How Tech is Enabling Thousands of In-Home Vaccinations for Massachusetts’ Most Vulnerable

By: Courtney Murphy, Chief Operating Officer at CCA

The mass vaccination effort taking place across the United States isn’t only integral to saving lives, it’s essential for resuming pre-COVID life: hugging family members, attending sporting events, returning to the office or in-person classes. As states across the country work to make vaccinations as accessible as possible for everyone, special attention must be paid to those who are homebound and unable to visit vaccination sites.

That’s what my team at Commonwealth Care Alliance (CCA) has been focused on in the Commonwealth of Massachusetts since the pandemic began. As an integrated care system, we serve individuals with significant medical, behavioral health, and social needs. With more than 42,000 members, CCA focuses on the state’s highest-cost, and highest-need individuals — most of whom are at an elevated risk of complications from COVID-19.

Since the beginning of the pandemic, our team has worked closely with the Commonwealth of Massachusetts to care for these individuals, including COVID-19-positive homeless and marginally housed residents of Massachusetts at the Isolation and Recovery sites.

In February, CCA also began vaccinating its own health plan members who were homebound — developing a structure for coordinating vaccinations, scheduling shots, and putting logistical and safety protocols in place. As of May 24, CCA administered 1,210 COVID-19 vaccine doses to its own homebound members, and 2,279 total vaccine doses through the Homebound Vaccination Program, a joint effort with the Commonwealth of Massachusetts to provide vaccinations for high-risk individuals who cannot safely leave their home. On May 24, the Homebound Vaccination Program was expanded to any eligible resident who is unable to visit a vaccination clinic.

As of May 24, CCA had administered 2,279 total vaccine doses to Massachusetts’ most vulnerable population through the state program.

Pandemic Pivots: Telehealth and Virtual Care

From the earliest signs of the COVID-19 crisis, we grounded our response to the pandemic on the solid bedrock of our mission: putting people first. CCA’s unique member population includes Massachusetts’ most high-cost, high-need individuals, and it was imperative they continued to receive the same quality of personal, integrated care throughout the pandemic as they had before.

We implemented several initiatives to keep employees and members healthy and the organization financially stable during the COVID-19 pandemic.

We quickly transitioned to telehealth and virtual care technologies, which have proven highly effective in closing gaps in primary care access, treating acute and chronic conditions, and enabling behavioral health interventions at home.

Our team also rapidly deployed a $4 million COVID-19 relief Member Support Program. The program provided every member support for everyday health and wellness items to help them follow sanitary guidelines and avoid unnecessary acute care settings during the pandemic. Over 17,155 members accessed their credit, with over 414,000 items distributed.

We expanded access to home-delivered meals for members, handling nearly 900 interventions for food resources and benefits. Additionally, we convened a specialized team to work with marginally housed members facing evictions. Approximately 2,500 CCA members received housing assistance, including 210 potentially homeless members, 63 of whom were placed in new homes.

To address transportation needs, we expanded our transportation reimbursement program. This initiative allowed CCA members, their caregivers, and their families to be reimbursed for transportation to obtain food, medications, and necessities.

Our team extended technological support to members to help maintain connections to family, friends, and care teams during the pandemic. In 2020, we helped close to 900 members gain cell phone access through referrals to the government-supported Lifeline Assistance program.

Implementing a Homebound Vaccination Program

When a vaccine became available, we knew we needed to expand our services to help increase equitable vaccine access in the state. Aside from our own efforts to vaccinate homebound members, the Homebound Vaccination Program was critical to meet the needs of high-risk individuals who cannot safely leave their home.

CCA designed and implemented the operations of this vaccination effort, providing a technological infrastructure, conducting patient outreach and scheduling, and executing complex distribution logistics. In addition, CCA has built a network of qualified vaccinators across the state in partnership with local boards of health, local providers, home health agencies, medical and nursing students, and emergency medical services.

The Commonwealth screens residents for eligibility and transmits that list to our command center, where CCA organizes and leads workforce management, field vaccinator management, patient scheduling, and patient data management. Johnson & Johnson vaccines are distributed weekly to our geographic vaccination hubs in Charlestown, Springfield, Lawrence, and Worcester.

Contracted or volunteer vaccinators (EMS, home health agencies, students, or local boards of health) come to these hubs at scheduled times to collect supply bags that include appropriate personal protective equipment (PPE) and the necessary number of vaccines. The vaccinators access the list of appointments through Skedulo, a native Salesforce app, and are then able to provide eligible individuals with a vaccine in their home.

CCA used Health Cloud to manage vaccine recipients and their household members, and Skedulo to manage appointment scheduling, vaccinator availability, route optimization, and mobile immunization record capture.

Expanding Vaccine Access with Health Cloud

Technology played a crucial role in enabling the homebound vaccination program. The goals for our Salesforce-built technology solution included the following:

• Maximizing the time of mobile healthcare professionals in vaccinating homebound recipients by optimizing their travel times.
• Optimizing vaccine usage and minimizing waste.
• Scaling the program by enabling high-volume scheduling of homebound individuals and their household members.
• Deploying an app that empowered vaccinators to be mobile while creating timely immunization records.
• Enabling the solution within a four-week timeframe to stay on track with the goals of the homebound vaccination program, which was estimated to be around 20,000 homebound individuals and their households.

To accomplish these business objectives, our team utilized the Infosys Vaccination Management solution built on Health Cloud with an integrated scheduling and vaccination resource management solution. The Health Cloud platform was used to manage vaccine recipients and their household members with Salesforce workflow solutions, creating an immunization registry. To integrate with the immunization registry, we utilized a Salesforce integration platform to move data from the immunization registry to the State’s system.

Other areas of homebound vaccination solution included inventory management, vaccinator network availability and administration, training of vaccinators, and timely reporting to the Commonwealth.

It’s been said before that the COVID-19 pandemic didn’t just exacerbate social inequities — it spotlighted them. We have an incredible opportunity right now to rethink our processes, restructure our safety nets, and reimagine our systems to create a more equitable society. Putting people first means centering those with medical, behavioral health, and social needs as we build the “new normal” of the post-COVID era.

Read more about how tech is powering vaccine management and distribution for children and countries across the world.

About the Author

Courtney Murphy 
Chief Operating Officer at CCA

As Chief Operating Officer, Courtney directs CCA’s market and operating performance, including corporate strategic planning and client partnership strategies. She received her undergraduate degree from Merrimack College and holds a Master of Business Administration from Boston University.