Locally made app could make vaccine rollout easier
In a typical year, nurses and other health-care workers at the Bruyère Hospital line up to get their annual flu shots. The worker signs a consent form, a colleague gives them the shot and the worker receives a paper record of the immunization.
This year, Bruyère is using new technology called Clinic Flow to streamline that process. It allows workers to make an appointment and complete the consent and screening forms for COVID-19 before arriving at the flu shot clinic.
The vaccine recipient gets an electronic record, which can be uploaded to an app on a cellphone or tablet.
The paperless method has found fans, said Dr. Sufian Zayed, the unit director of Bruyère's family medicine centre, who is overseeing the clinics.
“Flu shots are more important than ever this year,” he said. “The response has been phenomenal.”
Bruyère started the immunization program at its Elisabeth Bruyère and St. Vincent campuses on Nov. 2. Flu shot recipients are being encouraged to get heir shots as part of a family “bubble.”
So far, 1,200 staff members and patients in Bruyère's family practice unit have been immunized using Clinic Flow, developed by CAN-Immunize, a free app developed in Ottawa to help families keep track of immunizations.
Even with additional requirements for PPE and social distancing, the flu shot clinics can handle about three patients every 15 minutes, said Zayed. He and his team are aiming to increase that to four patients in 15 minutes.
The Clinic Flow pilot project is considered a trial run for an even more complicated endeavour — getting Canadians immunized against COVID-19.
“We are looking at this as a process where we can scale it up, potentially across the country,” said Zayed.
COVID-19 immunization will create a number of logistical knots for the public health system, as well as confusion among those seeking to be immunized.
There will be multiple vaccines on the market. Each will have its own safety and effectiveness profile. On Monday, AstraZeneca became the third major drug maker after Pfizer and Moderna to report on late-stage trials of its COVID-19 vaccine.
If vaccines are to be effective, patients must be reminded about when to get their shots on schedule. Medical practitioners must have the right products on hand, said Katherine Atkinson, the chief operating officer for CANImmunize.
If a patient gets the Pfizer vaccine, for example, there will be a second shot 21 days later — and the vaccine needs to be stored at -80 C, she said. The Moderna vaccine calls for a second shot 28 days later.
Because little is known about the long-term efficacy of COVID-19 vaccines, as time goes on, vaccine recipients may require booster shots. This means being able to contact patients with updates and reminders.
Meanwhile, the eligibility requirements may change as vaccines roll out in stages. It is likely, for example, that health-care workers and long-term care residents will be among the first to be immunized for COVID-19, said Atkinson.
The app can let people know if they are eligible for a particular vaccine as requirements change. There may be some people, such as the very young, who are excluded from receiving some vaccines, said Zayed.
The app will allow people to self-screen before they go to an immunization clinic. It's crucial that no one is vaccinated if they have COVID symptoms, said Atkinson.
The technology will also track the safety of multiple vaccines, including among people who don't have easy access to health care. Vaccine administrators will be able to digitally document details, such as lot numbers.
CAN-Immunize was created by Dr. Kumanan Wilson, a physician and researcher at The Ottawa Hospital Research Institute, after he heard complaints about the frustrations of keeping track of children's immunizations on the “yellow card,” a paper record that could be incomplete, or go missing.
More than simply keeping a record, the app provides reminders and allows families to receive updates about vaccine recommendations. The system is managed and maintained with funding from the Public Health Agency of Canada. There are about 100,000 users now.
Atkinson believes that people will be motivated to carry an electronic record of COVID-19 immunization as they start getting back to normal.
Ticketmaster, which sells tickets to concerts and other events, announced earlier this month that it has been working on a framework for “post-pandemic fan safety” that will use smart phones to verify that concertgoers have been immunized, she said. It's also likely that travellers will have to provide proof of immunization before leaving the country.
“If people need it before they go to a concert or get on a plane, people will be quite motivated to use it.”