be used to do any kind of mass or large scale vaccinations.