DoH booking a whole lot of trouble
By far the biggest story of the week has been the confusion that has surrounded the roll-out of the Department of Health’s alleged National Booking Solution to support the Covid-19 vaccination program in primary care. Such has been the confusion that some software vendors who sat in on a departmental call with their trade association on Tuesday came away completely shocked that the department did not mean to do what they all feared it would.
Rumour has swirled in the industry over the design of the solution, with many hearing that Accenture had been awarded a contract to build it. Accenture certainly is developing a data solution to trace the vaccines from receipt from the manufacturers to post-administration surveillance, but it appears it is not involved in the last mile of managing bookings and recalls for vaccination clinics.
Instead, that will involve a mixture of existing online booking systems, Healthdirect’s National Health Services Directory and direct appointments with regular GPs and pharmacies. Late this week the Department released a second lot of frequently asked questions that clarified a bit about how it saw the system working, although there appears to still be a lot of work to do. And with Phase 1b to begin in March, there is not a lot of time left.
There are also a lot of major problems with the government’s plans. While it is a good thing that existing infrastructure is going to be used and a monolithic system is not being imposed from above, we have serious doubts that the government has thought through the implications.
A case in point is the mention in the FAQs that there will be an eligibility checker made available that will allow the public, clinicians and presumably administrative staff to check whether the patient is in a priority population group before they make a booking.
What disturbs us is this: “As the online checker is a self-declaration, and not a prerequisite for making a booking, evidence would need to be observed by the clinic at the time the patient arrives.”
People are going to try to jump the queue. People not in the priority populations are going to try to get in early, and then when they turn up at the practice or pharmacy to get their shot they are probably going to be told to come back another time. They are going to be furious and some will unfortunately take out their frustrations on reception and pharmacy staff.
Some will also try to make multiple bookings just to be sure, either through the Healthdirect site or through calls to their regular GP or pharmacy, and no-shows are going to go through the roof. This is already happening overseas.
This could all have been avoided with proper forward planning. We are aware of several approaches to the department last year, when it became obvious a mass vaccination program would be necessary. One we are aware of included proposal for a vaccination management platform that thoroughly assessed all of these risks and covered demand management, supply planning, resource management, patient population prioritisation and consumer communications. The solution would be developed through different iterations and thoroughly tested so that it would be ready when the vaccines were.
The department appears to have sat on its hands. It only issued the data solution tender in November, and is only now getting around to thinking about bookings. Countries as diverse as Lebanon, Egypt and South Africa have all got the jump on their solutions, and on us.
It has left booking solution and practice management system vendors scrambling to start to build new features and applications to help clinics and pharmacies to manage the process efficiently, including things like pre-registration forms for new patients and allowing patients to book for both injections at the same time.
It should not have come to this and we’ll be lucky if we dodge a disaster. We can only hope that the communications campaign the government is planning will be done properly, but we are not holding our breath. The My Health Record opt-out debacle showed that selling these concepts is tough and a lot of people will not be listening.
As part of the campaign, the government should consider encouraging people who opted out to get a My Health Record, telling them it will give them access to their COVID test results and vaccination status, usually within 24 hours. With digital vaccination passports now being developed around the world, we have the start of a ready-made one here.
Let’s hope it doesn’t turn out to be another failure, but again, we don’t hold our breath. Neither do Pulse+IT readers, if our poll from last week is anything to go by. We asked: Is Australia adequately prepared for the mass vaccination roll-out? That was a big no from our readers: 92.5 per cent said nope, with just 7.5 per cent saying yes.
This week, we ask:
Is the national booking system going to work?
Vote here and feel free to leave your comments below.