Ascension’s Dr Cacchione Discusses How the Health System Brought Vaccines to the Communities It Serves

Chief Healthcare Executive™ recently sat down with Ascension’s Joseph Cacchione, MD, FACC, executive vice president, Clinical & Network Services, for a wide-ranging discussion on vaccine distribution and hesitancy and other challenges of healthcare delivery during COVID-19.

This segment has been lighted edited for clarity.

CHE: Could you tell us about efforts to bring the COVID-19 vaccine to the communities that you serve?

Cacchione: We’ve been strongly advocating for the vaccine with our patients early on. The populations that we were reaching out to started with our own employees, and getting our own employees vaccinated. We made vaccinations available very early to many of our employees. … We knew that supply was not going to be the issue—that eventually it was going to be about hesitancy. And so, it was very much pushing anybody who was willing to get a vaccine—we wanted to get them a vaccine—that we had plenty of supply. And then the second wave [involved reaching out to our patients and looking; what we did was a multi-channel approach: we had mass vaccination sites, we partnered with communities, we partnered with other providers. For us, it was an “all hands on deck” approach to getting everybody vaccinated [who] wanted to be vaccinated.

More importantly, [was] what we did through our practices. Through our advanced analytics, we mined our data looking for those patients [who] are most at risk for COVID—those with high-risk conditions, the most vulnerable populations. We actually use a social deprivation index—looking at those ZIP codes, and we reached into those communities and proactively called those patients, and said, “Please come in, you qualify for the vaccine based on the current criteria. …We want you to be vaccinated.” And we had a fair amount of success getting some of those people in at a time when others might not have had much success.

“We’ve also now partnered with Phreesia and the Commonwealth Fund, and have data now on several hundred thousand patients on vaccine hesitancy through an online portal. We tried to understand why people are refusing to get the vaccine or hesitant to get the vaccine.”

CHE: All health systems are facing the challenge of some level of vaccine hesitancy among the staff. Do you have a particular strategy for how you're dealing with this issue at Ascension?

Cacchione: Early on, it was about urging and educating and making it readily available. That was the approach. And now we've hit a plateau in our employee population, it's probably still about two-thirds of our people are vaccinated. And unfortunately, our working population is a microcosm of the U.S. population. A lot of our people with high social vulnerability index scores—even in our employee group –are the people not vaccinated. So, we've been proactively reaching out, we can convert about one in five of them to get the vaccine by continually proactively reaching out, or having their physicians reach out. But we're at a plateau right now. And I'm somewhat worried about that. I think once [the vaccine] comes off of emergency use authorization [and receives full FDA approve], I suspect we'll get a little bit more prescriptive about that; we may require the vaccine going forward.