“Change” is a recurring theme in health care. With each new initiative we hear: “This will fundamentally change health care!” From the Affordable Care Act to how doctors and hospitals are paid, to consumers’ responsibility for their own health, the coronavirus pandemic has forced sweeping changes on health care delivery. We are adapting to new ways of care delivery, from face masks to using technology to reach patients at home.
In a recent article in Health Leaders, American health care leaders were interviewed about the changes in health care delivery after the pandemic subsides. I’d like to share some of their thoughts that may have an impact on Arkansans.
While the doctor’s office has traditionally served as the home base for most patients, quarantines and social distancing have changed that. The rapid increase in the use of telemedicine is teaching patients and health care professionals new ways to interact. Telemedicine – health-related services and information provided through electronic means – allows long-distance patient and clinician contact, care, reminders, education and monitoring. This is an opportunity to have increased “virtual touch” to improve patient access and care management. Most physicians still want to “see” their patients and the face-to-face visit probably will not go away. As a proponent of the Patient Centered Medical Home (PCMH) model of health care delivery, I want my patients to have a seamless and comprehensive health care experience.
Telemedicine could move to the forefront of service delivery as more health care professionals will work from home. Sarah Richardson, vice-president at Optum in Los Angeles said, “It will be hard to bring everyone back from home once they have demonstrated improved productivity, wellness, happiness, and its (telemedicine’s) ultimate impact on the bottom line.” Telemedicine has many advantages:
- Increased access to a PCMH with new opportunities for improved care and cost efficiency;
- More convenient appointments without missing work or school, or arranging for childcare or transportation;
- Less need for travel;
- Reduced risk for sick patients to expose healthy patients;
- Better access to specialty care, especially for rural Arkansans; and
- Improved patient engagement in their health.
The economic downturn caused by massive unemployment will affect health care coverage and access. To meet the financial paradigm shift, health care will be delivered, “with as much globalization and technology as possible. The human touch will be rationed to those paying a premium,” according to Neil Carpenter, a vice president with Array Advisors, Washington, D.C.
Physicians, nurses and other health care professionals working on the pandemic’s front lines are feeling intense pressure during this time, risking infection, even death. They must weigh the risk of infecting family members and take extra precautions to reduce those risks. Their burnout and suicide rates far exceeded those of the general population before the pandemic. Some may not return to practicing medicine.
Many clinics and hospitals are having to adapt to survive financially. Estimates are that 25% of hospitals will close due to insolvency (not all of them will be in rural areas) unless the government helps support them financially. Arkansas hospitals have reported a loss of $437 million since the pandemic began. Now is the time for them to invest in reliable platforms for telemedicine, robotic automation, use of artificial intelligence, virtual care and other technological advances.
Hospitals and clinics have had to upgrade safety and pandemic policies under the intense pressure of an onslaught of very sick patients. The institutions that do survive will be stronger, but only if they focus on pandemic preparedness in every aspect of their business operations and services. Increased costs will be associated with workforce safety issues.
How hospitals operate will change, with more virtual meetings, new communication methods, and doctors who will demand greater accountability over hospital operations and emergency preparedness. The pandemic has pushed front-line professionals to demand changes in emergency protection supplies, hazard and sick pay and protocols to avoid family contamination.
“The days of relying on huge teams of humans to accomplish routine mission-critical processes are over,” according to Sean Lane, CEO of Olive in Columbus, Ohio. “Health systems will hire artificial intelligence workers to take on critical ‘keep the lights on’ processes and shift their human workforce to focus on quality of care delivery.”
The levels of debt facing the American economy after the pandemic will affect health care spending for consumers and institutions. The push for more preventive care will continue as a key health improvement initiative. The demand for everyone to have access to acute and preventive health care (in person and virtually) will persist.
The coronavirus pandemic has made is it evident that any health care system that does not include access for everyone puts all of us in jeopardy of illness and an increased risk of death. It has especially put health care professionals at risk at a time when their financial health and safety are tantamount to our own. Because consumers will be paying more out-of-pocket for health care, we all need to get serious about taking personal responsibility for our health, including access to better health management tools.
The Center for Health Care Strategies, Inc. emphasizes that social determinants of health (SDOH) will increasingly affect health care services and our ability to stay healthy. SDOH include access to food, housing, green outdoor spaces, education and other factors. The differences in our lives – between rich and poor, rural and urban, black and white – determine who gets sick, who has a home in which to social distance and who gets health care.
Health care is constantly changing to to cover more patients, adapt new technology and prepare for future pandemics. A diversified health care work force will want more control over their working conditions. Each of these challenges is a unique opportunity to improve and strengthen Arkansas’ health care system. If we carefully plan for it, change can be a good thing.
Editor’s note: Dr. Chad Rodgers is an Arkansas pediatrician and is the Chief Medical Officer for the Arkansas Foundation for Medical Care. He also shared his thoughts on changes to health care in the video below. The opinions expressed are those of the author.