Client Spotlight: Utah Department of Health

• Population: 3.2 million
• Location: State of Utah
• Tyler Solution: Medical Cannabis Regulation application

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The Need For Medical Cannabis Administration, Regulation

After a ballot initiative legalizing the sale of medical cannabis, the Utah state legislature passed an amendment calling for an administration and registration system. The Utah Department of Health (DOH) selected a Tyler Technologies system to manage the registration of the patients, medical providers, and pharmacies involved in the sale of medical cannabis in the state.

For a new, state-wide system, the project had a short timeframe for launch: The Utah state legislature had specified that the system had to be in place within six months.

“Worked on Launch Day!”— and Flexible Afterward

Despite the fast pace, the system, built on Tyler’s Application Platform, was ready to go live by the scheduled launch date. The Tyler team worked diligently with the client throughout the project to ensure that the aggressive timeline would be met. “It worked on launch day!” said Kayla Strong, who served as Utah Department of Health, Center for Medical Cannabis - Pharmacy Program Manager at the time of the implementation. She noted that the Tyler team was answering email questions up until the day before the launch, despite it being a weekend.

From that first day that the system launched, it has been used by patients to pay for and print cards showing that they have been approved to purchase medical cannabis. Medical providers also use the system to approve patient registrations and issue dosing guidelines. These guidelines indicate the amount and/or the type of medical cannabis the patient is authorized to buy. The dispensing pharmacies access the system to verify patient eligibility and prescription amounts.

However, as it stands today the system is not identical to the one implemented at the initial roll-out. Immediately after launch, system users provided feedback about how patients and providers use the system. The initial design required patients to select a medical provider as listed in the system; however, if they chose the wrong provider or had not been in contact with their doctor recently, the registration request was likely to get stuck in the approval process. Based on this feedback, adjustments were made to the workflow to ensure that registration requests are promptly reviewed.

In addition to this immediate adjustment, configuration enhancements since launch have:

• Turned off interfaces that proved unhelpful to users
• Enabled reciprocity with other states
• Added more data fields
• Prepared the system for additional legislation-driven changes anticipated in the coming year

Seven Key Tenets for Medical Cannabis Implementation

Utah’s Medical Cannabis Regulation system was a major software implementation for the Utah DOH. To ensure the project’s success, Utah DOH held to the following tenets that can serve as a guideline for other states embarking on a medical cannabis initiative.

1. Choose a provider with experience. The team that implemented the system has extensive experience both with the Tyler Application Platform and with medical cannabis programs in other states. Their expertise enabled the project to move quickly and give the Utah DOH confidence as they neared launch. “The Tyler team was thorough, thoughtful, and could anticipate what I needed because they knew the system inside and out,” said Strong.
2. Determine clear ownership of the program. The Utah medical cannabis initiative is jointly owned by the Department of Health and the Department of Agriculture (as cannabis is a regulated crop). The communication and collaboration between the two departments, with clear differentiation of which portions of the processes and software components belonged to whom, contributed to the implementation’s overall success.
3. Think creatively. Legislators are not necessarily technology experts and may require timeframes or functionality that is difficult to accommodate. It is important to remain open to creative solutions to achieve the legislative requirements of your state.
4. Anticipate changes. As noted, Utah’s implementation included changes almost immediately. Legislative changes have already impacted the system, with more to follow. Even consumption patterns have changed, with the COVID-19 pandemic making it necessary to update the system to support home delivery. Having a flexible team, and a flexible software solution, is imperative.
5. Establish clear deadlines. The tight timeframe of Utah’s initial project was a challenge, but it did keep the project moving and provided structure to the overall initiative. Having a clear plan with specific deadlines is a useful tool to get the system up and running so that patients can benefit as soon as possible.
6. Focus on the end-user. Medical cannabis patients receive their prescriptions to relieve suffering. The system must not be a barrier that makes things harder for them. Remember that patients may be using outdated phones, old computers or tablets, or have no technological experience at all. Think critically and empathetically when designing the user experience.
7. Brace for usage beyond your calculations. Utah’s initial expectations were 20,000 patients over the first five years, and up to 500 providers. Instead, in just one year, they have reached 32,000 patients and 800 providers. Make sure your solution is architected to scale for more users than you have predicted.

The program has been working effectively, with dispensing pharmacies steadily coming onboard to access the system and serve patients. With the flexibility of the system and the support of the Tyler team, the state of Utah will be able to administer and regulate their medical cannabis program whatever changes come their way.