Without a solid plan in place for scheduling vaccinations, revenue cycles will easily find themselves overwhelmed by the influx of phone calls, emails, and appointment requests.
As hospitals across the country take on the gargantuan task of vaccinating tens of millions of people against COVID-19 in just a few months, there's one element of the effort that revenue cycle leaders cannot overlook: Scheduling.
Without a solid plan in place for scheduling vaccinations, hospitals will easily find themselves overwhelmed by the influx of phone calls, emails, and appointment requests. That's already happened in some places, including Carolinas HealthCare System Blue Ridge in North Carolina, where the CEO issued an apology for the vaccination phone system issues.
Hospitals and health systems that have already invested in streamlining patient scheduling will find themselves at an advantage, and organizations that haven't done so can learn from their example.
Among the leaders is Georgia-based Piedmont Healthcare, which launched its Patient Connection Center (PCC) in 2017. The PCC is a centralized department that completes preservice functions for all hospital‐based services and employs more than 400 people.
Once the vaccine was approved, the PCC implemented its scheduling process quickly and efficiently.
"It was very much heads down, brainstorming, working through process flows," Allyson Bonner Keller, FACHE, the Patient Connection Center's executive director, tells HealthLeaders. There were "a lot of people working through long hours and late nights to make it happen."
That work is paying off. Keller says that between January 11 and 28, the PCC handled more than 23,000 vaccine–related calls, in addition to its day-to-day work, including 2,000 vaccine calls on January 27 alone, making it the highest call volume day yet. In total, Keller says Piedmont vaccinated more than 20,000 patients within that two-and-a-half-week span.
Here are four ways that Piedmont Healthcare successfully optimized its vaccine scheduling.
1. Use technology to its fullest
Nearly overnight, the PCC staff was handling thousands of additional inbound calls, navigating complex vaccination procedures and questions, and scheduling vaccines at multiple locations for both Piedmont staff members and patients. They couldn't rely on sheer manpower alone to do it.
"We stood up [vaccine scheduling] in a very quick time frame and have relied on multiple pieces of technology to help support that along the way," Keller says.
First, the PCC staff set up a dedicated phone line for vaccination calls from hospital employees seeking to schedule an appointment. When the state of Georgia expanded vaccine access to include the first group of eligible patients, Piedmont added prompts to the phone line so callers could specify whether they were a patient or Piedmont employee.
Although patients can schedule vaccinations via their Epic MyChart patient portal once they receive a ticket via email, many choose to call the PCC to do so. The PCC staff uses Epic to schedule patient vaccine appointments. They also use scripting and workflow tools, daily updates, and FAQ documents from Salesforce.
In addition, Keller says using Microsoft Teams has also been helpful, especially since staffers are working remotely.
"They can chat at any point and ask us a question if something comes up," she says. "As things change rapidly in this situation, it allows them to ask us a question anytime and while they still have the caller on the phone."
Technology helps with the vaccine dosing itself, too.
For example, there are 21 days between Pfizer vaccine doses and 28 days between Moderna vaccine doses, but patients aren't guaranteed which vaccine they'll receive when their first doses are scheduled. For that reason, each dose must be scheduled separately.
Scheduling through Epic automatically generates an order for the correct second dose after the first dose is administered, and patients can either schedule their second dose via MyChart or call the PCC to schedule it for them.
2. Get all hands on deck
The PCC took a multipronged approach to handling the new influx of vaccine calls. During phase one of the vaccine rollout when only Piedmont employees were eligible to make appointments, the PCC shifted some of its staff to work on the vaccine line. Keller says they have dedicated employees for the vaccine lines but shift people to work in other areas as needed, depending on the vaccine line volume.
In addition, once eligibility expanded to include certain patients, they enabled all PCC employees to be able to handle a vaccine call if one came in outside the dedicated vaccine line.
"As soon as we knew the state had opened up the larger criteria beyond the healthcare workers, we enabled and empowered anyone that answers the phone in the connection center to be able to schedule that vaccination," Keller says.
They achieved this with the help of the PCC's Operational Effectiveness Team, which formed in August and is responsible for staff training (including on the Salesforce workflow) and onboarding.
The Operational Effectiveness Team works solely on training, quality assurance, and staff effectiveness, which allows team leaders to focus on the day-to-day business of staff management and patient care.
In addition, the PCC has added new employees, onboarding more than 50 people since the end of November, including 25 people between January 1 and 19 alone, Keller says. It's also in the process of onboarding a float pool, which will provide additional staff support.
3. Prep for complexity by keeping things simple
Nearly everything about the vaccination process is complex, from who is eligible to receive it under the state's rules to the different dosage schedules for different vaccine brands and the different vaccination locations within the Piedmont system.
Those complicated factors mean that vaccine scheduling should be as streamlined as possible. That's why the PCC isn't asking vaccine callers for insurance information.
"We have minimized that specific to the vaccine flow," Keller says. "We're only asking for basic information right now … we're keeping it as seamless as we can."
While vaccine doses are free for patients, the CDC says that vaccine providers can charge an administrative fee and be reimbursed for the fee "by the patient's public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration's Provider Relief Fund." Piedmont is not billing the administration fee at this time, Keller says.
Piedmont is also responding to calls driven by word of mouth, including people who aren't currently Piedmont patients. However, the PCC will create an account for those patients and schedule them, too.
"As long as they meet [vaccination] criteria, we're getting them scheduled," Keller says.
4. Don't underestimate the emotional elements
Although it isn't often discussed, pre-access employees are among the first people who patients interact with during a healthcare encounter, and patients may be feeling stressed, nervous, or anxious.
For many people, the COVID-19 pandemic has only intensified those emotions, so patient schedulers shouldn't overlook or underestimate the emotional elements of their role.
"We've experienced everything from people crying, to people thanking us," Keller says. "They just want the vaccine."
That emotional aspect of the pre-access role is part of why the PCC is including "behavioral" type interview questions and discussions in the interview process when hiring new employees.
"It's a focus of how we're recruiting people and the people that we're hiring," Keller says. "We're focused on identifying the right people. People who have the right heart would be the right people to handle these patients' questions and concerns."
Although the process of scheduling vaccine appointments has been a whirlwind, Keller says it's been worthwhile.
"It's a pretty exciting thing to be part of," she says. "It's extremely rewarding but also just nice to be able give people some relief."
Alexandra Wilson Pecci is an editor for HealthLeaders.
Use multiple technology platforms and tools to help with complex scheduling tasks.
Streamline patient scheduling functions.
Prepare employees for emotional elements of vaccine scheduling.