Industry Voices—Rebuilding healthcare after a pandemic

In healthcare, our adaptability and innovative execution in the weeks since the novel coronavirus outbreak has been faster than at any time in the decades the industry has been pursuing systemwide innovation.

Healthcare innovation combining technology, data integration and data sharing with a core of human-centered care has become our battle cry against COVID-19 today and in the near future. This pandemic has shown us that access to care, personalized behavioral health support and mobile health solutions are imperative to not only overcome a public health crisis, but to the future of the U.S. healthcare system.

Consumers have always needed help navigating healthcare efficiently and effectively, whether that’s going to the ER or determining whether to self-triage symptoms at home. Even before the pandemic, the healthcare experience could be chaotic for both consumers and providers.

Despite knowing this and “pursuing” transformation for decades, the healthcare ecosystem—payers, providers, manufacturers, policymakers and others—continued to be challenged even with the best individual intentions. Cracks in the system have led to all stakeholders blaming other parties and pointing fingers.

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The damning realization is that had we moved faster, worked harder and been more willing to collaboratively innovate before the pandemic, the losses today may have been less devastating for all our communities.

The perfect storm for transformation

Before COVID-19, the tools to improve care existed, but we sat on them waiting for the right incentives, or as we describe it, aligned incentives. We already had the technology to support various modalities of telehealth, but a lack of legislative consensus stalled widespread adoption.

For years, the absence of interstate licensing for providers has been a major obstacle to mobile health, but in the face of a crisis, legislators lifted that restriction in just a matter of days. We have expanded billable telehealth services by adding 85 new billing codes since COVID-19. Tracking and sharing aggregate outcomes data is sparse, and the burden has been carried by academic organizations, not our state public health departments. Today we are sharing data nationally and in real time.

Health disparities that have existed forever are today at the forefront, showing that quality, accessible healthcare must exist in every community, and digital health plays a role here. We must close the digital divide. Period.

The pandemic has proved that under the right circumstances, we can break through self-imposed barriers and work together to implement new technology, enact new policies, collaborate across all healthcare disciplines and stakeholder groups and remember that when people are sick, they need allied health professionals and physicians to provide care. 

Connecting care while safely distant

Mobile health has brought invaluable relief for our hospitals and providers on the front lines. Tech-enabled solutions are enabling people to access care for COVID-19 symptoms, everyday illnesses, behavioral health needs, specialty consults, dentistry and more. Healthcare is just beginning to understand the potential of internet of things (IoT) technology to automate tasks and improve patient monitoring while increasing efficiency and reducing costs.

Routine medical exams can be conducted virtually with remote diagnostic devices that deliver clinical quality data in real time. For behavioral health providers, video chats are offering insights into an important measure of well-being that was usually out of reach—the patient’s home environment.

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Mobile technology is enabling providers to deliver care effectively from a safe distance as they too shelter in place. Through mobile apps, consumers can navigate care options, manage prescriptions, coordinate care, manage healthcare finances, chat with a nurse, book appointments, connect with a health coach and so much more.

We are also enabling care at home including acute and emergency care with hospital at home models and treatments that are growing and demonstrating success.

Whether for healthcare or communication, mobile technology is giving us the ability to maintain human connection and even the opportunity to connect with each other more frequently as we physically isolate for the safety of our communities. Each year for the last several years was heralded as the year of telehealth—that’s finally coming true in 2020.

As providers and consumers become more familiar and comfortable with mobile health, the landscape for convenient, tech-enabled on-demand care options will continue to evolve. Hopefully, we continue to move forward and not reverse this progress.

Expanding our front lines

With physicians overwhelmed and focused on the most urgent of cases, patients have also been able to turn to the wider ecosystem of providers to address many of their healthcare needs. Nurses, pharmacists, therapists, health coaches and more have stepped in to fill care needs across the country.

Traveling nurses are providing primary care in rural communities already strapped before COVID-19, with many states loosening licensing restrictions to give those with clinical skills more fluidity in where they practice. Combined with mobile health, nurses and health coaches can offer check-ins for patients with severe or chronic illnesses more frequently than physicians while removing the hardships of travel for those with mobility issues.

Many providers are stretching beyond their typical specialties while delivering top-level care in response to COVID-19. The universe of medical services we can provide remotely is expanding exponentially, but consumers will always need human support. These clinicians are showing us that it’s possible to expand patients’ care teams without sacrificing the personal touch.

Making innovation stick

The pandemic is revealing how we can operate at our best as we work together to overcome the worst public health crisis in modern times. At the same time, healthcare is advancing toward limitless possibilities for people to engage with their health and well-being. From IoT to interoperability to machine learning and artificial intelligence, technology will continue to improve care delivery and strengthen our goals for human-centered, anytime, anywhere care.

As we recover from COVID-19, we need to remember the lessons learned from our struggle to contain the virus and not return to "business as usual." We need to be more open to change, step out of our comfort zones and embrace the unfamiliar. Barriers that have stymied innovation in healthcare aren’t as insurmountable as we once thought.

The improved delivery of healthcare requires ongoing scientific research, collaborative data sharing and improvement in digital access for everyone. This pandemic is proving that our industry is capable of rapid, innovative change and we can’t afford to lose the gains we’ve been able to make together.

Cheryl Pegus, M.D., is Cambia Health Solutions’ president of consumer health solutions and chief medical officer.