Washington State Department of Health Harnesses the Power of Providers for COVID-19 Vaccine Outreach
Innovative Strategies Helped State Achieve One of Nation’s Highest Vaccination Rates
As of November 10, 2021, 75.1% of all eligible people in Washington Stateexternal icon are fully vaccinated compared to 58.5% in the U.S. overall.
As COVID-19 vaccines became widely available, most of the state’s eligible residents were eager to get vaccinated and did so at mass vaccination clinics, events, hospital systems, and participating pharmacies. As demand waned, the Washington State Department of Health (DOH) partnered with pharmacies and healthcare providers to reach out to communities through mobile vaccination clinics.
While vaccines continue to be available at participating pharmacies and providers, the DOH now focuses on reaching residents with COVID-19 vaccine information through their providers during their routine health and wellness visits.
To address a decline in vaccine demand, DOH leadership called for an initiative to mobilize healthcare providers to leverage their influence as trusted voices and encourage COVID-19 vaccinations during their routine patient encounters.
Drawing on research findingsexternal icon indicating that doctors are the most trusted source of COVID-19 information, and answering the call for a provider initiative, the DOH created the Power of Providers (POP) initiativeexternal icon.
We are calling on all licensed healthcare professionals to talk to their patients about COVID-19 vaccines. It’s one person at a time. One conversation at a time. One vaccination at a time. It’s opportunities we should not miss at the diabetes check, at the blood pressure check, at the knee repair.
The DOH launched POP in July 2021 with the endorsement of more than 20 provider associations statewidepdf iconexternal icon. The agency invites healthcare and wellness providers and associations across the state to participate in POP to promote COVID-19 vaccines as part of patients’ overall health and wellness.
Providers enroll in POP by completing an online commitment formexternal icon asking them to agree to follow a four-step process at every patient encounter to help “SAVE” lives:
- Seek patients’ COVID-19 vaccination status verbally or through immunization records
- Ask/Educate unvaccinated patients about the vaccines, and offer more information if they’re unsure
- Vaccinate patients who agree to be vaccinated, or refer them to a COVID-19 vaccine provider
- Empower patients and staff to share their vaccination status with their friends, families, and communities
As of October 1, 2021, POP enrollment includes 64,418 of the state’s roughly 400,000 providers. The agency’s goal is to enroll 212,000 providers.
Community Vaccination Partner Certificates
Providers participating in POP receive a “Community Vaccination Partner” certificate for display, and access to a portal where they can order free swag for their patients and staff, including tear pads, buttons, stickers, and window clings.
Providers are encouraged to use the DOH’s COVID-19 Vaccine Toolkit and Resources for Enrolled Providersexternal icon. The toolkit contains protocols for storing, handling, and transporting vaccines, and other technical information. It also has valuable communication guides to help providers advise their patients about COVID-19 vaccines, including:
- Addressing vaccine hesitancy
- Addressing misinformation
- Informing about COVID-19 vaccines and reproductive health
- Building confidence in COVID-19 vaccines among immigrants and refugees
- Providing care to people who are homeless
- Building confidence in specific vaccines
POP is flexible. We are not telling providers how to have their conversations. Providers are free to adapt their messages to the needs of their communities.
Program Emails, CE Opportunities
Participating providers receive POP emails every two weeks with information to help them talk to their patients about COVID-19 vaccination. Some DOH presentations offer continuing education units.
New CPT Code & Reimbursement for COVID-19 Vaccine Counseling
To further incentivize providers to talk with their patients about COVID-19 vaccination, the state’s Office of the Insurance Commissioner created a Current Procedural Terminology code for providers to be reimbursed for COVID-19 vaccine counseling, even during visits unrelated to vaccination. For flexibility, the state’s vaccine depot program enables providers to order small vaccine quantities to match their needs.
Partnerships with Providers, Associations, Health Systems, Pharmacies, Media
The DOH maintains strong partnerships with individual providers and with large health systems and pharmacies, which some patients consult more regularly than their doctors.
Before we launched POP, we talked to provider associations and got their buy-in. By taking time to get associations to partner with us before we launched, they became our allies in promoting the initiative.
The DOH also works with a media relations firm to inform providers about POP through professional newsletters, magazines, journals, briefings, webinars, and social media channels. The agency welcomes associations and managed care organizations to join the program, and provides them with phone scripts, email templates, and moreexternal icon to help them recruit their provider members.
As the Department of Health, we need to build strong communication and relationships with all our providers ─ in all healthcare settings ─ not only primary care. Providers typically hear from the Department of Health about license renewals, new rules, or disciplinary actions. We developed a strategy to engage with providers in a way that tells them we bring value to the table.
“We are building the plane as we are flying it, adapting our strategies to new challenges,” Mr. Endler said. “With Governor Inslee and Secretary Shah’s strong drive to help save lives by enrolling providers as quickly as possible, the agency stood up the POP initiative within weeks. But we did not have adequate staff or structure in place. In hindsight, we would have needed at least a few months to develop a solid foundation and plan of action.”
One of POP’s first issues involved the suitability of various providers. The DOH marketed POP to all licensed Washington providers but learned that, while some specialists — physicians, orthopedists, and pharmacists — were effective at nudging people to be vaccinated, others — nutritionists and massage therapists — tended to be less persuasive. The agency adjusted its strategy to focus on reaching more traditional healthcare providers.
The DOH also made efforts to identify providers that could best access hard to reach community members. “We’re expanding our efforts by widening our definition of ‘providers’ to include community health workers, who visit people in their homes and talk with them using culturally-appropriate language,” Ms. Koenig said. “They may not be licensed, but they are trusted. Community health workers are effective vaccine messengers.” DOH teams made phone calls and sent emails to meet the challenge of enrolling providers in areas of Eastern Washington with high social vulnerability index and low vaccine uptake.
As for lessons learned, the DOH noted that automatically enrolling providers in POP and allowing them to opt out would have been a much more efficient way to handle enrollment than the agency’s initial approach of requesting each provider and association to enroll. Also, the “provider type” question in the initial enrollment form is open-ended. Data captured is not uniform and requires manual categorization. A drop-down menu with specific choices would have been more efficient. Lastly, an initiative of this size and rapid growth requires dedicated full-time staff.
Bringing all partners to the table and working with people appropriately has been key to POP’s success.
In the long term, we will need to maintain these engagements with our providers, so when this occurs again, we will have that army of professionals ready to help us. I hope POP can survive beyond COVID-19 and we can hard-code the POP initiative and the SAVE framework into all encounters with patients to ensure they are protected from vaccine-preventable diseases.