Texas has 79 vaccine hubs but most sites don’t have enough shots to meet the demand. Red dots indicate no availability and blue dots mean a first dose is available.
Image: TechRepublic

The COVID-19 vaccine process is literally all over the map. New York State has an “Am I eligible?” app. California has a “My Turn” website. Texas has a collection of 79 vaccine hubs each with its own website and sign-up process.

Pharmacy chains that offer vaccine appointments each have their own process as well. In February, the federal government launched a retail pharmacy program to expand vaccination sites beyond state clinics and hospitals. Twenty-one retail stores ranging from Kroger to Publix to Walgreens to Costco will offer vaccines once the supply increases and more people are eligible to get the shot. This availability varies as well with each state having a specific set of retail partners.

SEE: Big data’s role in COVID-19 (free PDF) (TechRepublic)

Kroger uses a chatbot to determine eligibility and access to appointments. Meijer asks eligibility questions about age and occupation and creates a waiting list. Individuals who signed up will be notified when they are eligible for a shot.

The free-for-all nature of the search for a vaccine appointment makes distribution more difficult. Individuals don’t understand the process which makes it hard to trust the system. Here is how government and health system leaders need to improve the sign-up process to make it more user-friendly.

How to make the vaccine sign-up process more user-friendly

Arielle Trzcinski, a principal analyst in Forrester’s healthcare practice, said that many sign-up processes count on individuals being able to navigate a mobile browser. Focusing the sign-up process on digital channels means that large groups of people will have a hard time getting the vaccine.

“We are leaving people behind and we’re not making them feel like a valued part of our community,” she said.

This is particularly true for low-income individuals and older Americans, she said.

Trzcinski said there four key elements to consider when designing an online sign-up process:

  • Emotion
  • Allowing for mistakes
  • Ease of navigation
  • Mobile-friendly design

Background colors and font colors provoke certain emotions in a user. Trzcinski said that designers building healthcare websites should consider what emotions they are creating with these design choices.

“We see a lot of red text on these websites,” she said.

Design choices also influence the level of confidence a user has in a site. If a user can pick up on the scent of information, he or she feels more confident in being able to find a certain piece of information. As Jared M. Spool, Christine Perfetti, David Brittan described in the report, “Designing for the Scent of Information,” users make wild guesses when the scent of information is weak. When the scent is strong, a user feels more confident about locating what they are seeking.

Designers also should assume that users will make mistakes during the sign-up process and build guardrails into the process.

“It has to be OK to hit the back button to figure out where you are in the journey,” she said.

With many vaccine signup sites, hitting the back button means starting over and losing your place in line, which likely means losing your chance at getting an appointment. This design element also influences a user’s confidence level in the process, Trzcinski said.

“My wait times went from 5 minutes to 1,200 minutes at one point and I’ve seen screenshots of wait times of 60,000 minutes,” she said. “This also conveys a certain set of emotions to a user.”

If the process has five steps, the website should indicate to a user what step he or she is in to make navigation easy. Users should be able to search for appointments based on date, time, and location, not just the shot availability, Trzcinski said.

Finally, any vaccine signup site should work equally well on a desktop and a mobile browser.

“If you are going from a laptop to mobile phone, the experience has to be consistent and if it isn’t that erodes user confidence even more,” she said.

Trzcinski said that the key to success is testing the signup process to see how users will react to it. This includes journey mapping and empathy mapping.

“People don’t always follow the path that you lay out for them, so you have to figure out what people will do that you didn’t account for in your design,” she said.

Many states have vaccine hotlines that residents can call to get more information and help to sign up for a shot. Trzcinski said states should use hotline calls to gather qualitative data about the signup process. Operators should ask callers about what parts of the signup process worked well and what worked poorly.

“While you have folks on the phone, you can get some qualitative data to inform feature enhancements,” she said. “There’s so much rich data collection in having a conversation with individuals.”

Trzcinski said states and healthcare organizations should track these metrics to see how well the signup process is working:

  1. Task success: Compare how many people entered a digital waiting room and how many made appointments
  2. Dropoff points: What is the trigger for a person to exit the process?
  3. Trust levels: Did the person have enough information about what to expect at the vaccine appointment?
  4. Iterative improvement: Did completion rates go up after the process was revised?

Trzcinski said that organizations managing the signup process have to keep collecting user data to improve the process over time.

“If more people are signing up and they’re happier with the process, that means they’ll recommend it to other people and that means we are getting closer to herd immunity,” she said.

Advice for states running vaccine distribution sites

Spark Advisors is a consumer concierge service designed to help Medicare beneficiaries enroll in Medicare and take advantage of all benefits after enrolling. James Jiang, CEO of Spark Advisors, said the company has helped members schedule COVID-19 vaccines and access special COVID resources from their insurance plans. Jiang said he has seen two common problems as advisers have helped schedule vaccines in 10 states:

  1. Variability: The process to schedule vaccine appointments varies from state to state, county to county, and administrator to administrator. Vaccine availability differs across all as well. For instance, Georgia’s Vaccine Locator is a simple list of phone numbers, whereas South Carolina’s Vaccine Locator provides distance-based sorting and direct links to scheduling
  2. Ambiguous workflows: Many processes will provide basic information about when a person may be able to receive a vaccine and a phone directory of possible administrators. From that point, the person has to find out who actually has vaccine availability and navigate the scheduling process. There is no standardized solution currently available where an individual inputs required personal information and receives scheduling options across all vaccine sites that have shots availability.

Jiang recommended that healthcare systems running vaccine distribution sites simplify the scheduling process so that patients can get an appointment quickly without having to create log-ins or navigate phone trees.

For states and counties that are distributing vaccines, Jiang suggested that officials provide information on vaccine availability at each site.