CDC paid $ 44 million to Deloitte for a flawed vaccine appointment system

• The CDC gave Deloitte $ 44 million as a federal contractor to create a website for vaccine appointments.
• Most states chose not to use the tool due to concerns about its performance, but nine states chose it.
• Several health officials in those states say they have technical issues, including crashes at the site and canceled appointments.
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Americans eligible for coronavirus vaccines are still struggling to secure appointments.

“Each clinic, each hospital has its own mechanism for communication, recruitment and appointment scheduling,” Mississippi public health official Dr. Thomas Dobbs said at a press briefing Thursday. “That’s the real challenge because we basically have 100 different ways of doing the same thing.”

It wasn’t supposed to be that difficult. In May, the Centers for Disease Control and Prevention signed a $ 16 million deal with consulting firm Deloitte, a leading federal IT contractor, to create a centralized website where states could schedule their appointments. you for vaccines. The system was also intended to monitor vaccine inventory and report each injection as it was administered. Deloitte received an additional $ 28 million for the project in December, bringing the total to $ 44 million.

The tool produced by the company is called the Vaccine Administration Management System (VAMS). State officials and health clinics can use the site for free to coordinate their vaccine deployments. But in the end, only nine states opted in, the others – Mississippi included – speaking out against VAMS. Many have said no to the system due to concerns about its performance.

“We refused to use the VAMS after checking it in January, spending a lot of time looking at it and kicking the tires,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention at Thursday’s briefing. “We found that it had several limitations so we didn’t activate it at all.”

Most states now find themselves without a centralized system to streamline their responses. But of the nine states that have started using VAM – including Connecticut, New Hampshire, South Carolina, Virginia, and West Virginia – many have experienced technology issues, including website outages, appointments you canceled and connection difficulties.

Since mid-December, VAMS has helped deliver just 4% of the total injections administered in the United States, or more than 1.5 million.

Appointments canceled and no confirmation email

Paula Bronstein / Getty Images

States encountered problems with VAMS soon after vaccinations began in December.

Marshall Taylor, acting director of the South Carolina Department of Health, told Greenville News the system would spontaneously cancel appointments and couldn’t tell the difference between a first or second dose (the Pfizer and Moderna vaccines require two injections).

VAMS, he said, “has become a bad word” in his department.

Lorrin Pang, the district health officer for Maui, Hawaii, told the MIT Technology Review that the tool would not allow him to send instructions to people on how to prepare for their appointments for them. vaccines. The system often excluded him from the clinic admin dashboard, he added. Pang’s drive-thru clinic quickly reverted to hand-held vaccination recording.

In New Hampshire, residents said they had not received confirmation emails for their second dose appointments.

“The VAMS system clearly has problems. It’s clunky, it’s messy, and we really can’t control it,” New Hampshire Gov. Chris Sununu told the New Hampshire Union Leader.

Officials say VAMS ‘broke promises’

Ethan Miller / Getty Images

A spokesperson for Deloitte told Insider that VAMS was originally designed to help CDC track vaccine distribution and administration “at a limited number of prequalified sites.” But out of courtesy to states without the time and resources to create or procure their own planning systems, he added, the CDC has given them the option of using VAMS.

“Since it was commissioned to support the critical first phase of vaccinations, VAMS has experienced no downtime due to system or performance issues,” said the Deloitte spokesperson. “Although some users have reported issues, VAMS does not spontaneously cancel appointments.”

The CDC did not respond to Insider’s request for comment.

According to Shah, VAMS was supposed to be available to anyone who wanted to sign up for a date. But the tool “really did not keep its promises,” he said. Without a centralized system, Maine’s vaccine appointment solicitation process has been “suboptimal,” Shah added.

“We can hope that there will be a successor [to VAMS] in the future, ”he said.

But creating a centralized government-run website is “super difficult,” according to Pouria Sanae, CEO of ixlayer, a healthcare software company that helps streamline COVID-19 testing and some vaccinations for business, healthcare systems. health and government branches.

“Let’s take taxes as an example,” Sanae told Insider. “We don’t have a centralized tax platform, and it’s something we do every year.”

A “Google effort” with “old-fashioned” technology

Valerie Macon / AFP / Getty Images

The CDC identified Deloitte as the only “responsible source” capable of building a centralized immunization platform, so the company did not have to bid on the project. Many software experts, however, believe that VAMS would have been in better hands with a large tech company.

“It’s a Google-like effort,” Sanae said. “It is not intended for government organizations.”

To avoid bottlenecks in vaccine deployment, he added, states need a website that can be constantly updated while in use. That way, if a patient misses an appointment or clinics run out of doses, these obstacles won’t slow down the entire vaccination process.

Deloitte’s technology, by contrast, is “old-fashioned,” Sanae said. It relies on a fixed “waterfall model” which, for the most part, cannot handle many changes.

“There’s a reason Apple and Windows are bothering us with these updates: because they’re being iterated,” he said. “We really need it for any software that is going to support immunization.”

VAMS is likely to create more bottlenecks on the road, Sanae thinks, as people return for their second photos.

“One thing you will see in a month, I guarantee you, is the people who got the first dose showing up in different places with different vaccines, showing up in different states,” he said.

Switching systems pose new challenges

Sean Rayford / Getty Images

At least one state, Virginia, is already in the process of switching from VAMS to a different vaccination system called PrepMod, which is also used by several other states. Tammie Smith, a spokeswoman for the Virginia Department of Health, told Bloomberg that the platform is “more customizable” than VAMS.

Yet in early February, a flaw in the PrepMod system allowed a handful of residents of Roanoke Valley, Va., To sign up for vaccine appointments before being eligible. Residents got their hands on a recording link that was not supposed to be sent, local TV station WSLS reported.

According to the Los Angeles Times, clinics and nursing homes in California have also had difficulty accessing the PrepMod system.

Sanae said PrepMod found it “a bit tricky” for the patients on board. He added that states may also struggle to move patient data from VAMS to a new platform. He likened the process to moving each person’s Gmail account to Yahoo.

Changing appointment systems can also be costly.

“At some point with IT solutions there is a bit of a lockdown effect and the cost of switching from one recording platform to another can be significant,” Shah said.

But he added that some states are still seeking to abandon VAMS as soon as possible.

“I spoke with at least one of my counterparts, where their condition activated [VAMS], and they can’t wait to find another solution, ”Shah said.

Maura Fitzgerald, spokesperson for the Connecticut Department of Public Health, told Bloomberg that her state is exploring alternative systems. New Hampshire also plans to unveil a new planning system by March.