Public health management

Digital pen and paper streamlines flu vaccination process in Solano County

The drill

In the event of an actual emerging flu pandemic, Solano County Public Health and Social Services knew it would need to have the capability to treat as many of its inhabitants as possible in as short a time as possible.

In order to achieve this, the Department used digital pen and paper technology from Anoto to assist in a practice drill involving hundreds of volunteers who received real doses of seasonal flu vaccine free of charge.

The key objective of the drill was to promote the importance of getting vaccinated, rally the community to come to an event, and safely offer and administer free vaccines to the county’s inhabitants.

In addition, the Department wanted to not only evaluate how well it marketed the event but also determine how well it’s targeted marketing messages reached the community.

The volunteers had to use the pens to fill in their personal health survey. The survey was designed to capture a patient’s medical history and contact information as well as guide them through a question-and-answer process.

The data collected by the Digital Pen and Paper system was critical to the screening process in helping non-medical staff determine whether the patient would need to be seen in a second screening process by a nurse, and in helping to ensure proper protocol was followed prior to administering the vaccine.

The ultimate goal of the exercise was to achieve a vaccination rate of approximately 350 patients per hour as established by the Center for Disease Control and Prevention (CDC), which Solano County confirmed was indeed possible based on the rate at which they processed their 267 patients.

Setting up the system

The Solano County team spent weeks preparing for this flu vaccination event, which used the services of over 100 county employees, including doctors, nurses, health educators, the Public Information Officer and numerous county line staff.

267 members of the public participated in the event and were screened, with 265 receiving vaccinations. Two patients were deemed potentially allergic to the vaccine and therefore were not vaccinated. 100 pens were used in the drill.

A screening protocol was established that entailed two screening processes. The first involved non-medical screening personnel who would distribute approximately 100 digital pens and health surveys printed on digitally encoded paper. The survey was developed in a way that would guide the patient through a series of comprehensive workflow questions and answers that needed to be documented prior to anyone being given the vaccine.

Thanks to the digital pen and paper, the participants themselves could supply important details of their own medical history, such as allergies, as well their addresses and contact details. The staff noted that fewer data errors occurred when participants filled out their own surveys.

Additionally, the use of digital pen and paper reduced the need for manual data entry and accelerated the processing of survey data. The patient’s data could be immediately downloaded from the digital pen and used by non-medical screeners in order to decide whether to send the patient for further screening by a nurse.

Nurses conducted the second screening because they were better qualified to determine whether a patient could have an adverse reaction to the vaccine. The final process involved another check with the participant before the actual administering of the vaccine, which the nurses also conducted.

Goals achieved

The goal to see 350 patients an hour was achieved thanks to the digital pen and paper, which allowed data to be collected easily and processed immediately, once the patient data saved by the pen was downloaded.

The drill revealed that the digital pen and paper system caught errors in judgment made by non-medical screeners who should have directed patients to see a nurse. When the digital pen’s data was downloaded onsite, the nurse was immediately alerted that the patient would need further screening prior to receiving the flu vaccination based on their survey answers.

The drill also showed that about 15% of the public would need to go through a secondary screening prior to vaccination. Equipped with this knowledge, the health department could prepare adequately and react quickly to a real pandemic.

Integrating patient addresses captured by the pen with Google Maps enabled the team to see how effectively they promoted the event in each city and area within their county. They learned which residents from which areas of the county did not show up and which areas would therefore require additional marketing and promotional efforts.

“Solano County Public Health is constantly working to prepare for public health emergencies, including the very real possibility of a pandemic flu,” said Robin Cox, Health Education Manager for Solano County Public Health.

“This technology gave the county healthcare professionals the critical patient information in real time to ensure that they were able to administer the flu vaccine to patients who would not have an adverse reaction. They were also able to assess the geographic locations that need additional communications of the US Department of Health’s message.”