Q&A: UVA Alumni Drive Indiana’s Vaccination Effort

Time has always been precious, and the pandemic has made that point all too clear. For Cory Law, working against the hours’ hard-charging march has been a relatively nonstop battle; throughout the last 10 months, his company has been tasked with helping the state of Indiana deploy coronavirus vaccinations – and all that goes with the endeavor.

The widely publicized issues surrounding the production and distribution of vaccines underscore the world’s desperation for quick access to them – and the hope of moving toward a post-pandemic life with more freedom to gather and travel safely.

No surprise, then, that Law is working under pressure. Overseeing patient billing solutions for Zotec Partners, his family’s health care practice management services firm, the 2015 graduate of the University of Virginia’s McIntire School of Commerce said that the company’s immense effort in Indiana is directly related to its growth in areas such as scheduling, registering and billing processes. As such, the incredibly hurried timeline and sheer scale of the issue at hand present a herculean challenge.

Law’s father, T. Scott Law, founded Zotec in 1998 and for decades the company has provided software solutions, billing and management and logistics services for hospitals and health care practices Aiming to get vaccines into the arms of Indiana residents, Zotec has had to work up its ability to tackle inventory management, which Law and his colleagues have attempted to solve through automation and machine learning.

So far, Indiana has been comparatively successful in its vaccination efforts, topping a Jan. 25 list of states with the most vaccinations administered per 100 people. Zotec’s contributions to that effort have been buoyed by the input of other Hoos at the company, which include Law’s brother Scott, a 2011 McIntire graduate. The elder sibling heads Zotec’s health care technology venture fund, Meridian Street Capital, which focuses on the firm’s core strategic belief: “The future of health care revolves around automation, digitalization and creating more consumer-friendly experiences,” Cory said.

Central to Zotec’s machine learning progress are the skills of Jimmy Comfort, co-founder of Onehot Labs, along with colleague Andrew Cassidy, its director of engineering; both are 2011 graduates of UVA’s School of Engineering & Applied Science.

Comfort says his team’s mission is to implement machine learning to streamline the medical paperwork process, thereby “freeing doctors to spend more time taking care of patients and allowing patients to spend less time worrying about their medical bills.” In the face of office closures and stay-at-home orders, he believes the pandemic created a fast track to advance these technological solutions that reduce costs for providers and lessen stress for patients.

Yet the stress of solving the state of Indiana’s ever-changing vaccination logistics remains.

We spoke with Cory Law to find out more about how his business has adapted and what he and his fellow alumni have learned about finding solutions while working under such demanding constraints.

Q. How has your work fighting the pandemic differed from your usual business?

A. This project is relatively in line with where we’ve been growing over the last few years, so it wasn’t necessarily a departure of what we do, as much as how we do it.

One of the biggest departures for us was in timeline and scale. We’ve had to onboard and implement more than 1,300 testing and vaccine locations for the state in the last few months – oftentimes with less than 24 hours’ notice before they start seeing patients.

Brothers Cory, left and Scott Law both graduated from the McIntire School of Commerce; Cory in 2015 and Scott in 2011. (Contributed photos)

Additionally, we’ve had to build our products to scale very differently because of the way patients schedule their vaccinations. We see massive jumps every time Indiana expands the vaccination age range. As a result, we’ve had to retool our appointment-scheduling products to have the same robustness and protections that a ticket website would have.

Finally, we’ve had to expand our ability to do inventory management and create complex clinical logic to incorporate which dose a patient gets, and how long they have to wait until their second dose. That automation opens up appointments based on available inventory and tells the clinics how much of the vaccine to thaw each hour.

This was all totally new for us and is one of the reasons Indiana has one of the most efficient vaccine deployments.

Q. How have you overcome some of the biggest hurdles you’ve been facing in the vaccination rollout effort?

A. Both the scale and the timeline are very difficult. We ultimately stood this up in a matter of weeks, and yet have had over 2.7 million interactions with the app. We’ve scheduled a million vaccine appointments in the last month alone. Having to move insanely fast while also having to be organized for the scale and complexity has been a huge challenge.

The restrictions around administering the second dose, which are different based on the vaccine manufacturer, while still monitoring inventory levels and providing a consumer-friendly experience, are very taxing. It even comes down to the most basic questions about how much flexibility we give patients to reschedule or cancel their appointments, knowing that those decisions might have inventory ramifications down the line.  

Q. What issues are you still hoping to solve?

A. Supply of the vaccine is absolutely the biggest factor in our fight. It’s why our solution needs to include a ton of logic around doses, inventory and timing. By using our software, a facility will know exactly how many vaccines they need each hour so they can thaw it.

But we can only schedule appointments if we have the doses. Right now, Indiana receives only about 78,000 first doses and 78,000 second doses each week. To put that into perspective, the facilities can actually vaccinate closer to 50,000 a day, and we can schedule over 60,000 an hour. The real bottleneck is just availability of doses.

Q. How have your personal experiences shaped your approach to this incredibly high-stakes undertaking?

A. I spent the first few years of my career working at Miramax, helping develop a handful of pretty large studio movies (“Halloween,” “The Gentleman”). I’d say that what informed my approach most on this project was a sense of the stakes. In movies, you’re always racing against the clock, and if you don’t get a shot before the end of the day, then sometimes you just don’t get it. The stakes are high every day on a movie set.

That’s how our COVID work has been as well. We don’t really have two weeks to storyboard every possible use case scenario: We sometimes have only two days after we get word that a new feature needs to be implemented. Operating in that environment and knowing when to move fast, versus when to take your time, versus how much the team can push, versus knowing when it’s a good time to lay off the gas, feel like a pretty natural extension.

I’d also say that the cadence for this project is very unlike most software development we do, and maintaining the sprint pace of development over what has been roughly 10 months has been a real challenge.