Over the past 12 months, Arcadia has empowered our customers to reach out to millions of patients to improve engagement and coordinate critical vaccinations and other preventative care. Those health systems and health plans have gained experience with complex patient engagement campaigns; their learnings offer important lessons as we prepare for COVID-19 vaccination outreach.
As infections, hospitalizations, and deaths from COVID-19 climb around the country, hope is on the way. But that means healthcare organizations must quickly prepare a patient engagement strategy for COVID-19 vaccinations, and that strategy needs to include four key components:
Your organization may be starting to distribute the first doses of COVID-19 to healthcare workers and elderly patients, but rising cases and the limited vaccine availability mean that you will need to continue to educate your patients on how they can stay safe and reduce risk until the vaccine is more broadly available. Now, it’s more important than ever to encourage patients to stay home, socially distance, and wear masks. As cold and flu season picks up, more patients are going to need help determining whether their symptoms warrant testing.
Meanwhile, you will need to share important information about COVID-19 vaccine safety and availability. Patients are getting news about vaccines from a wide range of sources, both reliable and unreliable, and some may have questions or concerns; others are eager and wondering when they’ll be able to get vaccinated. Health care providers are uniquely positioned to offer trusted resources to inform patients and encourage them to get vaccinated, moving us closer to herd immunity.
“Ensuring that messages are accurate, available, and comprehensible is insufficient — recipients must also trust the messenger. Trust is most likely when information is delivered by a messenger who is known and has a positive relationship with the community.”
— Annals of Internal Medicine
Providers need to consistently and repeatedly deliver and reinforce medically accurate messages that their patients are hearing from public health leaders on television and other media outlets. Health systems should actively explore opportunities to partner with local community organizations; this is an important strategy to connect with populations that may be historically underserved.
Finally, you will want to identify high-risk cohorts of patients for specific vaccine outreach campaigns. You may want to survey patients to understand risk factors such as occupation and incorporate this data into your stratification approach.
Successful patient engagement campaigns are not one-size-fits-all, but your approach to stratifying your population needs to be carefully considered. Many of us are now familiar with the dangers posed by relying only on historical cost information to risk-stratify populations; this approach can exclude underserved population and suffer from racial bias in identification of needs and access to services.
To identify cohorts of patients who meet the criteria for early vaccinations, you will want to leverage additional clinical and demographic data, including insights about job type that you may have gathered from patients and condition history. Be sure to incorporate race/ethnicity and census block data to ensure you are surfacing high-priority vaccine candidates in historically underserved communities.
Once you have identified priority patient cohorts, you can run targeted outreach campaigns to those cohorts to send information on scheduling appointments to nudge patients to get vaccinations. You can also inform patients about locations that are offering the vaccines and continue to reiterate the importance and safety of getting a COVID-19 vaccine.
Some patients may receive vaccines administered outside of your health system. You will want to use screeners and assessments to capture this information and move these patients to a different patient engagement campaign focused on ensuring series completion.
Many health systems worry that patients will not return to receive the second dose of the vaccine. If enough patients skip the second dose, it will take longer to achieve herd immunity and at least one scientist fears that the COVID-19 virus could become vaccine-resistant.
University of Michigan medical school professor Mark Fendrick estimated that, “as many as 30% of patients who get the first dose of a COVID-19 vaccine may not return for a second.” In normal circumstances, patients frequently miss scheduled appointments or do not fill prescriptions — and the side effects of the COVID-19 vaccine could be severe enough that patients do not want to receive a second dose.
In the absence of a coordinated federal initiative to engage patients on series completion, health systems and plans will need to step up outreach efforts. You will want to monitor that patients who have received the first dose — at your facility or elsewhere — to educate them about side effects and ensure they have appointments scheduled for the second dose. Send reminder messages to patients who haven’t scheduled their second appointment and in advance of the second appointment to help ensure they complete the vaccine series for optimal outcomes.
Population-wide vaccination is an enormous undertaking, and your organization will need up-to-date performance insights about patient engagement campaigns and vaccination administration to understand where to invest effort. You will need to track the portion of the eligible and total population that initiates and completes the vaccine series, present a glide path to herd immunity, and track intermediate milestones.
With the pandemic having the severest impacts on historically underserved populations, ensuring health equity is critical. You will need to monitor for racial, ethnic, and socioeconomic disparities in vaccine administration so that you can identify populations not receiving vaccinations and adjust your engagement approach.
Black Americans are less likely to get the vaccine, but research reviewed in the Annals of Internal Medicine found that having Black physicians present educational messaging is likely to increase patient engagement. You will want to ensure you can monitor engagement, determine if certain populations are not responding consistently, and finetune your educational messaging accordingly. Consider surveying patients on their attitudes toward the vaccine to understand the types of concerns your campaign will need to address.
Women in your community may also be more skeptical of the COVID-19 vaccine. In addition to statistically being more risk-averse than men when it comes to new medical advances, they may have specific concerns about the impact of the vaccine on pregnancies. Consider partnering with primary care providers and OB-GYNs in your system to develop more target campaigns as needed.
Finally, be sure to incorporate exception reporting. It may not be clinically advisable for certain patients to get the vaccine; carve these patients out of your reporting so that you can focus on the actionable population, and monitor these guidelines as they may evolve.
If you’d like to hear more about successful outreach strategies from innovative healthcare organizations, watch our on-demand webinar discussing new strategies for patient engagement.