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Vaccine distribution

Helping seniors navigate digital healthcare must go beyond COVID-19 vaccine distribution


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    Riley Leight
  • Apr 07, 2021
TLDR

Getting seniors vaccine appointments is a top priority—but the digital systems used to do so are often inaccessible. Healthcare and technology leaders must bridge the digital divide to proactively bring seniors the tools they need before another crisis takes hold.

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Getting the COVID-19 vaccine to the public is one of the largest, most complex tasks that the global healthcare system has ever faced. There are numerous challenges: limited supply, storage complications, communication breakdowns, labor limitations, and more.

But one particularly unsettling challenge has been brought to light in recent months: many seniors—the population most at risk of severe illness and death from COVID-19—are unable to access the digital systems for finding and scheduling vaccination appointments.

Some, like Ambar Keluskar—a pharmacist in Brooklyn, New York—have opted to circumvent the digital barrier; as reported by The New York Times, Keluskar responded to the lack of appointments being scheduled at his pharmacy by deciding to host pop-up vaccination events in communities with high-risk populations.

According to Keluskar, many of those he vaccinated were homebound or didn’t have access to the digital devices needed to find and schedule an appointment in the first place.

Digital solutions in healthcare are meant to create more connections and choices for everyone, not just those with the means and knowledge necessary to access them.  So how do we arrive at a future where virtual healthcare fulfills its promise of creating equity, connection, and convenience for everyone?

One thing is clear: the systems we rely on are in need of radical innovation. 

Finding the cracks

COVID-19 has exposed many cracks in our digitally-connected world, far beyond just healthcare. Inequities in remote learning, for example, have made clear the “digital divide” is severe and widespread, but in the context of health and wellbeing, the stakes of these inequities become even higher.

According to a 2021 report from Older Adults Technology Services (OATS), about 42 percent of our nation's over-65 population don’t have broadband access at home. That comes to nearly 22 million people who, in many cases, will have to rely on loved ones or other caretakers to make a simple, potentially life-saving appointment. 

If you get close enough to really look, one crack in our systems always leads to far more. It’s best to treat the most visible flaws not as the totality of a problem, but an entry point that guides you deeper.

That to say: if we can see how many American seniors don’t even have an internet connection, let alone knowledge of how to access complicated appointment portals, that means many more groups are struggling too—likely with even less widespread awareness of their situation, and less support to overcome it. Data shows that older, more rural, and lower-income households are all significantly less likely to have broadband access.

For those without the means necessary to have internet access at home, unhoused populations, and those physically or otherwise disabled, the lack of simple, efficient solutions to find vaccine info and appointments is today’s crisis, but it’s not going to be the last. Vaccine distribution efforts must do everything possible to reach these populations.

Building with access and preference in mind

Communication preferences and access vary widely, whether that’s based on age, nationality, or a litany of other factors—which means understanding how the communities you serve prefer to communicate is crucial. Organizations can overcome many barriers by adopting the most effective, accessible variety of communication channels available. 

For seniors, most indicators show that one-on-one communication is the most effective, whether that means knocking on someone’s door or calling their home phone. Outreach efforts should consider these preferences at the earliest stages.

To solve the immediate crisis, many are relying on traditional methods of outreach. Some, like The Bronx Rising Initiative, are going door-to-door to help ensure community members get signed up for vaccine appointments even if they don’t have the information or access necessary to do so.

This work is essential to meet today’s challenges. It is also essential to put forth digital-first strategies with access and capabilities in mind. There are many ways to build adaptable, digital solutions: providing multi-channel engagement options to reach wider demographics, automating systems to disseminate information and free up healthcare workers’ crucial time, and launching new communication strategies are just a few of the ways we’ve seen organizations step up to the plate. 

When the International Rescue Committee realized that in some regions they were serving users preferred getting information via WhatsApp, they deployed a multi-channel, remote contact center with Twilio Flex that could reach these users on the platforms they were already familiar with. 

In understanding their initial older audience, St. Luke’s University began calling their patients to let them know it’s their turn to get vaccinated instead of waiting for patients to jump through hoops to find them. By building with preference and accessibility in mind, they were able to carry out their mission more effectively.

Education unlocks accessibility

Building an accessible, easily navigable solution and putting it into the hands of those who need it is just the beginning. There’s an equally important component that must follow: educating users.

"This is the kind of problem technology can solve," Thomas Kamber, the executive director of OATS, told Axios. "But it requires a minimum level of technology capacity and engagement, which as a country we've failed to create the baseline for among seniors. And we're seeing the consequences right now."

The digital divide is not new—but we can use the energy and urgency surrounding vaccine distribution efforts as an opportunity to start solving it. According to research published in Frontiers, seniors are eager to gain the skills necessary for successful digital inclusion, but common methodologies for teaching them can create more barriers than opportunities. 

“The fact that older people are often considered dependent and lacking in initiative and determination can lead to education programs being conceived in a condescending manner,” wrote Claudia Isabel Martínez Alcalá, et al. 

Rather than assuming seniors are disinterested in or incapable of gaining digital literacy, education efforts should be focused on empowering them to apply their existing language, logic, and critical thinking skills in a digital context. 

Advocates like those at Seniors Go Digital are making autonomy-oriented education more widely available, and there are even start-ups like Getsetup that provide seniors with virtual, one-on-one guidance on the digital skills they’re interested in gaining.

While face-to-face education and resources are a short term necessity for getting vaccines to communities who need them today, digital education will make the future of this process safer and more efficient for everyone.

We have to be ready for what's next

Your business or organization might not be able to solve the deep-rooted, global problems related to internet access and digital literacy, but everyone in the healthcare and technology ecosystem has a part to play in empowering the public.

Much of today’s work around vaccine distribution has shown the power and possibility that comes with putting equity first; from Lyft offering free rides to vaccine appointments for low-income communities and Google pledging support for vaccine education and distribution, there are many examples of what can happen when we recognize and address these needs.

With herd immunity on the horizon, many are thrilled for a return to normalcy—and that renewed sense of safety, connection, and opportunity is absolutely worth celebrating. 

But we can’t forget the toll of this pandemic, and the deep, devastating flaws it revealed about our systems of care and governance. If we don’t learn, adapt, and prepare, every future crisis will continue to disproportionately wreak havoc on the most vulnerable, isolated, and digitally disconnected among us. 

“In the long-term,” said Susan Lucas Collins, Twilio’s Global Head of Healthcare Services, “we will see critical, life-changing transformation thanks to software, such as the connected doctor experience that enables proactive versus reactive care.”

This distinction—proactive versus reactive—is at the core of what must change in our healthcare systems. 

An effective approach to public health will require ongoing collaboration, lasting commitment, and attentive listening to underserved populations so that gaps in access, equity, and care can be solved before they have life-threatening consequences.

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Riley Leight

Riley is a full-time writer based in Annapolis, Maryland.