It's Day 60 of VaccinateCA.com and it's a big day, but most important news first:
Today we called hundreds of pharmacies looking for the covid-19 vaccine and eligibility criteria, and published what we learned.
Tomorrow, March 15th, is the largest expansion of eligibility for California yet, to include workers in several industries plus individuals with pre-existing conditions which would place them at elevated risk.
This substantially increases the count of people eligible.
Describing eligibility in a tweet is hard so a sneak peek: vaccinateca.com/checklist ; we're publishing a tool tomorrow to help vaccine seekers (and people managing care for others) easily navigate the decision tree.
The tool asks questions most people likely know about their employment / health status and outputs eligibility (which is on a spectrum now, from Yes to Maybe to Probably Not), next steps, and a guide on preparing for the vaccination appointment.
A PSA, which we're writing prominently in our guides: the state has directed medical providers to _not_ inquire about the specifics for pre-existing conditions. Patients will sign generic attestations that they're at elevated risk. No doctor's note or similar should be required.
We anticipate, and indeed have anecdotal evidence of, on-the-ground patient experiences which do not match what the state believes the policy to be, and will be working to quickly collect ground truth and report it to policymakers.
One of the benefits of having Dangerous Professional friends is that we were able to get our guides, which are partly pre-written and partly filled from our data set, checked by the medical reviewer for a biotech startup.
In other vaccination news, MyTurn ( myturn.ca.gov ), the statewide* scheduling website, has started to offer appointments to people with pre-existing conditions. We have multiple reports of successfully scheduling those appointments using the tool.
* "It's complicated"
We continue to gather data on practices of individual locations and chains, because it allows us to continue helping patients navigate to accessible vaccine close to them.
We are bringing on two call centers tomorrow to deal with rapid changes in availability and, we suspect, not-formally-intended variable time delay in rollout of the new criteria.
These call centers offer us a ~5X increase in call capacity. We'll certainly be able to keep them busy for the next few days. After that, we'll have to find some productive use for those calls.
We're also continuing to work on getting our data into the hands of patients and care managers, via a variety of mechanisms.
It's been a very busy two months.
Our society is not yet near the end of the covid-19 pandemic. The next few months are critical. A lot is going right at the moment, but much can yet go wrong, and we are still are not moving fast enough.
As a project, we're working as fast as we can.
The quicker shots make it into arms, the more marginal lives are saved, the quicker daily life gets back to normal, and the quicker the US's substantial resources and talents can be redirected to solving the pandemic globally.
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One reason that the national conversation on vaccine availability isn't necessarily reflective of ground truth is that we've set up an auction where you pay not with money but with PMC-level brainsweat.
People who participate in national conversation have a lot of that to spend.
(This is subtly different from the PMC's diagnosis of the issue. The language of power can say what it will about root causes, but one side effect of being the language of power is that it is very, very, very good at getting what it wants out of bureaucratic processes.)
Imagine if there were figurative passwords being passed out right now to get a vaccine, and a great debate on whether publishing the passwords was justice-maximizing, conducted largely by people who professionally specialize in guessing passwords of complex systems.
The thing most technologists would do well to internalize is the notion of fraudogenic environments, where one can (unintentionally!) set up an incentive system which causes fraud to happen w/o there being a top-down directive to commit fraud.
This is against the intuitions of a lot of people, who think there is some seedy back room where four senior banksters in suits have developed a multi-billion dollar fraud and want them marched out in handcuffs.
Have you ever found yourself doing something which you know is strikingly irrational and which you feel powerless to resist?
This is me when one of the banks says that I have 18 cents worth of points expiring on March 31st. "This here is a P0 drop-everything-and-resolve email."
And then I spent a few minutes reading through the various things I could convert those 20 expiring points and 100 non-expiring points into to maximize the conversion ratio, because darn it if I was going to leak 30 cents worth of margin by picking the wrong point ecosystem.
"This sounds even crazier than airline miles. What ecosystem works like this?"
There are numerous competing points systems in Japan and one thing that the less-well-distributed systems do is offer point conversion to more-well-distributed systems, often below par value.
A lot of enterprises look at payments and see a cost center. We've been getting good the last few years at turning it into incremental revenue for customers, and enterprises are starting to notice.
Payments becomes incremental revenue when you use your payments stack to optimize your conversion rate, which is particularly powerful with B2C companies.
Banging a very, very old drum for me: a lot of places treat conversion at some steps as essentially a constant. We won't.
It is a frustrating, maddening, "Seriously, what are we all doing in this industry?!?!" moment when you see how many credit card transactions are declined for no reason more than "I dunno sometimes credit card transactions get declined. YOLO."
It's been a busy few days, but we still did the same thing we do every day: call hundreds of medical professionals to confirm ground truth about the availability of the covid-19 vaccines.
The state has announced a major change in eligibility criteria (broadening of vaccine availability, including prominently to individuals with pre-existing conditions, who are at high-risk if they contract covid-19) on March 15th.
We are sprinting to get ready for this.
This is going to include:
1) Needing to understand and model how the healthcare system(s) understand pre-existing conditions 2) Assisting in communicating that message to our end-users and those of community-focused organizations 3) Rearchitecting to capture on-the-ground truth