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When Ireland recorded its first case of COVID-19 in February 2020, the Health Service Executive’s (HSE) IT team knew they had to move swiftly to protect lives. However, like most other national health services around the world, HSE found itself in unknown territory overnight. With the pandemic building pace and government advice changing regularly, it was impossible for the team to plan – they simply had to act. 

As the race to develop a vaccine began, HSE knew one thing for sure – they needed to be ready to roll out a nationwide vaccination program to Ireland’s population as soon as one became available. 

“The situation was developing daily, so we weren’t in a position to articulate our requirements upfront,” explains Fran Thompson, CIO of HSE. “We wanted a solution that could keep citizens informed of their own vaccine journey and the overall progress of the vaccine rollout program, but we didn’t know what we might need in the future. Any solution we chose had to be flexible and scalable.”

IBM and Salesforce helped HSE create a national vaccination management platform, known as COVAX (COVID-19 Vaccination Information System). COVAX gave HSE the tools to manage communications, intake, and personalize case management work at the scale demanded by COVID-19, freeing up time and energy for frontline workers to focus on getting jabs in arms, faster. The project also required the team to integrate large volumes of data at speed and scale. 

“We were vaccinating people in GP surgeries and pharmacies, which meant we had to cross-reference, standardize and validate a huge amount of data,” Thompson continues. The system also included a patient registration tool that people could complete online. “It was imperative that we brought all this disparate data together and integrated it into our Salesforce platform quickly,” he says.

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Accelerating integrations to drive automation  

A key reason why HSE chose Salesforce was the integration and API management capabilities of MuleSoft. Adopting a modern API-led integration approach would enable HSE to embrace a composable enterprise strategy, making it easier to unify data through automation and deliver a single view of the patient. Using MuleSoft, the team built six reusable, standardized APIs that could securely link core data domains such as patient data (Individual Health Identifier / EIRcode), GP systems (Healthlink), pharmacy, appointments (OptaPlanner), and vaccination events. 

“MuleSoft was critical to the success of this project,” Thompson says. “It offered the flexibility to adapt to our needs as we went along. Using APIs to integrate data enabled us to scale at speed. If we’d had to rely on manual point-to-point integration, there’s no way we could have rolled out the program in time to protect the population.”

MuleSoft also helped HSE standardize data by enabling teams to import data in one format and export or integrate it in another. Standardization was essential when combining health profiles from different clinical systems into COVAX and processing data in real time. Thompson estimates that HSE processed about 400 million transactions through MuleSoft and sent around 4.5 million vaccination messages between GP surgeries and pharmacies. 

Since they had never worked with MuleSoft before, a small team of five had to learn the technology quickly. Additionally, staff in vaccination centers needed to understand how to use a new vaccination system that changed and updated regularly. 

As Thompson notes, “When you’re operating at scale, you can’t simply take the platform down for a day to run updates. We were operating seven days a week, around 15 hours a day, and performing real-time processing in the evenings. There were times when we would launch a release around 1:00 a.m., and with vaccination centers opening at 8:00 a.m., our team and vaccination center staff had no choice but to hit the ground running.”

To support HSE with these challenges and ensure a successful outcome, MuleSoft added extra people to the project, to provide additional support and guidance on driving the maximum value from its solution. 

HSE also used Salesforce’s customized learning platform, Trailhead, to ensure vaccination center staff were trained on how to use the system. “We were relocating staff, both admin and clinical, who had never given vaccinations before,” Thompson says. “MyTrailhead ensured that people knew how to use the system immediately in real time without having to endure lengthy training courses.”

Using APIs to save lives 

For HSE, it was important that Salesforce and MuleSoft were cloud-based platforms. This took the pressure off HSE, as the IT team did not have to build or manage capacity or throughput. The result for HSE enabled teams to do more with less, quickly creating workflows and integrations that delivered efficient and faster time to value instead of wasting time on repetitive tasks and complex integrations. 

Putting the user first 

HSE used Salesforce Service Cloud to provide an omnichannel user experience. “Service Cloud enabled our agents to answer queries to update records where the data wasn’t originally captured correctly,” Thompson explains. “For example, in the early days of the program, people didn’t know that the name on their vaccination certificate had to match the name on their passport. People could go online to update their details, or they could call us. We used Service Cloud to manage the calls and make changes to COVAX. This helped us give users a much better experience.”

The platform launched in just nine working days, which would have taken months if the team had used a traditional point-to-point integration approach. To date, approximately 3.7 million people have been registered on COVAX via Salesforce, an additional 2.2 million people have self-registered via the public portal, and over 7 million vaccines have been administered. “We have vaccinated about 90% of Ireland’s population, which is astonishing,” Thompson says.

A wider impact 

Since developing and launching a successful national program in a global crisis, Thompson and his team have witnessed the benefits of a composable enterprise strategy and are using an API-led approach to accelerate other projects. 

“The work we have done here has solved today’s COVID-19 vaccination challenges, and will pave the way for years to come,” he says. “Reusable APIs enabled us to deliver quickly in an agile way and were central to the successful outcome of COVAX. We are now looking at projects that use some of the same processes to see how we can use APIs to speed up delivery and provide amazing patient experiences.”