Google Enters the Fray to Help States Scale Up Vaccination Push

Ken Terry

February 15, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

At a time when COVID-19 vaccination efforts have been hampered by a lack of coordination and overwhelmed by public demand, Google is entering the fray to try and help states and localities better organize and focus their initiatives with cloud-based analytic, scheduling, and informational software.

Although Google reports that "a number of states" are already using its new solution, at least one state says it will continue to lean heavily on its own statewide health information exchange (HIE) while using just part of Google's suite of tech tools, a North Carolina health department official told Medscape Medical News.

Google's Intelligent Vaccine Impact technology package "helps increase vaccine availability and equitable access to those who need it, and assists governments in building awareness, confidence, and acceptance of vaccines," according to a blog post by Mike Daniels, vice president, global public sector, Google Cloud.

The tool suite includes four parts. First, Google and its partners have built vaccine information portals that help people learn about vaccine availability, determine if they qualify for a shot, sign up for vaccination, and submit their information. Google claims that these portals have the scalability to meet the needs of hundreds of thousands of people registering simultaneously.

Google's scheduling management component uses "virtual agents" to respond to callers and help them determine their eligibility, get registered, and schedule vaccine appointments, even if they can't get online.

For those who have internet access, Google offers online registration and prescreening, location searches and appointment setting, as well as automated reminders.

Google also uses a machine learning approach to inform infectious disease policy decisions. The artificial intelligence software forecasts how policy changes such as mask mandates, modified reopening plans, or vaccination programs may affect the trajectory of the pandemic in particular areas.

In addition, Fierce Healthcare reports, these tools can help organizations forecast and model COVID-19 cases to ensure equitable vaccine distribution.

To address vaccine hesitancy, Google features a "sentiment analysis" component that measures how individuals feel about getting vaccinated, based on data from "call centers, websites and apps, chatbots, advertising campaigns, social media, search, and news feeds."

Government agencies then potentially use this to "direct communication efforts that provide clear and accurate information to specific audiences, addressing specific concerns as they arise," writes Daniels.

The Google vaccination initiative joins those of several other large technology companies, including Microsoft, IBM, and Salesforce, according to Fierce Healthcare.

North Carolina's Hybrid Approach

North Carolina is using Google's platform for eligibility screening and to provide information on COVID-19 vaccines and vaccination locations, said Sam Gibbs, deputy secretary for technology and operations at the North Carolina Department of Health and Human Services

In addition, the department plans to roll out Google's chatbot and virtual agent to automate its call center, which has been receiving millions of consumer calls regarding the vaccination program, he told Medscape Medical News.

North Carolina health officials selected Google's platform to rapidly scale up these functions after they realized that the public health infrastructure developed for flu vaccines and the like was simply not up to the overwhelming task of vaccinating the state's entire population against COVID-19.

Gibbs explained that they needed a solution to be able to respond rapidly to changes from the Centers for Disease Control and Prevention (CDC) on which groups to vaccinate and in which order. The state also needed to better communicate with the public and answer questions about COVID-19 vaccination.

After considering a variety of platforms, he said, "we chose to use Google's screening tool to solve the problem of having a large, scalable, mobile-friendly platform where people can go in and answer a few questions, and we can communicate back to them by text or email that it's your turn to be vaccinated."

The state government is not, however, using the tech company's forecasting and analytic tools. Six months ago, Gibbs said, his department developed its own software to use racial and ethnic information to ensure that "marginalized" populations receive a proportionate share of the available vaccines. Similarly, he said, it's not clear that the state needs Google's Sentiment Analysis to help overcome vaccine hesitancy, especially in minority communities.

The department hasn't decided whether to use Google's scheduling software, Gibbs said. Scheduling is complicated and is changing with circumstances, he noted.

Early on, when the state was mainly vaccinating healthcare workers, the major healthcare systems used their scheduling software. In the current phase, people age 75 and older are eligible — local health departments are holding vaccination clinics and doing the scheduling for that. CVS and Walgreens handled the scheduling for long-term care facilities, and now the government is distributing vaccines directly to Walgreens.

"So we're trying to figure out where our scheduling system will be used and by whom," Gibbs said. There will be a statewide scheduling system, however, and Google's solution is among those being considered by the state, he added.

North Carolina Refines Its HIE

Long before big tech companies like Google appeared on the healthcare scene, more than 100 public HIEs were connecting healthcare providers in communities across the country. The North Carolina HIE, Gibbs said, includes most providers in the state, partly because the state requires any provider that receives public funding (including Medicaid) to belong to the exchange.

The HIE is an essential part of North Carolina's public health infrastructure, Gibbs said, and added that it's been a crucial advantage during the pandemic. When a health system vaccinates somebody, he noted, the vaccination is reported to the HIE, which sends on the information to the state's vaccine management system. While it's also possible to report directly to the state, he said, the HIE does patient matching and creates a unique identification number for each person, making it easier to track their vaccination status.

His department is now refining the system so that any provider will be able to look up "whether someone has had their first dose or not, and which vaccine they've had," Gibbs said. "So we were lucky we had this HIE so we can have more of a closed loop system." 

To augment the database, he added, CVS and Walgreens, which are getting their first vaccine shipments from the federal government, will send data to the vaccination registry.

"If a patient goes to a different part of the state, this system can validate that they got this kind of shot on this date, and when they're due for a second shot," he said. "We're almost there. We're close."

Other HIEs across the country could be used for the same purpose. In a recent Brookings Institution brief, Niam Yaraghi, PhD, MSc, and Peter L. Levin, PhD, note that "HIEs electronically retrieve, organize, and share medical data between clinical points of service, like doctors, hospitals and specialty care providers. While they are designed to exchange lab results, prescriptions, and so-called admission, discharge, and transfer records confidentially and securely, they could also be used by public health officials to monitor outbreaks and, importantly, vaccination status."

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