December 17, 2020
Utilizing IoT sensors and employing alerts along the cold chain are among the ways members of Protocol's Braintrust see tech affecting distribution, but not all experts see wastage as the problem tech companies should be solving.
Good afternoon! With vaccine(s) at the ready, we asked Braintrust members how tech could be used to fight vaccine wastage, either by examining the kinds of health tech that could be employed this time around or considering how data from this distribution could be useful in the future. And if you missed Protocol's virtual event on the logistics of vaccine distribution earlier this week, you can listen to the full panel here.
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Dr. Este Geraghty
Chief Medical Officer and Health Solutions Director at Esri
Wastage of the COVID-19 vaccine can occur in two main ways: disruptions in the supply chain or failure to deliver two doses per person.
Technology can help in both areas. On the supply chain side, technology can help manufacturers and governments coordinate a distribution network that ensures each vaccine is only shipped to facilities that can properly handle it and are within reasonable proximity to the phased population groups. While shipments are en route, IoT-enabled sensors can monitor location and temperature of vaccines so intelligent algorithms can optimize routes for efficiency and avoidance of potential disruptions like severe weather that could compromise shipments. This requires data, collaboration and the right tools, but this a solvable problem.
Failures related to administering the vaccine will be much more difficult to overcome. Health agencies should establish intelligent inventory systems that enable tracking of the first dose and notification for the second course. In such a system, personnel would scan the barcode of the vaccine and record a patient's details when they administer the first shot. Based on the vaccine, the system would automate follow-up communication through SMS text messaging and other channels to encourage individuals to get their second shot and even guide them to open locations. Agencies can supplement these efforts with focused outreach campaigns that target populations based on their communication preferences. Relying on paper immunization cards is not a sufficient solution.
Karin De Bondt
President at Thermo King Americas, a strategic brand of Trane Technologies
The race to deliver an effective COVID-19 vaccine brings forth numerous cold chain complexities and considerations. First, experts estimate that between 12 billion and 15 billion doses will be needed globally. Second, there are at least two vaccines that require ultra-low temperature storage throughout their distribution. Third, nontraditional delivery points — mobile clinics, pop-up hospitals and rural communities — need to be factored into each state's distribution plans.
The cold chain infrastructure is in place with the transport and storage solutions to meet even the most unusual temperature requirements. However, to ensure the safety and security of the COVID vaccine, real-time monitoring and data are key.
We're working with governments, public health organizations and transportation companies to identify potential challenges and mitigate the risk. Our end-to-end cold chain solutions include remote access and monitoring, which can help prevent vaccines from spoiling due to an extended amount of time outside their required temperature range. Real-time monitoring of the vaccine as it passes through each point in the cold chain — from manufacturer to storage and distribution center and last-mile delivery — can provide assurance that temperature requirements were maintained. If a product is at-risk, a customer will receive an alert, which they can address remotely or by notifying their driver. This real-time monitoring and data can also prevent theft or tampering.
We are at a critical point in defeating this pandemic and the most important thing is helping to support safe — and fast — delivery of the vaccine to people around the world.
Chief Transformation and Digital Officer at Novant Health
The way to look at vaccine wastage is not actually through the lens of a tech company's solution. It's not really a burning issue that companies should spend money addressing because there's just not a market for a specialized solution beyond tracking mechanisms that can be built from commercially available tech.
For example, if the idea is to reduce vaccine wastage because the vaccine itself is in limited supply and must be preserved at any cost, a technical solution to vaccine wastage would be easy to craft. You'd have smart connected vials with integrated/connected delivery mechanisms that provide real-time location and other status data throughout their lifecycles. Each delivery mechanism would have a unique identifier that could be linked to patient records (or community outreach efforts) when the vaccine is administered so that patient data could be queried by providers for vaccine batch information. Usage data and status data would be used for — among other things — automatic reordering when supplies are low, and alerting for return when vaccine supplies expire. But no vaccine is of such limited supply that such a cost would be justifiable, so I would not recommend that tech companies go out and invest in this.
Vaccine wastage is typically of interest because of the cost associated with open vial wastage, so the fix has traditionally been a combination of finding the optimal vial size to reduce waste, and in creating asynchronous tracking mechanisms for supply chain leaders that automate the reorder and return processes, and to provide visibility into unnecessary waste based on operational weaknesses. If tracking data has been collected for a length of time, and if wastage were a big enough issue, it would be fairly straightforward to build predictive models to allow for proactive automated reordering. And so with optimal vial size, manual data entry and sophisticated back-end automation, vaccine wastage can be identified and tracked, and steps can be taken to pull the right levers to reduce waste. There is no need for additional action on the part of tech companies.
Chief Commercial Officer at Color
The pandemic has made clear a simple reality: The U.S. does not have a functional public health infrastructure.
What has this meant in practice? We haven't been able to distribute critical resources quickly, affordably or in a way that's easy to access and understand. In many areas, there are enough clinicians, tests and swabs to go around, but they aren't reaching the people who need them most.
We need to build a better version of health care that uses technology to improve efficiency and access to public health and health care services, all the way into local communities. This will be paramount as we embark on an unprecedented national vaccination campaign. A significant amount of capacity is about to be created: hundreds of millions of vaccines, manufactured and distributed to centralized facilities across the country. The distribution challenge isn't tied to clinicians or other high-risk individuals. It's about reaching two-thirds of this country's population where they are, and reducing health inequities by eliminating common barriers among underserved populations.
Having an asset to fight COVID-19, such as a test or vaccine, is only as good as the logistical framework designed to get it to patients. What we need, and what we've helped build for the state of California, universities and employers, is a comprehensive and extensible infrastructure that applies the lessons learned from COVID-19 testing to this new challenge, on both the local and population level.
This last-mile problem is going to create incredible opportunities to build the true public health and population health infrastructure of the country — the rails that will deliver health care services to communities across the U.S. for years to come.
CEO and co-founder at GYANT
The areas of vaccine waste are twofold: There's the clear waste of vaccine doses, and the time of our frontline providers is a scarce resource that needs to be spent directly on care delivery. Patients are eager to get vaccinated and are flooding hospital support systems with inquiries about vaccine distribution and eligibility, threatening inefficient use of time and doses. Digital health companies should focus on automating communication and care navigation in order to optimize health care resources.
With the proper framework in place, patients can use on-demand tools to understand their eligibility, book appointments and be reminded to schedule the second dose. These technologies lead to fewer patients restarting the process due to missed appointments and significantly reduces administrative overhead so employees can spend more time providing quality care.
During times of high patient traffic, or when doses begin to run low, AI-enabled smart scheduling enables appointment bookings to be dispersed to facilities with sufficient capacity and supplies. Ultimately, streamlined patient education and self-service tools will ensure that our limited quantity of vaccines are distributed through a clear and concise process that will maximize the impact of the available resources.
See who's who in Protocol's Braintrust (updated Dec. 16, 2020).
Questions, comments or suggestions? Email firstname.lastname@example.org.
Kevin McAllister ( @k__mcallister) is a Research Editor at Protocol, leading the development of Braintrust. Prior to joining the team, he was a rankings data reporter at The Wall Street Journal, where he oversaw structured data projects for the Journal's strategy team.
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