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MACC Scandinavia uses Twilio to scale vaccinations in Sweden’s third largest county

MACC Scandinavia is a healthcare provider operating the largest-scale vaccination effort in South Sweden. In partnership with the Swedish regional government, MACC set out to vaccinate the third most populous county in the country.

The Results
+ vaccinations
able to be served weekly
people hired to serve new demand

When COVID-19 vaccination efforts began to ramp up in Sweden, healthcare provider MACC Scandinavia took on the immense task of vaccinating residents in Skåne county, which is home to more than 1.3 million residents and is the third largest of Sweden’s 21 public health regions.

To do so, MACC needed to communicate and confirm vaccination appointments, on the communication channels residents preferred. They’d never reach their goal of 250,000 vaccinations without a scalable solution, so they partnered closely with the Swedish government to develop a strategy that worked.

Testing a pilot program

To facilitate successful vaccinations, MACC wanted to confirm that once a person booked a vaccine appointment online, it was as easy as possible for people to show up and receive their dose. Creating that patient experience included sending a confirmation, appointment reminders, and physical directions to the vaccination site.

“During our first pilot program, we believed that using email as our main mode of communication was a no-brainer,” said MACC owner Kenneth Kronohage.

However, within days, they received more than 5,000 email requests with no way to manage responses. The staff managing the vaccination campaign were overwhelmed and unable to efficiently schedule and confirm vaccination appointments. To solve the problem, they quickly built a patient management system using the .Net framework and integrated an online form asking for the patient’s email.

While they solved one issue, they quickly ran into another: human error. Many people were misspelling their email addresses or had overflowing inboxes, causing people to overlook communications from MACC. Having just one method of confirmation meant that small errors could easily result in missed appointments and confusion for patients.

Taking the guesswork out of confirmations

For a mobile-friendly country like Sweden, adding an SMS option seemed like the best way to leverage another accessible mode of communication. When they realized sending a single email would not cover all of their bases, MACC added a text message option for vaccine appointments using Twilio Programmable SMS.

As it turned out, SMS made vaccine accessibility easier than ever. Having a second form of communication meant that a single typo wouldn’t be the reason someone missed their vaccine appointment. While most residents had a SMS-capable cell phone with them at all times, the elderly population were also able to use feature phones to receive text messages. Those who signed up also received a text confirmation, reminders, and even a Google Maps link providing directions.

MACC also partnered with Twilio to make sure residents could receive messages in the first place, using Twilio Lookup to verify if the number provided was capable of receiving an SMS. If it detected that the number was a landline, the person signing up would see a warning message asking them to provide another number.

“We now have a very near 100 percent show-rate for our appointments. We are also able to release 15,000 open slots overnight that will be gone by the morning,” Kronohage said.

We now have a very near 100 percent show-rate for our appointments. We are also able to release 15,000 open slots overnight that will be gone by the morning.

Kenneth Kronohage, MACC Owner

Finding the right partner

When looking for an SMS solution, Kronohage said he didn’t have to look too far: “Our developers recommended Twilio right away.”

As a publicly-funded organization, MACC was wary of the costs associated with employing a second layer of communication. They found, though, that Twilio’s flexible pricing options allowed them to integrate an essential mode of communication without worrying about depleting their budget.

“From there, I was all-in to provide the best, accessible service for the people in the county,” Kronohage said.

MACC has now vaccinated more than 120,000 people. Their appointment system has scaled so well that they have hired 450 people in just a few months to keep up with demand vaccinating as many as possible as fast as possible.

Next challenge: vaccine hesitancy

Now that MACC has seen the efficacy of their SMS notification system, they are setting their eyes on the next challenge of the vaccination effort: hesitancy. MACC is working closely with public authorities to explore how they can use accessible communications to provide communities with vaccine education and confidence.

“What the scientists have been able to create to help our world heal from the pandemic is incredible,” Kronohage said. “It’s wonderful to be able to play a small part in that.”