Pandemic ripe for surveying patient experience

Our blog from last week on the difficulties some people have had trying to find and book in for a vaccination took on extra meaning this week, as metropolitan Sydney’s outbreak worsened and Melbourne snapped into a hopefully short and sharp lockdown. Vaccination is the key to all of us getting out of this, but besides the problem with adequate supply in Australia and late supply in New Zealand, it’s our IT systems that we are relying on to help us navigate our way out of disaster.

NSW Health’s systems are among those that have come in for a lot of criticism, and confusion still reigns over what exactly they plan to do about it, but we have also been closely watching what each state and territory in Australia is doing, along with the national system in New Zealand.

NZ puts up a good front but it has put all of its eggs in one basket in just choosing the Pfizer vaccine for the whole population, and it has also come in for a bit of criticism about its immunisation register and national booking system, which isn’t even scheduled to go live until the end of July.

The NZ Ministry of Health’s head of data and digital Shayne Hunter has been at pains to explain that there were other priorities before rolling out the booking system, now being dubbed Book My Vaccine and using the Skedulo app, originally designed to manage mobile healthcare staff and built built to interact with Salesforce’s health cloud. It is also being used by Western Australia.

Health Informatics New Zealand is reporting that all of the old district health board appointment systems have now migrated to the national system, so fingers crossed that all goes well when the national system goes live in a fortnight.

Meanwhile, Microsoft has been touting the benefits of its system for Victoria, although we understand that not all health services are using it even though it was destined to be a statewide solution at a cost of $9 million. Austin Health, for example, is now going to implement a local solution from HotDoc, as is St Vincent’s in Sydney. Queensland is also using the Microsoft solution, and from what we can garner from our readers, it’s doing pretty well.

South Australia is using its Allscripts EMR for some purposes, the ACT is using its Epic system known as MyDHR, and Tasmania is using Oracle. NT Health finally came back to us with an answer to questions lodged a while back about what it is using, in stereotypical bureaucracy speak: “NT Health has worked with the Department of Corporate and Digital Development to develop the Territory’s COVID-19 vaccine online booking system using specialist resources sourced from local Northern Territory digital businesses.” No, we don’t know what that means either.

Unlike Pulse+IT’s experience in NSW, down in Tasmania we have pretty much found the process seamless. When the 40 to 49-year-old cohort became eligible in early June, we hopped onto HealthDirect and found the recommended Pfizer vaccines available through the Royal Hobart Hospital Community Clinic. We clicked on that clinic as the preferred choice (it was the only one), were directed to the Tasmanian COVID-19 vaccination booking system, which uses Oracle’s mass vaccination solution, and were able to book in for our first shot within five weeks.

We were sent an email confirmation on booking, another the day before the appointment and another two hours beforehand. The whole process was exemplary, including the shot itself, the information provided, the shake of the head from the nurse when Pulse+IT’s staffer told her we didn’t read the website properly and didn’t download and pre-fill the consent form, the QR code to scan in for the AusVaxSafety survey while waiting the mandatory 15 minutes, the booking of the next shot on the spot, and the backup emails from Tas Health and AusVaxSafety with second-shot booking confirmation and the side-effects survey within hours and days. We also were able to see our vax status on our My Health Record and Medicare the next day.

While Tasmania’s system has been seamless, it also must be said that a state of half a million people is not an actual metropolis like Sydney or Melbourne, and the load on its systems is minuscule in comparison. The only criticisms we have, and these are minor, are poor signage and wayfinding at RHH – it’s not alone there – and that patient experience data is not being collected when it should be.

This brings us to the results from blog and poll from last week, which garnered a lot of comments and votes, most of which were overwhelmingly positive about everyone’s experience so far, whether it is in a hospital, a mass vaccination centre, a pop-up clinic or a general practice. In particular, we received some really good data – both positive and negative – from 135 free text comments, which are incredibly constructive and something that health services could learn from.

The ease of use of SMS booking reminders and patient experience surveys, and simple technologies like Press My Button, should really be used to refine health service provision not just for pandemics but for everyday experience. But in a time of pandemic, when our attention is purely on it, this is the time to gather patient experience data and use it to refine the booking and vaccination journey.

We particularly like this tweet about the side-effects of the vaccine and the willingness of patients to tell their stories: “Experienced some shortness of breath after getting vaccinated; quickly realised it was from telling everybody I'd been vaccinated.”

Our poll last week set out to gauge where people were getting their shots, but we also asked for optional feedback. 43.5 per cent said they attended a hospital, while the rest were a mixture of GPs, mass vaccination centres or pop-up clinics. The vast majority had an excellent or good experience, although some found the process very difficult to navigate, much as Pulse+IT did last week with the NSW booking system.

Overall, we found that the more difficult people found the process, the more detailed were their criticisms. There is something we can all learn from this.

That brings us to our poll question for this week:

Has the vaccine roll out in Australia and New Zealand been handled competently?

Please feel free to leave your comments when you click here to vote or leave your comments below.

Tags: COVID-19


0 # Simon James 2021-07-23 17:50
In the week following this editorial, Pulse+IT received many responses via the poll in an optional comments section. Respondents were asked to comment on what their governments had done well and where improvement was needed. Some of the more substantive comments are included (unedited) below:

- Could have Utilize ‘flu vaccination networks’ already established systems; stop dictating vaccine type by age; acknowledge political stuff-up of investing in one vaccine type, then forcing that vaccine type on the population, to offset the spend present and future on multi million dollar contract; Poor or absent communication Nothing done well.

- Made solely a nationally directed project with defined national decision makers

- I concur with Steven Duckett's assessment of the problems: Plus, the politics has got in the way of responding to this national emergency. The PM set up a national cabinet to deal with this but he and the Premiers still play politics. A good example is how the Federal government criticized the Vic Labor govt but has been silent about the NSW Coalition Govt during this lockdown.

- Should have had mass vaccination centres from the start and vaccinate aged care and disability workers with residents

- By making sure this Federal Government has nothing at all to do with it. Devolving responsibility to the States has improved the situation.

- Have 3 streams , 1 front line workers - use health id numbers to track us, 2 risk groups ie aged and chronic disease - use gps to identify their at risk patients, 3 others who want it - to get the herd numbers up

- I am 66 and after attempting to be vaccinated by my GP's clinic (Astra Zenica finally advised against due to my medical condition) was sent by my GP with a written medical history to get Pfizer. Was turned away here after confusion on the part of security and staff. Minimal signage in Sydney to vaccination centre, contradictory information about what I needed to do, no assistance to resolve information with me towards a positive end. After long and distressing waiting I was turned away, unvaccinated. Told I had not followed procedure and neither had my GP, by a hospital vaccination manager. She told me to go online and make an appointment. Suggested November would be the earliest due to demand. I have tried online ever since with no positive results. The National Vaccination Health Line 24/7 was answered by a machine saying that it was overloaded with calls. Telling me to ring back, it hung up. Multiple attempts to get through - the same. What has been done well? One on one support and advice from my GP. If he had had Pfizer vaccine on the day, I would be vaccined by now. Instead - frustrated and at risk.

- Take the responsibility off the feds and let the states do their thing - they deliver health care. The Aged Care vaccination program and allocation of vaccines by Feds has been a complete shambles.

- Microsoft, Salesforce etc have all failed, unlike what Sydney LHD has done with an Australian home grown system. So got could have panned since last year and worked on keeping these international companies accountable, especially when millions of $'s of Australian tax payer money is being spent. The system in QLD is so bad that not only ppl are having issues getting an booking, but I have heard of cases where they are told that their first dose was AZ when it was actually Pfizer.

- Govt could have just planned this all so well, rather than playing dirty politics.

- It was done well! However, it is hard to stop people who do not realize the benefit of heard immunity! Perhaps they need to be reminded of Polio, Diphtheria and Tuberculosis?

- Simple where I live in Toowoomba. Rang up GP and got an appointment for AV. Process took about 1/2 hour including the wait time. No dramas.

- Should have used general practice more and engaged us earlier

- Astrazenica roll out should have all been through the GP system, same as flu.

- The country should have been pushing vaccinations out faster when the country was in a good position than while there are multiple state outbreaks which frustrates people waiting.

- Agree on a national approach with bookings. India has delivered 350M vaccinations all citizens receiving a digital certificate. Booking system handled 13.5M registrations in 8 hours when launched for 18-40 y.o. They have states and yet developed national solution. Sine having my AZ 8 weeks ago I have not been contacted once asking about my experience or any side effects. Nor has anyone else I know who has been vaccinated. What a waste of valuable information.

- I am in 1b and when my category was announced, I looked for the nearest government supported respiratory clinic, booked in, went in and all done. So what I had to drive an hour? To save my life that is a small thing. Do better? It all worked for me and that has to be my base for making a comment.

- Actually ordering several different vaccines from multiple supply sources and getting them to the "coal face" of General Practice in hours and in sufficient numbers to meet demand.

- More urgency, actually vaccinating groups 1A & 1B. NSW Health has run clinics well, once started.

- Act sooner, consistent messaging, emphasis all vaccines have risks to give perspective, ramp up pharmacies, GP's and COVID testing sites as immunisation hubs. Bugger all was done well.

- By having the national and state leaders co-operate cohesively, as in this day and age, data should be travelling across "Lines on Maps", instead of point scoring

- Follow the UK model. Send people an appointment as they become eligible. Relying on people to be informed and take appropriate action is not efficient or effective. Target priority groups.

- IMPROVE: National quarantine coordination (transport Australians from OS, have National quarantine sites identifed eg., Armed Forces bases with airports; National mass vaccination plan (not GP local proctices only) with logistics management of supply, delivery & in-situ jab of all prioritised workers Nationaly coordianted with States./Territo ries(heathcare, aged care, defence, welfare, education, police & emenergency services staff); data managemet of vaccination bookings on a National scale & post-vaccinatio n follow-up (the COVIDSafe App was a useless failure!)
DONE WELL: 1. showing how badly politicians make 'public health' decisions at random without strong Public Service & expert advice. 2. Using the post-vaccine survey (SMS/email) to follow-up for side effects in vaccinated people for each 1st & 2nd jab

- I think our pollies should be ashamed of how they've behaved to each other. This should have had bipartisan support and also not be a subject for federal-state point scoring.

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