This week Fred talks about his personal vaccine experience and some of the challenges of coordination that need to be resolved so as many people as possible get access to vaccination as quickly as possible. Different states and counties have different processes some work well, others create difficulties for people at different stages.
We also talk about health literacy and the unintended consequences of well-intentioned actions and behavior and the best incremental strategy for mitigating.
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here working with employers to help them reopen and operate and look at their broader employee health improvement programs and benefits packages.
Nick van Terheyden
and exciting week, Fred for you. I think specifically, you got the call.
Fred Goldstein
I did. I got the call. So I went ahead. And I registered for the vaccine on I think it was Thursday of last week got on this website that they had listed the newspaper and went ahead and registered. And I was sitting doing some yard work at about 945 in the morning on Sunday. And I get this call from the vaccine line. And I answer it and they begin to explain to me that hey, they’d like to schedule my vaccine, which was really fantastic. I said, Sure. So when I get go inside, pull up my calendar and they say, well, we have vaccines scheduled from the 14th through the 20th. I said the 14th. That’s today. He said, Oh yeah, it’s 945. We have slots open at 10. So I thought that was great I can get in that day which was a Sunday. So I scheduled for 11 o’clock. But I was a little perturbed that the slots were open. Obviously people aren’t taking them. They were just opening for those who were 60 and older. So I qualified. And here we go, I head down. They’re incredibly well done. Actually, before that, I went ahead and registered online and did the paperwork, which, interestingly enough is being done by sharecare. On the backside, the woman on the phone said, Could you sort of tell me what they’re asking? I’ve never seen what the questions are how that works. So I walked her through it as I did it. I said, Oh, yeah, I know, the sharecare. Folks. She said, Oh, yeah, they’re doing the whole state. They’re scheduling the whole state. And so nice system, a couple questions that would have rephrased because they were a little confusing. But otherwise, very well done. went in, got there 20 minutes early, and they just walked me in. No, wait. I had done the app, and I had the QR code. But that wouldn’t work there. They couldn’t take the QR code. Fortunately, I printed off the paper document. And when I handed it to her, she was surprised, because she was about to complete it all by hand. So once again, we’ve got some technology in place, not quite all interconnected, be nice to get there, but really did a great job.
Nick van Terheyden
So it’s interesting, there’s a couple of things that stand out to me, and I’m with you, you know, it’s great that you got in, I’m delighted. I think that’s fantastic. I think you even posted, you know, it’s, it’s really important to let people know, and you know, I keep saying and I’ll say, you know, the instant that a vaccine is available to me, I’m taking and, you know, it doesn’t matter which one. But the fact that they had appointments, and literally 15 minutes from when they called you and that you walked straight through suggests that, you know, it was efficient that they weren’t filling the hopper as it were. And I think I mean, you you shared it was a Pfizer vaccine, which is the super cold one. So there’s a whole bunch of I know, they’ve asked for the exception, and they don’t require it. But that, you know, once you defrost it, then it’s got to be used within a certain period of time. And if I remember, the job lots are much larger, it’s it’s of the order of 100 units in each of the things that you do for us. So that’s a lot of doses. So, you know, you really have to wish that they would get that piece of it right. And it sounds like they’ve got the front end, right? Because you just registered one time instead of the lottery system that we seem to have where you I get a text message from the state going, Hey, we’re going to be releasing some vaccine appointments, check in at 5pm. Well, guess what, check it at 5pm means there’s nothing available. In fact, the whole system crashed. I’m thinking just not as register, and allow us to do this. So you can clearly do it. We have to think and wherever it’s working. Let’s do that. Right. So there’s pieces working for you, but not for just oh my
Fred Goldstein
lord. Absolutely. It was really well done. They had a great flow through pattern, you know, a group of probably 30 registration tables when you first came in, then you went to probably 30 individuals who are giving vaccines and another section, it was done inside a closed mall and where that had lost a lot of business. And then they had another section with just a ton of seats to do your 15 minutes. And the National Guard was fantastic. The staff were fantastic. And it was set up by the state, it was really well done. I was very impressed. Literally probably 20 or 25 minutes I was in and out right now just you know, a few minor pains in the shoulder where the shot was after the first dose. And we’ll see what the second dose is like. And they’ve already scheduled me Give me the card come back at 11 o’clock on the next Sunday, which is good I did on the Sunday. So hopefully on Monday when we’re doing this again, I won’t be knocked out per day to the vaccine, as others have experienced. But we will see. Well, that’s also interesting. So they’ve actually scheduled your second appointment already.
Nick van Terheyden
So that’s in in the system, because again, I don’t think that’s the case. What I hear in other instances is we’ll send you an appointment or check in after this date, which I’m going really you can do this. I know.
Fred Goldstein
Yeah, this is this was clearly a good example of how to do it right. The state in this case is doing a great job with these, it would be nice to see more people getting through it, you know, but there were a fair number of folks it was, you know, onesies, twosies coming in. Once he’s used, he’s going out, no line or anything. Obviously, they could do more. And hopefully people will get that and we’ll see like you said, you know, as these vaccines come out, let’s get those into into people so we can begin to return a bit more than normal. I understand that as part of some of your work. Nick, you were looking into some HIPAA issues and areas about appropriate questioning things like that, you
Nick van Terheyden
know, so I had the fun activity of doing HIPAA training for I don’t know how many times I’ve had to do it, of course, you go with any different organization, you got to do it again, because you don’t get a certificate, I don’t think or at least I’ve never received one. So underwent HIPAA training specifically for vaccination activities. So I’m part of the Medical Reserve Corps in Maryland, volunteer. And, you know, they want to make sure that they preserve privacy. And we went through this, you know, it was all the things that I would expect and, you know, listened in, but there was something that really stood out to me. So one of the things that we had was, you know, multiple tables in the facility where I was volunteering, and they, you know, they were distance, but you could probably hear, so there was some level of potential for sharing a personal or private information. Specifically, you know, people get asked their name, date of birth, you know, that’s Ph. I, ultimately. And one of the suggestions somebody had was, well, you know, what I’m doing is I’m writing down the question so that nobody can hear, you know, there’s no transmission. And I’m, I’m sat there going, great idea. But actually, somebody comes on and says, Well, what you’ve just done is prevented people from accessing because that’s a literacy test. And it’s a language test all in one step of well intentioned activity. And, you know, the point that I think is important for people to understand listening to this is it. I always say that you don’t, I don’t think people have a mal intent or bad intention, things happen. You know, it’s like your situation where, you know, it worked, but they didn’t fill the hopper. Somebody didn’t sit there and say, How can we not make this work? There are reasons that this happens. And the answer for me is always from an incremental standpoint, is to bring in as many voices as possible. If you haven’t walked a day in the shoes, it’s really hard to see that. I haven’t, you know, that’s not a literacy problem for me, but others obviously have. And now that I’ve learned that I can bring that experience, but having as many voices and in particular, external voices, as you think about resolving and working through all the issues, not just for vaccination, but for other things.
Fred Goldstein
Yeah, it’s interesting when you consider the literacy issues you point out, and health literacy is a critical one for this country, we’ve got various programs, but being put in place to do that for employers and others. The other thing to think about also is cultural. So as an example of this, when we were doing some programs in Medicaid, our nurses learned early on that with certain cultures, if you go into interview the individual, and let’s say it’s an elderly male, and they’re in the room with others in their family, in certain cultures, they will never admit to a health problem in front of their children or spouses are
Nick van Terheyden
gonna say that’s not cultural. I feel like that’s
Fred Goldstein
absolutely. And so what you have to think of is understand that and get the individual alone. And and recognize those differences. It was really fascinating. We actually worked with individuals who spoke 65 different primary languages. So it was fascinating to learn the differences of working with these different cultures, and there’s a programs called class, KLA s that are very good to use. And then people really need to consider this go forward. It’s a great example, Nick of something you think you’re doing the right and it may actually, as you said, be a barrier and we don’t want to create those barriers. We want to knock those suckers down. Exactly. So once again, another fantastic week with you Nick, looking forward to next week as well. This is Fred Goldstein with accountable health and if you have any questions around your employee benefits practices, or your programs that you’re trying to do to improve your overall employee health, please feel free to reach out to one of us.
Nick van Terheyden
And I’m talking to Nick on the incrementalist here with incremental insights for better business, better health.
