Even after the immediate emergency of the current COVID-19 pandemic passes, the healthcare industry won't return to business as usual, experts say.
Healthcare is in a state of flux and there will be financial tough times in the near term for many health systems, according to Justin Gernot, vice president at healthcare advisory firm Healthbox.
"It’s an emphasis on the haves and have-nots of healthcare providers," said Gernot speaking during a recent virtual media event sponsored by the Healthcare Information and Management Systems Society (HIMSS) on the impact of the pandemic on the future of healthcare.
"The organizations that had a tight digital strategy, that were good at telehealth, had money in the bank, by and large, those healthcare systems, unless they are in hard-hit areas, those systems will do well and emerge with an eye toward acquisitions and advancing the position of strength they have,” he said.
The smaller, rural, less financially healthy systems will come out of this crisis “in a bad way,” he noted.
Some things haven't changed, such as the financial pressures facing hospitals.
“Other things have changed or been reprioritized. There are a lot of cracks in the system that have been exposed, from supply chain for PPE (personal protective equipment) to how underserved populations are more exposed and much more at-risk to COVID than others,” Gernot said.
While facing these changes, hospitals also must prepare for a potential second COVID-19 wave in conjunction with a surge of sick patients who put off getting care during the first part of the year, according to Neil Patel, president of Healthbox.
Health payers are modeling for a spike in utilization and spending later in 2020, Patel said.
"The second surge may worse than the first, even though we'll be better prepared for it, as we could have flu season and people putting off care through the spring and summertime," he said.
Healthbox, which was acquired by HIMSS in 2018, also runs healthcare-focused accelerator programs and focuses on helping health systems advance digital health initiatives.
From supply chain to technology innovations, here are four ways healthcare will change in the long term as a result of the COVID-19 pandemic, according to Patel and Gernot.
1. New strategies for elective surgeries
Patients who have put off elective surgeries and procedures will need to be reassured that it’s safe to enter hospitals and other healthcare facilities, they said.
Health systems are struggling with developing the right approach to engage patients and make them feel safe, Patel said.
“Hanging a shingle and saying, ’We’re open' is not going to be effective for those patients who feel that they can wait to have their procedures," he said.
"We see some health systems doing branding initiatives to be transparent about what they are doing to make things safe. Health systems are also recognizing that patients may not want to get surgery in a hospital and some organizations are providing patients the option to have their surgery in ambulatory surgery centers,” he said.
He added, “We know that hospitals are already hurting from the margins they typically see in those cases, so they are sending cases to a joint venture ambulatory surgery center where they are doing 50/50 on the profit sharing."
2. Developing local supply chain sources
The COVID-19 pandemic exposed critical flaws in hospital supply chains for vital equipment like PPE. Many health systems struggled with shortages and often competed with each other for necessary supplies, according to media reports and a recent Department of Health and Human Services Office of Inspector General report (PDF).
"With supply chain, for many health systems, it was analog; they have no real analytics on where supplies are coming from,” Patel said. This is exacerbated by hospital consolidation that has led to group purchasing which, during a pandemic, results in the risk of a “significant, single point of failure” on supplies, he noted.
In some regions, competing health systems are now looking to collaborate on obtaining equipment and supplies.
“Several Chicago hospitals are talking about creating a consortium and building some domestic manufacturing of PPE here locally to reduce their reliance on importing,” Patel said.
He added, “Going forward, supplies will need to have a primary or secondary sourcing that is local.”
3. Digital health options will accelerate
The COVID-19 pandemic has put the spotlight on digital health tools like telehealth and remote monitoring as healthcare providers had to quickly pivot to technology to take care of patients, Patel said.
“We’ve seen health systems doing a decade’s worth of work in the span of a few months,” he said.
Digital health has gone from a "nice to have" to a must have. Innovations in the area of at-home diagnostic equipment will enhance the ability of providers to do remote virtual care.
The pandemic also has accelerated the consumerization of healthcare as patients realize they have more virtual and digital options for healthcare services.
"Patients are loving it. They are wondering, 'Why did I ever have to go in to see my doctor?'" Patel said.
Health systems that had already invested in telehealth infrastructure before COVID-19 will be in a better place moving forward.
Other health systems that had to build up their virtual care capabilities from zero will now need to go back to address operational gaps, Patel said.
“The organizations that didn’t already invest in it had to pick a vendor quickly and are now delivering a suboptimal patient experience in these telehealth platforms. They never had a chance to train physicians in virtual encounters, and the technology platforms are not smoothed out,” he said.
4. Expect innovations with drones and robotics
The biggest impact of the COVID-19 pandemic has been on how consumers work and live with social distancing measures and working from home. With that in mind, there will be advancements in drones and robotics in the consumer world to reduce the number of people who interact with other people, Gernot said.
“We’ll see things like robots going in and cleaning floors and facilities on a daily basis so that you don’t have to expose people to disinfection routines,” he said.
These innovations will make their way into healthcare, Gernot said.
“We often see the technologies that become widely adopted in the consumer world then make their way to healthcare," he said. "It’s going to be outside of healthcare where the most interesting things are happening.”