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Equal Access Does Not Mean Equal Participation

13 ways we provide better access for more people

In the battle to contain the COVID-19 wildfire, healthcare partners have drawn on powerful resources to protect vulnerable communities at an unprecedented scale. States have set up free testing sites in sports arenas, and tech companies have hired hundreds of traveling clinicians to administer vaccines. But while efforts to provide testing, tracking, and treatment have been strong, in some cases, the number of people served has been lower than expected. Why the gap?

“We found that equal access does not mean equal participation,” said Andrew Kobylinski, Primary.Health CEO and co-founder. “Engaging people in the healthcare delivery process takes a combination of user-friendly technology and social sensibility.”

Here’s how we remove 13 barriers to participation—

1. Language access – US Census data shows 25 million people across all racial and ethnic groups aren’t able to communicate well in English.1 For those people, language impacts everything from access to basic information about the virus, to booking an appointment, to being vaccinated.

Our platform supports more than 20 languages, including rare East African languages that reflect our work in Minnesota’s immigrant communities.

2. Closing the trust gap – A September 2020 study found that most Black Americans and Latinx Americans mistrust the safety and effectiveness of a vaccine. Researchers say the best messengers and influencers come from within people’s communities.

Rather than hiring traveling nurses, we empower local clinics, community and faith-based organizations, county agencies and local pharmacies to run their own testing and vaccination programs.

3. Alternatives to Internet – Lack of Internet access can be a barrier for rural areas, lower-income neighborhoods, and older adults living alone.

We support phone registration so that those without internet access can register for testing and vaccination appointments. We also support automated messages to landlines for those who can’t receive emails or text messages.

4. Reserved appointment slots – Booking an appointment can take multiple devices, multiple individuals, and repeated attempts over hours, days, or even weeks. First come, first served means tech-savvy people with five laptops scanning for openings will scoop up all the appointments.

With our software, you can reserve 20 percent of your appointment slots for phone registrations or a specific demographic.

5. Streamlined registration – In light of fake vaccine registration scams, users are wary of anyone who asks them to install an app or software.

Our application is web-based, so there is no need to install an app or software.

6. Data privacy – People are wary of entering personal information.

Our platform doesn’t require participants to create logins and passwords or to have an email address. Our software is fully customizable to require as much or as little information about participants as our clients need to perform services.

7. Location, location, location – Even though setting up a clinic in a stadium might seem like an efficient way to serve large numbers of people, we have found that capacity is less important than convenience for vulnerable groups.

We set up clinics in places people are used to going to, like church parking lots and BART stations.

8. Familiar faces – Early in the pandemic, states staffed clinics with National Guard, fire, or police department teams. Understandably, homeless people and undocumented immigrants did not feel comfortable checking in.

We ask community leaders to serve as site greeters. Even though security staff might be present, the greeters welcome people and thank them for coming.

9. Multimodal testing – Saliva tests work great for kids, but seniors and persons with disabilities can’t always produce enough sputum for a valid test.

Multi-modal testing is critical.

10. Streamlined workflows – Streamlining processes reduces wait times and reduces traffic in clinics—important for staff and participant safety, for working parents, and for people whose health won’t allow them to stand in line for hours.

We see efficiency as a matter of health equity.

11. Going digital – Using a software platform to manage onsite workflows reduces errors, streamlines the reporting process, and ensures digital health records can be maintained.

12. Automate, automate, automate – Workflow automation saves time on performing routine tasks.

We automate result notifications to eliminate the need for testing participants to wait onsite for 15 minutes to get their results. This keeps your staff safer by keeping the flow of traffic moving and maintaining proper social distancing.

13. Data interoperability – Point of care software must integrate with electronic systems, such as electronic medical records.

Our consumer-friendly front-end software easily exports data to EMRs or billing management.

Kobylinski explained, “We empower community-based organizations and providers because they understand the local cultures, and they know how to deliver health care to those individuals. They just need the tools to do it efficiently at a mass scale. We help them trade their clipboards for the fastest and most accurate software tools.”

1 Lost in Translation: Language Barriers Hinder Vaccine Access. Brenda Goodman, WebMD, April 23, 2021 https://www.webmd.com/vaccines/covid-19-vaccine/news/20210426/lost-in-translation-language-barriers-hinder-vaccine-access

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