This Week Health
March 31, 2021

Becky Fox: Atrium Health VP on Mass Vaccinations

Mass Vaccinations & Herd Immunity with Becky Fox, VP and Chief Nursing Informatics Officer (CNIO) at Atrium Health

Becky Fox - Vice President, Chief Nursing Informatics Officer of Atrium Health

Becky Fox, Vice President and Chief Nursing Informatics Officer (CNIO) at Atrium Health, joined Bill Russell to discuss the mass vaccination events the health system has achieved and the impact of her role in clinical informatics.

Mass Vaccinations: Navigating Challenges

Atrium Health is a healthcare system committed to impacting the community, which motivated them to work toward herd immunity through their mass vaccination efforts, Fox explained.

"We recognize that the only way that we've got to get around this pandemic is to make a big impact, and that was with mass vaccination efforts," she said. 

Their key to navigating these large events has been creating strong partnerships. According to Fox, by coming together with varying expertise, they can combine these skills in a short time to deliver a mass event. 

Some of their partnerships come from the state and county, Honeywell, Temper Sports & Entertainment, and the venues where they held events, including Charlotte Motor Speedway and Bank of America Stadium. They also worked with their partner Wake Forest Baptist Health and local churches to bring vaccines to more marginalized communities.

According to Fox, planning a mass vaccination event was difficult because there were so many aspects to organize. In Atrium’s case, they had only seven days to put one together for multiple of their events.

"Vaccination efforts are not for the weak. It's really hard work. I've worked in informatics and healthcare for a long time, but when you add vaccines, working with the state, working with the federal level, and then recognizing that you've got to meet the demands of patients and have a great experience, how do you pull all that together?" Fox said.

Additionally, it was additionally challenging because the team needed to make adjustments to the process to accommodate evolving needs. Even during the events, Fox and her team were constantly readjusting event and staffing models. 

Changes were made throughout the day as the team consulted with partners and even varied each day of an event. According to Fox, some influential factors for adjustments were the patient queue, weather, hourly stats, type of vaccine available, and no-show rates.

It was important to understand the complexity of the vaccination process, especially when deciding if leftover vaccines can safely be utilized at another event, according to Fox. The health system’s mantra was not to waste vaccines. 

“Mass vaccination is a really complex process. So if you know anybody that's out there working in vaccines, be extra nice to them because it's not for wimps. That's for sure. There's lots of long hours and sleepless nights and weekends. But we know if we all work this way, we’re going to make a difference,” she said.  

Focusing on User Experience

According to Fox, it has been inspirational for the team to see patients appreciative and feeling like they have a new future ahead. The team’s goal is to make sure that there is a great experience for patients, teammates, and partnerships at events. 

Therefore, the team focused their efforts around user experience. Starting with scheduling, Atrium Health created a patient portal where anyone can sign-up for the vaccine with simply their basic information. When qualified, they could self-schedule an appointment, and their second dose would be automatically scheduled.

Then night before an event, participants would receive a text to answer questions and gave them a QR code for identification upon arrival at the site. When they checked in the next day, the code was scanned, and the patient’s information was pulled up in the EMR.

The time it takes for a patient to be vaccinated was also considered in the planning. According to Fox, their goal was for each individual to take less than one hour to complete. They wanted patients to experience a reasonable timeframe, so they have also created a timer tool to time the monitoring process after they receive the vaccine.  

The team also developed a multi-field barcode that allowed nurses to log information quickly on a mass scale, which reduced almost one minute per patient. When multiplying this by 20,000 patients, the impact of this innovation was substantial, she explained. 

“It's these little pieces of technology that help make the whole process faster. So whether it's checking in, screening the patient, documenting medication, or timing the patient and observation, we want to make that whole thing really seamless,” she said. 

Adopting IT Solutions

Fox expressed that the best way for this to be accomplished is by having a nurse informaticist. 

As CNIO, Fox's job is to strategize how clinicians use technology and optimize it. It is her job to bring the right technology to the right place at the right time. 

Clinical informatics is the glue between the clinical and informatic worlds, according to Fox. Informaticists serve as translators to explain to IT the clinical and business needs and to the clinicians why they need to adopt IT changes.

"What we find is if you bring everybody together and understand both worlds, then you can make bigger things happen," she said.

According to Fox, if hospitals are not optimizing clinicians in the nursing department to do their job better, they will miss out on an opportunity. It is not only about making workflow better for nurses; instead, it is for everyone because all clinicians work together.  

"When you do that, then you bring value again back to the organization, whether that's through streamlining and offering efficiencies impacting your bottom line of financial aspects," she said.

Having an executive team that understands IT and a desire to make things better together is when it can be leveraged to create a more significant impact, Fox explained.

To learn more about this episode of This Week in Health IT, watch the full interview at

Tess Kellogg – Editor-in-Chief
Katie Talpos – Staff Writer


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