Ontario Interchangeability + Consent Forms
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Taher Rehmanji
As a result of recommendations proposed by NACI, ON is likely to approve interchangeability for vaccines sometime this week. This means patients who have taken AZ for their dose 1 may be eligible to take a mRNA vaccine for dose 2. In turn, ON has created an additional consent form to guide patient's through their selection of a dose 2. To best implement this consent form and interchangeability into your workflow we have a few considerations:
1) Are you going to be receiving both AZ and mRNA vaccine supply simultaneously?
2) How would you feel about AZ dose 1 patients calling the pharmacy if they desired an alternative mRNA vaccine for dose 2?
3) Any recommendations that you have, which would make this transition more manageable for the pharmacy and patients
UPDATES - please feel free to comment on the below direction:
1) A mass rescheduling feature will be implemented shortly to help move booked appointments to a different dates en-masse
2) Our potential solutions for collecting preferred dose 2 brand information:
- For patients on the Dose 2 Waitlist: Option found on the Dose 2 Waitlist tab to send an email where patients are prompted to either stay on the AZ dose 2 waitlist OR switch over to a dose 2 mRNA waitlist
- When sending booking links to patients on the Dose 2 Waitlist OR when sending rescheduling links to patients with booked Dose 2 appointments: Give patients the option to switch to a dose 2 mRNA waitlist or continue to booking when links are sent out
Nick Hui
Hi Everyone - The solution is now deployed! For more information, please visit: http://helpcenter.medmehealth.com/en/articles/5322153-az-mrna-interchangeability-management
We've opted to not include the Ontario AZ Consent forms within the current iteration of the feature for a few reasons:
- COVaxON does not currently support mass upload of the AZ Interchangeability consent
- We think it's best to collect the consent at the time of the appointment instead of prior to the appointment as guidance/research on interchangeability is constantly changing with new information coming out weekly
- The Ontario forms currently say the form should only be filled out if not captured on COVaxON
Nick Hui
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Nick Hui
Hi Everyone - The solution is now deployed! For more information, please visit: http://helpcenter.medmehealth.com/en/articles/5322153-az-mrna-interchangeability-management
We've opted to not include the Ontario AZ Consent forms within the current iteration of the feature for a few reasons:
- COVaxON does not currently support mass upload of the AZ Interchangeability consent
- We think it's best to collect the consent at the time of the appointment instead of prior to the appointment as guidance/research on interchangeability is constantly changing with new information coming out weekly
- The Ontario forms currently say the form should only be filled out if not captured on COVaxON
Rui Su
in progress
Our solution is detailed here (both temporary and permanent): http://helpcenter.medmehealth.com/en/articles/5307646-on-az-mrna-switch-mass-reschedule
Rui Su
Hi Everyone! Our solution is detailed here (both temporary and permanent): http://helpcenter.medmehealth.com/en/articles/5307646-on-az-mrna-switch-mass-reschedule
Thank you so much for your discussions and input (:
T
Taline Shalvardjian
Rui Su: thank you so much, we will wait for the permanent update. What about patients who received AZ first dose vaccine elsewhere and they signed up on our Pfizer dose 2 waitlist. How will their consent to switch vaccine types be captured?
Taher Rehmanji
Taline Shalvardjian: Hi Taline, that's a great consideration. We are currently working on building a dose 1 brand filter, which will make it easy to filter which patients signed up on your Dose 2 waitlist with an AZ dose 1. After that, there are two parts to the scenaro you mentioned:
1) Future patients who are now signing up to your dose 2 mRNA waitlist who had AZ dose 1. For these patient's we'd likely modify the waitlist intake so that it can capture their explicit consent.
2) Current patients on your waitlist who haven't had this consent captured. This one may take some fine-tuning but we may be able to send them a stay/switch email that allows them to stay on the mRNA waitlist OR switch to the AZ waitlist if they incorrectly signed up or changed their mind.
T
Taline Shalvardjian
Taher Rehmanji: Please let us know once these features are available...we currently have over 100 AZ first dose pts on our dose 2 pfizer waitlist (they did not receive their first dose with us). Would like to capture consent through medme vs having them fill out a paper form when they come into the pharmacy.
Taher Rehmanji
Taline Shalvardjian: Hi Taline, the permanent solution is still on track for a Friday release. If it is accelerated and releases any earlier than that, you will receive an update from the team!
J
John Walsh
Typing out loud here.
So I did AZ to start and I just received Moderna. I booked 2nd dose 16 weeks from their first.
I am trying to think of the simplest solution in regards to the move from 16 weeks to 12 and mixing and patient choice around that.
Is it possible to send everyone that is currently booked a link to rebook
but they can only book from 12 weeks from their first dose up to a specified end date
(I do not want to have to worry if they are booking it too early) This way I can open up enough days/weeks, send out email and link and then they can choose time/date and what vaccine, and fill in any consents that are needed...Also I have no idea yet how to manage ensuring we use up a vial of Moderna once punctured if we had AZ patients that day...ugh...
maybe we have to have Moderna days and AZ days?
So the links go out and if they pick AZ it is only certain days or weeks I picked and if they picked Moderna they will see other dats/times to choose but I can limit the number of spots to the vial....
Taher Rehmanji
John Walsh: Hi John, great points! The mass rescheduling link will definitely have the option to set bookable days so that patients can sign up based on the availability you as the pharmacist specify. This should ensure no one signs up earlier than they are eligible. Secondly, knowing that it may be difficult to schedule with two different vaccine types, we opted to have patients who want to have an mRNA join the waitlist rather than reschedule an mRNA appointment type directly. This way you will have the flexibility to manage these patients, and send them a booking link based on the days/times you are able to.
J
John Walsh
No more phone calls please
James Woods
I think our main concern will be giving the people who had AZ as dose 1 at our pharmacy the option to select either AZ or mRNA as their second dose without having to contact the pharmacy. We have Dose 1, Dose 2 AZ and dose 2 mRNA waitlists open, so a person who did not get dose 1 from us is just going to join the waitlist that they want. Our dose 1 mRNA people don't really have a choice - if they want the other mRNA they are going to have to go to a different pharmacy. We won't be doing AZ and mRNA on the same schedule because we need to be careful of the number of doses / vial to minimize wastage. So, maybe something like giving an option on the rebooking link for AZ appointments to choose to join the wait list for the mRNA vaccine instead of booking the AZ appointment? It would have to be worded clearly though to let them know that they can't decide in the pharmacy that they are going to change. Also, by choosing to change, they would join the wait list for mRNA and may not be able to book right away.
Also, please do not allow a Pfizer 1st dose to join Moderna 2nd dose or Moderna 1st dose to join Pfizer 2nd dose. This might need to change eventually, but for Ontario at least the rule will be 1st & 2nd dose mRNA should be the same unless one of the mRNA vaccines becomes unavailable.
T
Taline Shalvardjian
We currently have not moved our first dose AZ patients to the dose 2 waitlist. They are still booked at 16 weeks. If we move them to a waitlist (either AZ dose 2 or Pfizer dose 2 ) based on their preference, then could some features/information be added to the waitlist that would inform us of when their 2nd dose would be due at 12 weeks? Right now we have to do our own math based on their first dose date. But if there was a column that calculated the 12 week interval from their first dose it would really help us identify who is due for their dose so we can send them the booking link. The same goes for all waitlists if their first dose was AZ all second doses whether AZ or mRNA need to be at 12 weeks.
T
Taline Shalvardjian
The dose 2 waitlist should also show what vaccine they received as first dose so we don't need to open each one and verify before we send booking link.
Taher Rehmanji
From Andrew:
Here are my thoughts on this...for now:
-Like most stores, we have abandoned our original AZ dose 2 appointment dates/times and have moved everyone that received AZ dose 1, to the AZ dose 2 waitlist.
-We're still awaiting the details of how this will work in Ontario, but yes, it does appear as though patients will have the CHOICE to receive AZ or mRNA as dose 2.
-Ideally your team would be able to create an email which we could send to our Dose 2 - AZ waitlist, giving patients the option to "Stay in the Dose 2 - AZ Waitlist" or "Sign up for the Dose 2 - Pfizer Waitlist" (we have Pfizer for mRNA at our pharmacy).
-If one wishes to stay in the Dose 2-AZ waitlist, no action would be required.
-If one wishes to move to the Dose 2-Pfizer Waitlist, ideally the email would be created in such a way that they click on a link, complete the necessary ADDED consents and get moved to the Dose-2 Pfizer Waitlist. In this scenario. I would suggest that we probably need to create a unique appointment type/dose 2 waitlist called "Dose 2-Pfizer (for Dose 1 AZ Patients)" so that we can clearly identify this unique group - as it's likely that the the timing of dose 2 for these patients might be different than those that received mRNA as dose 1.
-For Ontario, I'd let this sit until the end of the week so that we have some more details from the province, but I think what I suggested above would work well.
Rui Su
From Sameer:
As mentioned, we were doing 300 AZ per week and only getting 100-150 vaccines per week going forward (if at all). We need to be able to have a way to identify patients that received their 1st dose at our pharmacy (or at least who we put on the waitlist) so that we can prioritize them as we have provided them all 2nd dose appointments in the past (per the MOH requirements). If we start giving 2nd doses to patients before looking after the ones who had their 1st doses with us, we will have some very angry patients on our hands.
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