Lightspeed prototyping and iterating iterated iterations (3x a day): the vaccination campaign in Berlin
Markus Aeugle is the VP of Engineering for Doctolib Germany (Doctolib GmbH) since September 2018. Based in Berlin, Markus was the first tech hire in Germany for the company that started operations in France. Today the Berlin tech center is an important contributor for Doctolib’s global product development.
Today there are around 100 people working in Product & Tech, but when I started I was responsible for nearly everything tech-related in the Berlin office. From fixing the printer to on-site support at doctor’s practices.
In the past I’ve worked in multiple verticals as a developer, I founded startups, worked at big enterprises, with large, remote and distributed teams, led teams up to 300 people and worked in Silicon Valley for 3 years. But I’ve never experienced a rollercoaster quite like Doctolib!
Germany was the proverbial canary for France when it comes to the vaccination campaign. Normally we get to build on the experience of our French colleagues. We didn’t come out of this coal mine looking quite the same…
Growing Doctolib during the pandemic
Doctolib Germany is much smaller than our French branch. When you work here you wear many hats, you have your fingers in everything. Of course, the pandemic made onboarding and on-site training difficult. And it’s being in the complexity of the environment of your customers and users that is the best learning school!
At Doctolib we have developers going into practices for feasibility studies and development. That way they learn about the challenges people deal with. It makes visible the real world impact you have: Doctolib plays a crucial part in the healthcare system.
The Tech and Product teams are global, domains and feature teams are usually in the same country or office. We don’t want to build silos, functionality is owned by one team for all markets and countries. That being said, we often need to add logic so that a solution works for the German market. For example: a Practice Management System just launched in France. Mid 2022 practices in Germany will be able to use it, after we make sure it complies with local regulations and requirements.
In France, Doctolib mobile’s app is installed on your grand-dad’s phone. In Germany, we don’t have nearly the same level of visibility as our colleagues. But we’re getting there. In France Doctolib is a common synonym for finding doctor’s appointments and everybody knows our services. Compared to that we’ve only just left the starting blocks in Germany.
Operation vaccination
Once the date for the delivery of vaccines was set, it became clear that, based on the healthcare infrastructure of a big city, Berlin needed to set up dedicated vaccination centers in key locations, capable of guiding through a lot of people. When we were tasked with this challenge in the last week of November 2020, we answered that if we’d put all the intelligence in 1 room, we’d have a MVP in 2–3 weeks. Turned out they needed it by EOB (End Of Business) the next day. Everyone pulled their weight. We pitched our prototype to the Berlin Senate of Health (Berliner Senat), and on Monday morning we received the feedback that Doctolib would get the mandate.
We deployed the first vaccination center within 3 weeks. In the end Doctolib equipped 6 of the biggest vaccination centers in Germany: the Berlin Arena, Terminal C of Tegel Airport, the Erika Hess Ice Stadium, Tempelhof Airport, the Berlin West Fair and the indoor track cycling arena Velodrom. With a December 20th prognosticated start — which got delayed — we had to drop everything else we were working on.
Building the plane while flying
The person in charge of designing the blueprint for the vaccination centers is a former Head of the Berlin Firefighters who was “re-activated” from his retirement. He built the blueprint model for the centers’ interior with his grandson’s LEGOs. Creating the place where 20–25k vaccinations a day would need to be administered were his responsibility.
We had to design the process without knowing the logistics around the centers, nor the interior (throughput). As every bigger project in a political environment, the requirements go beyond just regular business needs. I mean, who in their right mind thinks that starting a vaccination campaign on Christmas eve is an attainable idea? It might sound good, every day counts after all, but it’s unimaginable that it would work in practice. We had to change our workflow with the project, and we went from Kanban (or: “scrum-ban”) and 2 week sprint cycles to an “agile waterfall” approach overnight.
Hospitals are not equipped to take phone call appointments on a scale quite like we experienced, they have different workflows. Instead 800 call center volunteers assigned to the vaccination campaign in Berlin used Doctolib to check priority and book appointments. People would receive letters to their home address with a 12–16 digit number that reflected their eligibility. With every booking we needed to check that code with the list we had. Imagine the challenge for a 90 year old to call and first list their 16 digit code, then find the vaccination center that works with their mobility, …
We were learning to fly while already mid-air. We were on-site for troubleshooting frequently. We iterated on our solutions every day, based on new insights and requirements. And we had to optimize while the load persisted. Daily changing availability of vaccines and changing time intervals in between the shots (depending on the vaccines) are just two examples of challenges we had to tackle.
The math of it all is dazzling. Imagine a center with more than 150 stations, where slots of 15 minutes are allotted per person (excluding the additional 15 minutes you spend in the “recovery area”). One appointment is de facto two appointments, which means slots 6 weeks from any given cohort are reserved for the second appointment. We weren’t only responsible for the appointments, but also for the documentation of the entire campaign, as well as providing the digital vaccination certificate.
All that we’ve achieved was only possible because we were able to combine a super agile team in the frontline of the Berlin campaign, and the intelligence and firepower of a global tech team in France and Germany with more than 400 people. Doctolib set a new standard.
Side effect: exhaustion
In a stressful situation — and a pandemic certainly is just that — there’s little place for common sense. Reporting was emotional at best, and at times plain false. Questions were raised in the media about why a French company would take on a German problem, pro bono.
This was not normal crunch time, the situation was unique, and most colleagues felt that they were contributing to something much bigger than themselves. Still, it’s tough to keep spirits up when there’s bad press and higher workload. Because the news was popping up everywhere, we’ve constantly let the pure data speak for themselves to convince our teams but also the outer world on Doctolib’s achievement. This brought the state of Berlin to the top performing states in vaccination with one of the — or even the most stable infrastructure in the whole republic.
A case of moving targets
There are multiple lines of defense to make sure the right people get in the right line. From the security guards in the front, then every center is operated by a different organization (e.g. the Red Cross, Malteser International), and there’s all the volunteers, even soldiers volunteered by the army.
We had to deal with moving targets on a daily basis. For dose management, we kept close connection with logistics and pharmacists, to see whether we could open up more slots. The situation would change 2 or 3 times a day. Vice versa we worked with the pharmacies per center, as they needed to know how many doses to prepare. At the end of the day there would always be several vaccines left, and volunteers could get their shots.
It was the first time Doctolib was in the frontline, connecting a team of stakeholders made up from the senator of health, physicians, planners, security experts, … Based on the first movers of the vaccination centers we were also one of the first to come up with a system to provide digital vaccination certificates way before it’s been rolled out in a broader scale in pharmacies.
What’s next?
In Berlin alone Doctolib supported more than 6 centers, hospitals and mobile units to boot. After a tumultuous time we’ve off-boarded centers and onboarding new again for the booster campaign. And we’re glad for it.
Doctolib equipped nearly all of the vaccination centers in France. I like to think the Berlin vaccination campaign and the execution of an outstanding global team laid the foundation for that success.
Standing in front of one of the Berlin centers, seeing hundreds of people walking by checking the Doctolib site/app on their phone or carrying their Doctolib appointment as a print out was an experience unlike anything else. Berlin reached a stage that was previously reserved for our French colleagues: people know about us! I couldn’t be more proud to be a part of this team.
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