The largest vaccination programme in New Zealand's history will begin on Saturday without a new cloud-based software system in place to manage the rollout - or at least the full version.
Earlier, the Ministry of Health revealed to the Herald it had engaged several partners, including United States giants Salesforce and Amazon Web Services, in a $38 million push "to develop a comprehensive new National Immunisation Solution (NIS)."
The full version of the NIS will not be functioning for months, the ministry confirmed this week. But a cut-down "interim solution", dubbed the "Covid-19 Immunisation Register" is expected to be in place for the weekend. A dry-run last weekend was successful.
About 60,000 doses of the Pfizer-BioNTech arrived in the country on Monday morning - enough to cover around 30,000 people, given the vaccine needs two doses, given about three weeks apart. The first shots will go to border workers and their close contacts. The general population will likely be offered vaccination in the second half of the year.
With multiple doses dispensed from each vial, two-dose timetabling, and a complicated cold-chain (once out of an ultra-cold freezer in Auckland or Christchurch, a dose will last up to five days at normal fridge temperatures, then up to two hours at room temperature), management systems will have to be on-point.
Dr Nikki Turner, director of the Immunisation Advisory Centre, which is providing co-ordination and training for the vaccine campaign, told the Herald yesterday: "There will be glitches along the way, but I think the key building blocks are there ... when you do programmes like this, things are not always smooth right at the start."
The inevitable glitches should not be blown out of proportion, Turner said.
The Covid-19 Immunisation Register will be fleshed out in the months ahead and become the National Immunisation Solution (NIS).
The cloud-based NIS will replace the existing National Immunisation Register (NIR), which is now regarded as outdated (it was created in 2005), and not suited to the Covid-19 inoculation programme because it was primarily designed to track early childhood vaccinations.
It was not clear what features would still be in progress by this weekend, but one that will definitely be in the works is a planned feature for members of the public to be able to access their own immunisation records online.
It's a move that could spark privacy and security controversies, going by the bumpy reception to the Australian government move to put patient records online under its My Health Record push. My Health Record will be used, in part, to manage Australia's Covid-19 vaccination programme.
"Once the NIS is fully implemented, any health worker will be able to record vaccinations anywhere, any time – and regardless of whether they are publicly funded or self-funded," a Ministry of Health spokeswoman said.
"The NIS will be able to prove vaccination for Covid-19 and confirm vaccination history.
"The NIS will match data to National Health Index numbers as they provide an accurate and unique way to identify individuals and their records. Using NHI numbers and directly inputting information at the place of vaccination, instead of using paper forms, will ensure accurate matching of individuals and their records."
The system will need to co-ordinate an estimated 2000 to 3000 vaccinators, who are likely to be drawn from pharmacists, retired medical practitioners and first-year medical students.
"We are designing the system to be intuitive and easy to use. As the Covid-19 immunisation programme progresses this year, we plan to link the NIS to GP patient management systems," the ministry spokeswoman said.
"We are still working our way through the later phases of the vaccine campaign, but it is likely to involve sending invitations to get vaccinated, and follow up reminders, to those we have contact details for once they are eligible."
A three-week-old product
Both Salesforce (market capitalisation $227 billion) and AWS (the cloud computing division of the $1.65 trillion Amazon) are regarded as safe pairs of hands.
Salesforce was the first major software-as-a-service company, and now dominates customer service (CRM) management software. If you work for a big company, your sales team might use it to track who they call, and how well those calls go.
AWS - whose nearest server farm is in Sydney - is already a partner on the Government's NZ Covid Tracer app. It's the world's largest provider of cloud computing services, ahead of Google and Microsoft.
However, Salesforce's vaccine rollout software is still very new.
In September, the company said it was adding vaccine management features to its core products, and that it was working with 35 US states, plus the Governments of Britain, Canada, Australia and New Zealand, on "Covid-19-related projects."
In October, our Government approved the $38m budget to create the new National Immunisation Solution in partnership with Salesforce, AWS and others.
On January 29 - that is, only three weeks ago - Salesforce announced its new Vaccine Cloud product, "to help government agencies, healthcare organisations, businesses, nonprofits and educational institutions more rapidly, safely and efficiently deploy and manage their vaccine programmes."
Salesforce said in a statement, "Many government agencies and healthcare organisations don't have the technology infrastructure in place to handle the complexity, speed and scale necessary for vaccine administration, such as inventory and logistics management, getting people registered and scheduled for their vaccines, and recipient outreach and vaccine outcome monitoring."
Salesforce products are typically customisable, and can be adapted to integrate with different third-party systems. Tinkering will be required for the NZ version. Salesforce public-sector president David Rey says there is no "one-size-fits-all solution".