Call to Action: Unique Circumstances Require Public-Private Collaboration

Today, over 31,000 pharmacies are electronically connected to state immunization information systems throughout the United States. The opportunity to increase this number to 50,000 in the next six months significantly strengthens Public Health infrastructure to support the COVID-19 pandemic and all future immunization and Public Health reporting requirements.  

As a new COVID-19 vaccine moves closer to approval, it is evident that increasing the number of connected partners prior to the delivery of the vaccine will be critical for the success of the eventual vaccine rollout. By utilizing the established network, leveraging current public-private partnerships, and additional investment, we are confident that these relationships will result in a 60% increase in the number of connected pharmacies.   

On behalf of the over 31,000 pharmacies participating on our network, we ask Public Health to consider investing in the expansion of the network in their states to specifically:

1. Ensure that all vaccines provided in your state, for all age ranges (including a COVID-19 vaccine once available), are administered to the right person at the right-time and that the data regarding population coverage is available to your Public Health team through streamlined onboarding and information sharing.
2. Leverage pharmacies to test and initiate treatment for flu, strep and minor ailments resulting in the preservation of scarce medical providers and hospital resources during this time.

When an existing or a new vaccine is required to reach large populations, the underserved, or targeted subpopulations the pharmacist becomes the third health care partner alongside physicians and Public Health. It is critical that every vaccine administered is available within immunization information systems through bi-directional exchange so all health professionals, Public Health, and individuals have access to this vital information. 

Ensuring the maximum electronic connections increases real-time information and situational awareness. Information derived from data empowers the users of this network to inform and influence. If 60% or more of the health care provider community is connected to Public Health, the increase in real-time information more than doubles.

The patient’s immunization information record, when retrieved from these consolidated Public Health systems, informs the provider, caregiver or individual what immunizations have been received and where gaps in coverage exist to better inform Public Health policy. This will be especially true during the rollout of a COVID-19 vaccine, as the world will be watching. Having access to real-time data will be critical for Public Health leadership to make informed decisions on vaccine distribution and administration.  

Provider connections to Public Health allow reporting of a vaccine adverse event, monitoring and managing inventory, analytics on the populations they serve, and best practice communication. Connected networks improve Public Health’s ability to determine population immunization coverage rates for diseases ranging from Measles to Shingles. Geographical representations of data illustrate areas of the underserved. The users of this network benefit by knowing where vaccine resources are available at any point in time. Health leaders have current data with analytical representations of information to support response, operational tactics, and information requests.

For 31 years, STChealth has provided Public Health programs with technology to support their immunization and disease reporting systems. Since the 2009 pandemic, we have partnered with a retail pharmacy and currently work with all retail chains and many of the independent pharmacies. Along with our partners, this national immunization data exchange network connects every state immunization system to pharmacies throughout the United States. 

But it is not enough. Too many of the pharmacies and many providers are only reporting immunization events. They have not activated these connections to support real-time data retrieval. Their ability to retrieve a patient’s immunization history at the point of care to include decision support that identifies the individual’s immunization gaps is limiting their ability to influence using Public Health as a trusted source. 100% of the current 31,000 connections should all support real-time 2-way communication.

It is also not enough that a significant number of pharmacies and providers are operationally ready and are waiting in queues for Public Health to on-board each location. This represents 30% of an additional 19,000 connections that would support our goal. As mentioned above, 100% of these would also support real-time communications.

At STChealth, our onboarding teams are working hard to more rapidly help Public Health connect to pharmacies, EHRs, and schools. We serve as the point of contact and facilitator for our partners, who include the pharmacy associations, state immunization coalitions, vaccine manufacturers, payers, EHRs, and Health IT vendors. Each is investing time and resources to support increasing this connected network. 

We have determined if every state set aside $250K-$500K to accelerate their Public Health immunization connections, we would reach and likely surpass the 50,000 goal. 

But we want to do more. While this network primarily shares immunization data, the underlying infrastructure in production is built to support all required Public Health reporting, including point-of-care testing results and notifiable conditions. It is time to operationalize this network to add pharmacy clinical testing, reporting, and potentially consumer COVID-19 in-home test reporting.  

We encourage Public Health officials to allocate funding to their immunization programs and preparedness funding for these types of efforts. We can take a more direct role and facilitate your state’s expansion by partnering through the state pharmacy associations, immunization coalitions, or leveraging national pharmacy membership organizations to fast track the state onboarding efforts with the support of Public Health.  

If we can provide you with an analytic view of the number of connections in your state and their current utilization, contact either Todd or myself through our email, michael_popovich@stchome.com, and todd_watkins@stchome.com.

Sincerely,

Michael Popovich |CEO STChealth| 520-488-9589 (c)

Todd Watkins | President  STChealth | 505-504-0037 (c)

Connected Health Networks Create an Opportunity

In the last decade, public health has made significant investments in disease surveillance, reporting, and management systems. They have made a significant investment in their immunization systems and in the electronic connections to providers that have increased the quality and quantity of data that is available.

One result which can be highlighted today is these investments have significantly improved public health preparedness during this present outbreak. The ability to report COVID-19 test results electronically to public health and CDC, rapidly create new patient and contract tracing forms and better manage this information is saving time supporting the impact on limited resources of health professionals.

Today immunization registries are capable of managing patient immunization events, tracking vaccine delivery, monitoring utilization of inventories to the dose level and providing real-time decision support to a clinician or pharmacist while their patient is receiving a requested or recommended immunization.

In 2020, our joint public health infrastructure is 50 times more efficient than in 2009 when the H1N1 pandemic occurred, and 100 times more effective after Anthrax in 2001. These technology resources are an asset to all working with the current pandemic. Every state has made progress. There are gaps that are highlighted when under stress. But these gaps are relatively minor when compared to the information systems in 2009 or 2001. Most importantly these gaps can be closed relatively quickly because of what exists today.

We at STC have worked across this technology ecosystem for 31 years. We see the next key is to connect more health care professionals and consumers to these existing public health networks. As connectivity grows we can increase value by building on immunizations adding RDT reporting and analytics that utilize the growing data assets. 

Four suggested “next steps” to increase the public health infrastructure are summarized below.

1. Strengthen the current data exchange network. Congruently, we propose to expand the 31,000+ pharmacy, 3000 EHR, and 1000 school locations currently connected to public health immunization systems to 50,000 total. The current number of connections varies by state with rural locations less served. Expanding this network to 50,000+ bi-directional connections increases the capacity of immunization programs everywhere.  Without these connections, state immunization systems have missing data that would prove valuable in supporting current vaccine programs as well as when a new vaccine is released. 

An emphasis will be placed on the retail pharmacy. The pharmacist is in a unique position to help. Approximately 90% of all US citizens live within 5 miles of a retail pharmacy location. With this type of reach and the ability for all occasions to share data with public health, we support closing the care gaps for all individuals within your state.

Our goal is to connect locations, public and private health care providers who provide vaccinations, ensure data is electronically reported to public health and real-time access through to data is available to the provider.                                 

1. Engage the consumer. We propose to expand consumer access to state immunization systems. This will be accomplished directly through partnerships with public health and through this network leveraging the pharmacy customer relationships. Partnering with pharmacies has demonstrated significant value when individuals have access to their family immunization histories. Increased awareness and uptake of other recommended vaccinations continue to help individuals avoid vaccine-preventable diseases. 

Our goal is to empower individuals through improved access to their immunization histories. 

1. Pharmacy remote diagnostic testing reporting and home COVID-19 diagnostic test reporting. We propose to add to this connected infrastructure the ability to report COVID-19 test results to public health from home or if in the future Pharmacy testing. In addition, as the clinical roles of pharmacists increase,  these networks will expand to report rapid diagnostic testing to public health. Part of supporting this infrastructure is ensuring pharmacists are allowed to test and initiate treatment for flu, strep, and minor ailments to alleviate stress on the rest of the medical community to help with treating COVID-19.  

Our goal is to deliver through this connected network pharmacy RDT results to public health and include a consumer reporting component.  

1. Analytics for Use. Currently, this existing network supports the immunization records of over 70 million individuals. The 31,000 pharmacies alone have reported over 600 million immunization events to public health in the last few years and nearly every day 1 million immunization forecasts are provided to a practitioner or pharmacist at the point of care. Data and reporting capabilities will continue to be an urgent need as public health fights to contain this disease and continue their efforts with all VPD. 

Our goal is to implement public health dashboards that deliver analytics to end-users supporting the objective of what gets measured improves. Furthermore, this analytical effort will expand information by populations and geographically to advance public health immunization program goals and provide views of immunization coverage to state health leaders and the CDC.