The Challenge
During the initial COVID-19 vaccine rollout in early January 2021, one of the country’s largest healthcare systems needed a digital registration and scheduling solution on an urgent timeline. We, along with the entire industry, were navigating an unprecedented vaccination rollout. Our team had no established implementation playbook for delivering two-dose COVID-19 vaccine scheduling under these conditions. Information about the vaccines, eligibility requirements, and available supply was still emerging, and we had to translate it into working workflows as we learned. The team was simultaneously defining the solution and building it, with little separation between receiving new information, making decisions, and implementing changes. Waiting for stable requirements or full integration with the client’s legacy systems would have delayed access to scheduling.
As the rollout evolved, the workflow needed to accommodate Pfizer-BioNTech and Moderna vaccines, which required two doses at different intervals, and the single-dose Johnson & Johnson vaccine. For two-dose appointments, we needed to track the patient’s original vaccine brand, calculate the appropriate follow-up timing, and coordinate second-dose bookings against available supply batches.
Every first-dose booking created a downstream scheduling obligation. With supplies extremely limited and vaccine brands generally not interchangeable for the primary series, opening appointments required careful coordination between immediate availability and future second-dose needs. A comprehensive notification strategy was essential to support timely completion of two-dose vaccination schedules. Patients needed reminders for follow-up appointments, while the client needed to coordinate those bookings with brand-specific supply and appointment availability.
Eligibility requirements created another moving target. Federal, state, and local authorities were frequently revising which populations qualified for vaccination. Depending on the applicable guidance, eligibility included different combinations of healthcare personnel, emergency responders, essential workers, age groups, and patients with qualifying medical conditions. Registration questionnaires needed to reflect those changes and direct patients to the appropriate next step.
The client also expected a fully integrated experience despite relying on an EMR approximately a decade out of date. This added technical constraints to an already compressed delivery schedule.
Commercial urgency added pressure to accelerate deployment because of the platform’s early market position and substantial business potential. Executive escalations also strained collaboration and placed additional demands on the project team.
My challenge was to give the team enough clarity to act while requirements remained unsettled: coordinating clinical, operational, technical, and stakeholder dependencies, making uncertainty visible, and keeping urgent decisions moving toward launch.
My Role
As Senior Technical Project Manager, I led the design and launch of an early virtual COVID-19 vaccine scheduling platform. I coordinated implementation analysts, product experts, technical resources, Engineering, Sales, internal leadership, and client stakeholders to assess feasibility, define the delivery approach, and move the solution toward launch.
My responsibilities included technical and operational coordination, dependency management, executive communication, and protecting the project team’s ability to work effectively under significant pressure.
How I Approached It
Defined a phased path to launch.
I led analysts and product experts through an assessment of client requirements, platform capabilities, and infrastructure constraints. We developed a phased strategy that separated the capabilities needed for initial registration and scheduling from the more complex integration work. Phase 1 would operate as a standalone platform with scheduled flat-file transfers, allowing us to launch while subsequent phases addressed interoperability and evolving requirements.
Aligned configuration, product requirements, and client readiness.
I coordinated implementation analysts responsible for platform configuration and client training. In parallel, I worked with product analysts to identify gaps between the client’s requests and existing functionality, document enhancement requirements, and seek expedited prioritization on the product roadmap.
Adapted the delivery structure to rapidly emerging information.
As new guidance and technical issues emerged, the existing implementation structure proved too slow for the pace of delivery. I assembled cross-functional tiger teams that brought the appropriate technical resources and decision-makers together to assess what had changed, determine the impact on launch, and agree on an executable response. This shortened the path from new information to action while giving analysts and technical specialists clearer direction as requirements continued to evolve.
Untangled legacy infrastructure dependencies.
I coordinated technical specialists and Engineering to untangle dependencies across the client’s aging EMR, pharmacy, and supply-chain systems. Together, we assessed integration hurdles and designed workarounds where the existing infrastructure could not support the requested workflow.
Maintained commercial and executive alignment.
I kept Sales informed as capabilities, constraints, and delivery plans evolved so they could communicate accurately with other prospective clients. I also partnered with Sales to manage the client relationship and executive expectations. Internally, I briefed leadership on progress, risks, and unresolved dependencies, seeking their support when competing internal priorities threatened delivery.
Protected team focus during executive escalations.
I served as the primary escalation point during increasingly confrontational interactions with the client’s executive medical stakeholder. I handled difficult conversations directly, including after-hours escalations, to limit disruption to analysts and technical specialists while keeping discussions focused on constraints, decisions, and next steps.
Results
We launched the Phase 1 minimum viable product in 10 calendar days, working nights and weekends while requirements continued to evolve. In that time, the team translated emerging vaccine guidance and client requirements into an operational registration and scheduling workflow. The platform operated independently, using scheduled flat-file data transfers to maintain operational continuity while work on the more complex integrations continued.
This phased strategy allowed the client to begin vaccine registration and scheduling without waiting for full interoperability across its legacy systems. Subsequent phases addressed evolving requirements, vaccine inventory variances, and integration across the client’s EMR, pharmacy, and supply-chain platforms.
The tiger-team approach also informed a repeatable framework for projects requiring accelerated cross-functional coordination. Lessons from this implementation helped shape standard implementation protocols, including clearer escalation paths, defined ownership, and criteria for engaging specialized resources when routine workflows could not keep pace with delivery needs.
What I Learned
I would have introduced the tiger-team model earlier, with shorter decision cycles and clearer escalation ownership. When the team is learning and delivering simultaneously, leadership requires making uncertainty actionable: clarifying what we know, identifying what needs a decision, and giving people enough direction to keep moving as new information emerges. The experience also reinforced the value of phased delivery. We launched a workable first phase in 10 days by distinguishing what had to be ready for launch from what could follow through subsequent releases.