“At the end of February 2020, we had our first case of COVID in Ireland,” says Fran Thompson, Chief Information Officer for Ireland’s Health Service Executive (HSE). “Schools and shops had closed their doors, arts and sports were stopped, no one could travel, and those still employed were working from home. Like the rest of the world, it was a situation my team and I could not believe the sight of, let alone how it unfolded overnight. There was no time to plan, no time to evaluate, just a call to action.”
HSE provides healthcare and social services to Ireland’s approximately 5 million citizens and has regional vaccine systems in place. But, for COVID vaccination, HSE needed a national program that could quickly and safely vaccinate the entire Irish population.
A way was to vaccinate people in non-HSE sites and remove the superfluous barriers that didn’t align with the ‘all hands-on deck’ pandemic situation. All staff—both HSE teams and frontline healthcare workers, including the many dedicated retired healthcare workers who rejoined the HSE to contribute to this effort—needed to be vaccinated within the same two-week timeframe as our employees so that they were safer while working on the frontline. This was about people, their lives, families, and communities.
The faster HSE could get shots in arms, the more lives would be saved. But, the effectiveness of this large-scale vaccination program also required seamless orchestration of all the associated processes: communications, scheduling, intake, case management, reporting and auditing. The new vaccination solution needed to rapidly scale while ensuring the security of each citizen’s health data. Plus, HSE needed to roll out a vaccination platform in only a few weeks. After reviewing the offerings and technology from IBM and Salesforce, HSE felt confident that these two companies had the partnership, technology, expertise and speed to deliver such a critical solution. It was December 14, 2020, and there was no time to waste.
Data Tracking at Scale
Tracked nearly 11M COVID vaccinations across Ireland
Rapid Deployment
Launched a functional platform in only 2 weeks
HSE chose to build a platform on Salesforce cloud technology with IBM Consulting using the IBM Garage™—a framework for transformation that combines people, processes and technology. The all-remote team was able to bring in top talent from around the world—from Ireland, the UK, Israel, Egypt and Australia to the US and India. Team members included solution architects, developers, designers, Salesforce technical experts and HSE employees who understood the agency’s needs. They followed the agile, user-centered IBM Garage Methodology—design, build, scale.
Adhering to human-centered design principles and maintaining empathy for users, the team focused on key people who would first use the vaccination platform: vaccinators, care-home patients and healthcare workers. For each persona, designers strove to answer the question, How can we make their lives easier throughout the vaccination process?
The collaborative team prioritized the features needed for the minimum viable product (MVP) that HSE would use to vaccinate the first cohort—healthcare workers and elderly care-home patients. Other features could wait until they were needed. For example, HSE would eventually offer a self-service portal where citizens could register for their vaccinations, but the platform didn’t need that functionality on Day 1.
The team designed COVAX (COVID Vaccination Information System), a secure and simple-to-navigate vaccine management platform. It captures all the necessary data to produce a vaccination certificate and ensures sensitive personal information remains in GDPR compliance.
While designers were still finalizing the solution plan, the technical team began building the COVAX platform because there was no time to wait. A challenge of implementing a national vaccination platform during a pandemic was that the situation—and therefore the team’s implementation priorities—would change as the team received updated guidance from the Irish government, European Medicines Agency (EMA) and National Immunisation Advisory Committee (NIAC). Therefore, the development team followed an extremely responsive process to develop, test and iterate the solution rapidly.
IBM, Salesforce and HSE team members adhered to agile ceremonies, including daily standups, retrospectives, deep dives, leadership reviews and governance meetings to keep the project moving quickly and collaboratively. Developers built the core COVAX platform on the Salesforce Health Cloud. The system also uses Salesforce Marketing Cloud for communications, Salesforce Experience Cloud for the public portal, Salesforce Lightning Scheduler for appointment scheduling, Salesforce Service Cloud for HSE helpdesk support, and the Salesforce myTrailhead learning platform for employee training and MuleSoft Anypoint Platform for integration with HSE systems, GPs, and Pharmacies. Salesforce Shield provides additional platform security and audit trails.
“Even though we were virtual, we were one team in one big room thinking and building together,” says Michael McKillen, Delivery Lead for IBM. “At all times, the left hand knew what the right hand was doing. It was very joined, and all the stakeholders were eager to help each other because all the different elements had to come together to make a successful program.”
In a single two-week sprint, over only nine working days, the dedicated team delivered the first MVP of the COVAX platform on December 29, 2020. “We achieved such impressive speed to value because of the strong partnership approach among HSE, IBM and Salesforce,” explains Tim Elcott, Delivery Partner for IBM. “There was a deep commitment from all parties because this solution was critical to saving lives. Everyone made personal sacrifices to be able to deliver something of this scale at this speed.” Project team members worldwide cancelled trips and holiday gatherings so that this solution would be a success.
The first MVP was rolled out at four acute hospitals, and 50,000 healthcare workers and care-home patients across Ireland received the vaccine. Since then, the joint team has continued to iterate and scale the MVP. “We’ve been pushing new features, functionality and/or locations ‘live’ every three weeks since,” said Thompson. “As vaccine availability changed and government policy shifted, the rollout plan was constantly adapted. None of us has worked through a pandemic before, so this level of agility has been that much more critical in helping us act on new information in real-time.”
Currently, the platform follows six steps to manage the vaccination process:
- Intake and outreach: Citizens visit COVAX’s public portal or dial the HSE call center to create a patient record.
- Service delivery: Once a citizen has registered to receive a vaccine, a scheduling algorithm determines the optimal vaccine clinic and appointment time. The system automates 2-way communications via SMS. At the clinic, frontline staff validate each citizen’s identity. The vaccinator confirms consent and eligibility, records vaccination details such as vial number and type of vaccine and administers the vaccine. The event is recorded in the patient’s profile, and a second appointment is scheduled.
- Relationship management: The HSE Live contact center supports over 2,000 service agents as they work through an average of 20,000 questions per day via email, phone and chat.
- Employee engagement and training: HSE staff receive relevant and timely training to help them rapidly learn how to best use the new platform.
- Reporting and employee enablement: HSE uses advanced business analytics tools to monitor and report on all aspects of vaccination data and citizen vaccination status.
- Integration and connectivity via the MuleSoft Anypoint Platform: HSE adopts an API-led approach to connectivity to provide citizens with a real-time connected experience which includes the rapid ingestion of vaccine data from GP and Pharmacy systems, and the look-up of Health Identifiers, GP details, location addresses, and vaccine labels scanning.
To date, COVAX has managed the delivery of over 11 million vaccines, and over 90% of eligible citizens have received at least one dose of the vaccine. Now, the system supports booster doses and continues to evolve and scale with needs and regulations. “The work we have done here has solved today’s COVID vaccination challenges and will pave the way for years to come,” says Thompson. “This strategy gives us a model, a framework, for linking doctor systems to hospitals, portals and patients. This strategy gives us a framework for delivering a modern patient experience, regardless of ordinary days or extraordinary times.”
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Established in 2005 and headquartered in Dublin, Ireland, HSE (link resides outside IBM) provides public health and social services for everyone living in Ireland. The organization employs more than 80,000 people directly and an additional 40,000 people through contracts. HSE’s annual budget is over EUR 20 billion.
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