Better Targeting of Vaccinations at Full Speed

Better Targeting of Vaccinations at Full Speed

W. Falk

Excellent presentation of some really difficult data by the Science Table on Thursday of this week. A full copy of the presentation is available here: https://www.tvo.org/article/heres-ontarios-updated-covid-19-modelling-0

Targeted Vaccine Scheduling to High Risk and Vulnerable Populations

Scheduling systems need to support targeting high risk populations. This needs to be done without degrading performance or efficiency of delivery. More shots in arms comes first. But if we can get better shots in arms without reducing pace we should do so.

This figure from Thursday’s report sets context:

Good scheduling software can subdivide visits by group at existing vaccination sites. This allows for geotargeting, ethical prioritization, and other features which are key to have in at least some of the centres in major metropolitian areas. Science Table recommendations in this area need to be supported by well designed software. Otherwise these prioritization frameworks have to be done by brute force using large call centres which are expensive for PHUs/Govt and frustrating for citizens and residents. The frustration is not only a problem directly (in that it reduces happiness) but also has the likely and  serious secondary effect of increasing vaccine hesitancy.

Good software can support this in at least three ways. First, directly by slot segmentation based on age, Geography (FSA), chronic condition, and workplace status. Our centres can support multiple slot types on the same day and these can be varied based on slot utilization. So for example, Verto Health is supporting Unity Health’s new initiative for 50+ adults in certain FSAs which went live a few days ago. Several other systems are now actively doing this. This approach was replicated across 90 postal codes today at the Premier’s announcement.

Secondly, A variant of slot segmentation can be used to focus call center and other groups to whom a PHU wants to give special rights. So when a site opens to a younger age group, one can allow the site to reserve slots for 80+ so that that key group keeps on having available slots. This has been missed in some large centres and creates an unnecessary tension between getting shots in arms and equity/targeting. Good software supports multiple goals. Again, Verto does this in a way that does not rely on just call centres. Both of the first and second methods here are done by several of our competitors include Microsoft BI, Iamsick, Medme, and Medessist (among others). The right software choice should support these two functions to create options for policy makers

Thirdly, Verto allows the distribution of Digital Tokens to targeted groups and trusted third parties. The ability to download digital tokens to smaller teams has now been demonstrated by Verto in several client sites. We do or can support FHTs, NORC distribution, Community vaccine sites,  and others. We think that this more advanced capability is going to be critical going forward. We are working with our client sites to think about distribution to at risk workplaces. We have considered faith-based groups and neighbourhood houses as distribution channels. We could even simply print off time-limited QR codes that could be handed out target people. Our competitors may be developing these capabilities as well but we are unaware of them in the market yet. To the best of our knowledge the “provincial system” supports none of these options at the moment. Although it does enable them by providing a common data store that it, we and all other competitors report into. The key point is that the data store functionality is entirely separate from the scheduling functionality.

It would be our privilege to better serve Ontario. We know that there are at least a couple of our competitors who could also step up. Many of the features we have discussed above are already widely available at enough of a level to handle without cost: Toronto, Peel, York, Waterloo, Durham, Algoma and London under existing contracts with no added fees. 

@willfalk

Conflicts Declaration:

I have writen this paper as an investor in and a member of the Board at Verto. Verto is a Toronto-based software company that employees 50 people. It developed and deployed a vaccination scheduling system in December of 2020. Currently that system provides the scheduling and system support for about 115k vaccines a week in Ontario. A little over 18% of the total. We support about 30% of the daily Toronto totals.

We have a “worm’s eye view”. We are passionate about great software development service the health care system. 

Good Software Opens Policy Option