Thursday, October 29, 2009

H1N1 Vaccine Chaos: Business Process Screw-Up

Our family doc led us to believe a couple of months ago that he’d vaccinate us against the H1N1 flu virus. He’s still waiting for his supply. In the meantime, we are being encouraged to join three to six hour line-ups coming to our “town” shortly. Someone has skipped a beat here in common sense planning.

Few if any of us pictured that we’d have to line up en masse on the basis of first come first serve for this vaccination. Make an extra visit to our local walk-in clinic or family physician—yes. According to one of our local clinics, the medical staff does not expect to be receiving any vaccine. How assumptions can be so wrong! Maybe things will change.

We are envious that Sault St. Marie has managed the process by having people book an appointment largely on line and I presume also by telephone. The real story might not be quite as streamlined as not everyone has access to the internet and many shut-ins cannot venture out to a clinic. Plus, the vastness of the north has accelerated the transition to e-records and e-communications ahead of more southerly cities and communities giving Sault Ste. Marie an advantage to start with. However, at this point in the roll-out in Southern Ontario, it is mystifying why the gap in “user-friendliness” is so huge between the north and south.

Understandably a mass vaccination of this type has never happened in anyone’s lifetime. The closest comparator is the polio epidemic in the 1950s where schools were the chief locations for inoculation. The target groups were school-age children not the general population. That then was relatively easy. However, there’s a lesson: implementation was highly de-centralized.

We are being funneled into too few spots as in a traffic jam on highway 401 when the on-ramps feed into narrower parts. I can understand that to take the pressure off the normal conduits for health care like emergency rooms, walk in clinics and primary physicians public health is providing temporary alternatives. Unfortunately, the timing is off as public health is the only source right now.

Where were the computer-modelers when we needed them?

This will get sorted out. The first time is always full of lessons learned. On the side of public health, it is likely hampered by uncertainty about vaccine supplies---how much and when available. Resources too are thin at the best of times.

Nevertheless, why some synergy has not been created at this stage with personnel at easy to access locations where there would be minimal line-ups still makes me scratch my head.

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