The City of Austin is a trailblazer in bringing public health services to the community.

The City of Austin's mission is to be a beacon of sustainability, social equity and economic opportunity. “We as a city have set up these blanket missions and different pillars to allow us to prioritize where we are going and what narrative we will adhere to ahead,” said Brian Morris, Senior Business System Analyst at the City of Austin. “We have taken this to heart in every initiative that comes our way, always driving back to the pillars of our mission and allowing that to drive our next move.” Austin is a place where diversity and creativity are celebrated, where community needs and values are recognized, where leadership comes from its citizens, and where the necessities of life are affordable and accessible to all.

Austin's community pride comes with a determination to make the city's vision of Austin being the most livable city in the country not just a slogan, but a reality. This includes a commitment to serving everyone in the community, and particularly people who are historically underserved and who struggle to access resources.

As a city aiming to serve everybody it helps to establish a primary objective. For Morris and team, that is public health and as mentioned above, those that are historically underserved, whether that be economically or physically or have a lack of resources. "Our focus is on ensuring that we are taking care of the diverse needs within the community," affirmed Morris. "With a mission to offer health services, our team began objectifying how best we could do this. Which is where we met the cloud."

1. Austin builds to meet the needs of today and the future.

2. The cloud is in the prescription to help keep Austin well.

3. An investment in public health starts a ripple effect of community impact.

This mission became even more critical when the COVID-19 pandemic hit. The city needed to mobilize quickly to offer pandemic health and information services in a way that would quickly make a community impact while collecting accompanying metrics that were appropriate and transparent. Considering all aspects of the population, Morris and team were able to ensure they were serving the community effectively and maximizing city resources.

A main pain point came in providing these services on a wide scale and as efficiently and quickly as possible— things like keeping people informed, getting people tested, and then getting them vaccinated were all kept top of mind. But it was clear that the system they already had in place for contact tracing and case investigation simply wasn't built to handle the influx of cases they were currently facing or to be easily adapted.

What's more, the city quickly realized that their processes also weren't built to scale, even at a marginal increase, nor were they extendable to other services. On top of that, there were important data security requirements to consider. The HIPAA Privacy Rule requires appropriate safeguards are in place to protect the privacy of protected health information, like medical records and other individually identifiable health information, when certain health care transactions are conducted electronically. But the city didn't have the infrastructure to manage this information in the way they needed to.

"We needed something that would work right away but that we could also scale for the future," said Morris.

Austin needed a system that was agile and interactive, able to support heavy traffic and manage services with more activity. "But," said Morris, "we didn't have an army of coders, so we needed something no-code, out-of-the-box-easy to implement."

The system simplified:

Power in compliance

Applying a two-pronged approach, the city built their system on Government Cloud Plus that, at its core, was designed to support the enormous logistical operation of getting people tested and vaccinated smoothly and efficiently. Powered by Salesforce Customer 360, the city used clicks, not code, to create a case management solution that could respond to an array of community needs while personalizing the customer service experience as individuals navigated the pandemic. Salesforce Shield was layered on to help the city stay compliant with applicable privacy and requirement laws to protect personal health information.

Efficiency in case management

The system initially launched to manage testing, adding vaccine management once vaccines became available. Individuals wanting to schedule an appointment for a test would first visit the city's online vaccine portal built on Service Cloud where they'd be able to quickly register and answer some simple screening questions. They'd then schedule an appointment, receiving their confirmation via email or text message.

Simplicity in self-service

Once at the testing or vaccination site, the city's operations platform came into play. Built on Experience Cloud, it used an omnichannel approach to move individuals through the process quickly and efficiently.

"Mobile access was very important to us," said Morris. "Not only did a lot of our clientele use the mobile platform to register, but 75% of our staff were using tablets and cellphones at the clinics to do the processing. So mobility and speed were essential."

Upon arrival at a testing facility, the client would share the appointment QR code which they received during scheduling, staff would confirm the individual's information, perform the test and check-off the appointment as completed. "At one point, we had a testing click rate where you arrived at the clinic , checked in, you got a test, and you were out in under two-and-a-half minutes," said Morris.

Tests were sent to labs at the end of the day, with the results updated directly into the city's system. A message would then be sent to the individual via email inviting them to visit the portal to view their results and where they could also review their testing and vaccine history and obtain necessary forms or other resources. Simultaneously, if the test result was positive, a case would be opened in the system automatically to enable case tracking and monitoring.

When vaccines became available, the system was mobilized to support mass clinic operations to get as many shots into arms as quickly as possible. "We had some sites in arenas that were seeing around 3,000 people a day," Morris said.
The city had to build this program from scratch and it had to scale up faster than any registering system in the state.

"Scalability was key for us, so we were intentional about building for that," said Morris. "And not something scalable 1X or 2X - we needed it scalable at 25X."

APH was #3 in the USA with a Salesforce Vaccine Management solution, right behind CDC and Chicago.

APH was #1 in Texas with a Salesforce Vaccine Management solution, right behind us were HEB and State of Texas

APH was #1 in Texas with a Salesforce Testing Solution, that allowed us to have on online portal, self-schedule, and receive lab results.

By building a system that they could use to continually improve and streamline processes ("There were moments when we had to change direction on a dime," recalled Morris), the City of Austin built confidence in the community that it could navigate the pandemic and an understanding that testing and vaccines would help them get through it.

"At one point, we had over 100,000 people try to schedule appointments at a single time. And we could actually monitor, real-time, the queue of people booking appointments," said Morris.

And this peace of mind and support went beyond Austin's city limits. Thanks to a system built to be transparent and easy-to-use, people from across the state of Texas were booking appointments in Austin. "When the pandemic hit, we were helping people from Houston and from Dallas. So, we were making such an impact that other metropolitan areas were seeking guidance from us," said Morris.

What's more, the city's COVID-19 testing and vaccine program has also provided the city with an opportunity to continue its outreach to the community, educating them on the services and resources available to them to manage their health and to discover other ways in which the city can help them.

"There's often an assumption that the government moves slow and is siloed. This is proof that it doesn't have to be that way," said Morris. "We can make real life-affecting changes, and we can do it quickly."