New Haven Register (New Haven, CT)
Many vaccine dates? It’s possible in CT
A quirk of Connecticut’s decentralized vaccination appointment system means that one patient could make many appointments with different providers, a scenario that has state officials hopeful that people will cancel appointments once they've been vaccinated.
“Unfortunately, that is the case that individuals can potentially make appointments on more than one scheduling platform,” said Maura Fitzgerald, a state Department of Public Health spokeswoman.
On Monday, about 600,000 people in Connecticut will become eligible to be vaccinated against COVID-19, including everyone over the age of 55, plus all teachers, educators and people who
work inside schools.
Any one or all of those 600,000 people could, theoretically, make an appointment using Yale-New Haven Health’s platform, and the site managed by Hartford Healthcare, Nuvance, CVS and Walgreens.
“There’s no centralized scheduling process,” said Ohm Deshpande, vice president for population health and a physician leader for Yale New Haven Health’s vaccination program. “The state has had something called VAMS, which obviously has not fully met the need.”
Cornelius Ferreira, system chairman of primary care at Danbury-based Nuvance Health, leading the Nuvance Health Vaccines Task Force, said it’s an attempt to make sure patients actually get an appointment.
“Individuals do sometimes schedule multiple appointments at different sites out of fear they will not get a vaccine,” he said. “We encourage folks to schedule one appointment only and to return to their first dose site for their second dose.”
But the ability to schedule multiple appointments isn’t necessarily a bad thing, Fitzgerald said. It means that people will be better able to make appointments. It means there is no centralized system that can crash, that there won’t be a bottleneck on the user side.
As long as people cancel their appointments when they decide to keep one.
“We would hope people who are shopping around for convenient times and locations would keep their fellow residents — who are also trying to secure appointments during a time when our supply of vaccine is dwarfed by the demand — in mind and would kindly cancel appointments that they don’t intend to keep so that other people can fill those slots,” she said.
Deshpande said Yale has maintained a philosophy to “waste no vaccine,” so when people do miss an appointment — perhaps because they’ve made another appointment elsewhere and failed to cancel — staff members hit the phones.
Other patients, whose appointments might not be for days or weeks, are often “thrilled” to come in for the shot that day, Deshpande said.
“We’ve been wasting pretty much nothing,” he said.
Though one patient making multiple appointments is an issue, it’s not a crippling one.
“It’s not something that is of such epidemic proportions that it impacts the process,” Deshpande said.
On the other hand, states that have fully centralized vaccine appointment systems have had some significant issues.
When Massachusetts allowed residents older than 65 to make appointments, the state’s vaccine finder website crashed. David Eaves, a lecturer of public policy at Harvard Kennedy School, said while that wasn’t predictable, it’s also not rare.
“This outcome is more common than one would think,” Eaves told the Harvard Gazette. “What is particularly challenging is that government is still wrestling to acquire the new skills and processes the organization needs to launch a service.”
Similar systemwide crashes and “latency issues” caused by demand were seen in Georgia, Indiana and Tennessee, among other places.
When the city of San Antonio, Texas, opened up appointments in January, 9,000 people signed up within six minutes. The centralized system did not crash, though officials were not prepared for that level of demand.
“The registration system worked as designed, but there is far greater demand than available supply at this time,” San Antonio Assistant City Manager Colleen Bridger said in a statement.
Though the state’s system is not centralized, Connecticut health care providers are working toward a solution in the coming weeks that will bypass any potential overload.
Many of the providers offering COVID-19 vaccinations use a medical records management system called Epic, which Deshpande said “allows for interoperability through separate health systems.”
So when a patient makes two appointments with separate health systems — with Yale and CVS, for example — the providers will be able to see that and decide which appointment stays on the books.
The goal, Deshpande said, is to minimize the possibility of a noshow, though the system is not yet ready to handle that application.
“I think we’re still in the process of integrating that data,” he said.