How can technology inject trust and reliability in vaccine distribution?
Blockchain and cloud offer government and healthcare leaders new visibility into a historic vaccine rollout
Technology like blockchain and cloud can help streamline vaccine distribution and adoption.
On December 30, for the second time in as many weeks, General Gustave Perna, head of the U.S. government’s Project Warp Speed vaccine program, sat inside a Pentagon briefing room and apologized—even for issues well beyond his command. While 20 million vaccines had been made available as promised, only a fraction had made it into people’s arms.
“There’s two holidays, there’s been three major snowstorms,” General Perna, dressed fittingly in battle fatigues, explained. “There is everybody working through, you know, how to do the notification, how to make sure we’re administering it the right way, how to ensure that it stays in accordance with the cold chain. There’s numerous factors.”
Weeks later and the situation has only grown more dire.
While truly historic efforts were made in developing the COVID-19 vaccine, the federal and local governments and public and private healthcare providers are still relying on a medical system that has long been fragmented and inefficient. The strain of COVID-19 may only be fracturing things further, as the familiar lines grow and forms pile up.
Add to that mistrust of the new vaccines over the course of last year—reaching 49 percent at one point, according to the Pew Research Center—while an alarming new strain first identified in the United Kingdom could be as much as 70 percent more contagious. Suddenly, the planet’s race for more shots versus more spread has become an all-out sprint.
Looking to gain any advantage they can any way they can, many leaders and organizations are turning to technology for a leg up.
While they can’t cure disruptions or distrust, services like blockchain, AI and cloud computing are proving as essential as nurses, needles and refrigerators for the successful adoption and distribution of vaccines around the world. The benefits start with vaccines to slow down the spread of COVID-19 but by no means will end there.
As with so many things over the past year, the work won’t be easy, but it will be necessary. It’s a challenging moment, as well as a historic one, in almost every way.
“We’re at a time with vaccines that’s a bit like hailing a cab a few years ago,” Chris Moose, a partner in the Healthcare and Life Sciences group at IBM Services, said in a recent interview with Industrious. “You used to just call a cab and know it was going to show up eventually. With all the apps, suddenly you knew how long it would be, who was coming, where from, you could communicate along the way. With COVID, that’s what we’ve needed, an execution engine.”
Blockchain for a trustworthy supply chain
Moose had been thinking about similar problems within the medical supply chain for years. He and a team at IBM had been looking at technologies, particularly blockchain, as tools to build up trust and transparency to combat issues as widespread as the counterfeiting, smuggling, false sale and mismanagement of drugs and therapeutics.
Just as the parts of a car or smartphone may be shuttled between factories, cities, even countries during manufacturing, the same has been happening with drugs and medical devices.
“The industry’s developed a very complex supply chain where the components of drugs, active ingredients or entire molecules, are being made all over the world, and we really don’t know where,” Mark Treshock, the blockchain solutions lead for Healthcare and Life Sciences at IBM, told Industrious.
For all the benefits, each new link in that supply chain also introduced the opportunity for intellectual property to be copied or medicines left out in unstable conditions. Between June and December 2019, IBM, Merck, Walmart and KPMG completed a pilot sponsored by the US Food and Drug Administration that demonstrated blockchain could help overcome medical supply chain blind spots. By uploading origination, shipment and usage data to an immutable blockchain ledger, the companies were able to demonstrate connect disparate systems and organizations in order to record a common view of product traceability.
As COVID-19 swept the globe early last year, the IBM team began to look for ways to aid deployment of the rush of vaccines already in research and production.
“There’s trust issues, but there’s also a crush of demand for vaccines,” Treshock said. “How can you leverage technology to give people confidence that they’re receiving good vaccines?”
Meetings with Project Warp Speed and other healthcare and government leaders ensued over the summer. With many still squarely focused on the historic pace of vaccine production, questions around its equally historic global distribution lingered.
In December, IBM proposed an open-source vaccine management system built on the existing blockchain framework and supported by the Linux foundation. As before, it can provide trust and transparency in the provenance of medicine—with the COVID-specific parameters now featured, such as whether the vaccines are kept at the right temperature or even if extra doses may be available.
“A lot of healthcare business models are built upon hoarding information, and that’s what we’re trying to avoid by going open source,” Moose explains. “It’s become in everyone’s best interests to understand where this stuff is coming from and where it’s going, to keep it as affordable as possible.”
COVID challenges trust everywhere
This trust will only grow in importance as demand—or lack thereof—shifts from those who have rolled up their sleeves for the vaccine to those who remain wary of it.
Dr. William Kassler, chief medical officer of Watson Health, outlined for Industrious how the issues have become as widespread as the virus itself:
“We are challenged by not only the complexities of the cold chain, of multiple doses, of a mass vaccination campaign that has never been attempted. We are likewise challenged by an atmosphere of distrust and vaccine hesitancy, some of which has been building for years.
“You add to that the polarization in our country that has caught up COVID-19, turning healthcare, public health and science into partisan issues. You add to that the fear of the unknown, with regards to these new vaccine technologies and the unprecedented speed of trials.
“You add to that the mistrust of certain communities, like African-Americans, because of systemic racism, and because the health care system and the government have an unfortunately checkered history of not treating that community ethically.
“And you add to that not every American has equal access to healthcare, and these are communities COVID-19 has really run rampant through. There’s transportation, mental health, housing or food-security issues that means they can’t prioritize or can’t get access to healthcare.”
“We’ve got to get ahead of this thing”
Overcoming so many factors, and more, means officials will need all the support and confidence they can get in the vaccines they have. The recent struggles with vaccine rollouts has caused delays, making the need to get back on track that much greater—for the health of not just individuals but businesses and economies, as well as the health of the flagging medical system itself.
“This isn’t just an economic reopening story,” Moose said. “This is a ‘stamp this thing out before things get even worse’ story.”
And, with a new, more contagious strain running rampant in many places, that could already be happening, undercutting any gains the current batch of vaccines is achieving.
“We’ve got to get people vaccinated,” Carl Zimmer, the New York Times columnist and author of A Planet of Viruses, recently said. “We’ve got to get ahead of this thing, because otherwise, it’s going to really do us a lot of damage.”
That’s one thing a blockchain-based vaccine management system can also help with. The transparency the drives trust can also give officials and leaders a greater handle on supplies, directing and distributing them with new speed and certainty.
Older systems and processes are a big part of the holdup over the past month. The initial desire to reserve shots for the most essential workers and at-risk populations confront the challenges of reaching and scheduling those groups. Consequently, access was throttled and some medicines even wound up being wasted precisely because it was harder to schedule and manage.
Many states and eventually the CDC loosened their restriction by January 11, which led to the opposite problem: the crunch many initially feared when drafting the tighter rules overwhelmed the fragile medical system. Hundreds are lining up at injection sites, sometimes without appointments. Others are spending hours online trying to get even that far.
Data for equitable injections
Signs of a straining system are everywhere. In the span of a few days, those eligible for vaccination in New York state jumped from fewer than 1 million to 7 million. Some Florida counties turned to sites typically used for selling concert and event tickets to schedule shots, calling it “the quickest, easiest, and most efficient way that we can think of to help the department of health solve this issue right now.”
“What we’re seeing is a data visibility problem,” Treshock said. “If we knew where every vaccine was in a state, in the country, even in the whole world—and we can do this with the right data on the blockchain—we could understand how these vaccines are moving around and getting used, and that would alleviate at least some of what we’re seeing now.”
Such visibility would also boost efforts at ensuring an equitable distribution of the vaccine that many are seeking.
And as data grows on who is getting the vaccine, it can be fed back into the system. Using cloud-based AI analysis, organization could then determine the communities that are either missing out on the vaccine or resisting it.
“We can identify those populations where they live and what messages are likely to resonate with them,” Dr. Kassler said. “Do they trust doctors? Their peers? Their leaders and institutions? We can craft our outreach around that.”
With the right approach, the data can continue to build, and continue to do good into the future.
“If we learned our lesson, if we make investments in technology and procedures and changes in practice, it can leave us stronger,” Dr. Kassler said. “Not only for future emergencies and future pandemic, which will inevitably come, but in terms of really reinventing how we work on a day-to-day basis.”