Almost four million certificates issued to five million citizens

INTRODUCTION

A rapid and unprecedented community care response

Lazio is the second largest Italian region in terms of size and population with approximately five million inhabitants. Thanks to its GDP, which is more than €197 billion per year, it is ranked as the second largest regional economy in Italy. LazioCrea SpA is an organization that supports the administrative activities and functions of the Lazio region, with a specific focus on the planning and development of information systems. LazioCrea was responsible for managing the region’s COVID-19 vaccination certification programme, designed to issue certificates to all vaccinated residents.

THE CHALLENGE

User demand puts an underperforming platform to test

The work with network and service infrastructure projects, digital coordination of e-government projects and other essential public services meant that LazioCrea SpA was the ideal candidate to take on the management of the COVID-19 vaccination certification programme in the Lazio region.

Since mid-March 2021, the Lazio region has issued vaccination certificates to individuals who have completed the COVID-19 vaccination cycle. "We created a regional vaccination certificate, with a signed graphic and a QR code which represented the digital signature that certified the data within, and we developed the SaluteLazio app,” explains Lorenzo Sornaga, Head of Central and Access Systems for Healthcare Division.

The existing Italian electronic health record platform for managing health documentation (Fascicolo Sanitario Elettronico) in the Lazio region had a relatively low number of accesses, considering that it is a resource for all citizens. “We had a maximum of 22,000 people accessing it monthly,” says Sornaga. “Which, in a population of over five million, is negligible. However, when the vaccination certificate was made available via the electronic health record, we knew that there would be more users than the system ever had before.”

When the Lazio region made the vaccination certificate available, and then when the EU launched the Digital COVID Certificate (Green Pass in Italy), the numbers increased rapidly. “The system began to register approximately 400,000 accesses per month from users who wanted to obtain a Green Pass,” recalls Sornaga.

The peak of the pandemic highlighted the true impact of vaccination certificates, which allowed the citizens to carry out their daily activities safely, from cultural and sporting events to long-distance journeys and dining inside restaurants. This caused intense workloads; secure certificates had to be generated and made accessible for citizens who needed to download them. The certificates also had to be authentic and universally recognized.

But first, it was necessary to launch the vaccination booking process to allow citizens to make appointments. For LazioCrea, the challenge lay in delivering a rapid response to manage bookings and make vaccinations accessible. In order to achieve this, it was necessary to manage large volumes of bookings while maintaining compliance with Italian healthcare regulations, which are frequently subject to change.

“During the pandemic we had an enormous amount of work to do to make the vaccination certification programme operational,” explains Sornaga. “Decisions had to be made quickly and we only had a short time to create a solution capable of managing vast amounts of data.”

THE SOLUTION

Transformative health monitoring

LazioCrea had previously worked with MongoDB, using Single View to create the infrastructure for the electronic health record, and it was the logical decision to use MongoDB for the process of managing documentation for COVID-19 vaccination enrolment.

MongoDB supported LazioCrea through upgrading the existing platform, responding to the speed and scalability requirements linked to high volumes of data.

"With a platform like ours, where it was necessary to develop processes to manage patient appointment reminders and online payments, we felt that MongoDB was the natural choice for merging the vast amounts of information contained in the electronic health record,” says Sornaga. "MongoDB put everything together and managed the vaccination certificates within patients’ files. MongoDB’s security protocols, efficiency with high volumes and a flexible data model took care of everything.”

As Italian health regulations continued to change and evolve, from data protection requirements to legal compliance, it was necessary to have a data model in which mandatory legislation could be updated. The scalable data platform from MongoDB helped resolve the issue of updates and rapid document processing challenges.

The capabilities of MongoDB prompted LazioCrea to widen its horizons for the entire healthcare system. "We are constantly seeking to offer better services for our patients,” says Sornaga. “All this is built on the availability of useful information and vast amounts of data. The capacity to manage big data opens up new possibilities for services to citizens. MongoDB has satisfied our requirements over the years, and is now helping us change the healthcare landscape, moving away from the relational database model to big data and new data-driven services in the healthcare sector.”

THE RESULTS

Significant numbers - among citizens and technology

LazioCrea tackled the issue of digital upgrading and now boasts one of the leading booking platforms in Italy. The organization also manages the platform for the COVID-19 vaccination programme which was developed more rapidly than in any other region in Italy or Europe.

This made it possible to accelerate its efficiency in terms of managing appointments for vaccination and general medical bookings, faster than other countries in the EU. Improved management of the platform backend is now one of its technical assets, with a significant improvement in customer satisfaction, thanks to quicker and simpler management.

Lazio residents have benefited from the enhancement of a platform that initially struggled to manage around 20,000 accesses. “Building the platform with MongoDB has guaranteed the efficacy and efficiency of the service and made it accessible to a much broader audience of residents, which is a fundamental factor for us. We have indexed approximately four million vaccination certificates processed in MongoDB at regional level, for a population of almost six million,” says Sornaga. “In addition to this, downloads have increased with the updated versions of the certificate.”

In a sector as people centred as the healthcare, the collaboration and relationship between LazioCrea and MongoDB has greatly simplified the work they have done together, helping to provide a strong sense of well-being in residents’ lives during a period of immense collective stress.

“Compared to other technology suppliers, we are always happy to work with MongoDB, as they bring energy and a distinctive spark to our partnership. It is important to stress that MongoDB has a thorough understanding of the ramifications of the healthcare sector, both in Italy and throughout Europe, and provides simple and effective measures for organizations like ours who provide public services.” concludes Sornaga.