Hospitals and health systems post-pandemic, and how to prepare for future outbreaks
It's been more than a year since the World Health Organization officially declared the COVID-19 outbreak a pandemic. According to a McKinsey report, an estimated 25% of outpatient services could move to telemedicine, which is among the necessary changes that could mean preparation and prevention for future health epidemics and pandemics, said Dr. Muhammad Ali Chaudhry, CEO of Emerging Health International, a healthcare technology and services company.
Further, the pandemic has caused a massive impact on the healthcare industry, accelerating transformations and hospital design needed to address the medical priorities of their populations and respond effectively to emergencies such as epidemics and pandemics, he added.
To get an idea of what needs to happen in healthcare in the years to come, Healthcare IT News interviewed Chaudhry to gain his expertise in healthcare transformation and healthcare technology.
Q: Will hospitals' infrastructure and healthcare delivery design needs change post-COVID-19? What does the future state of healthcare hold?
A: Impacts of COVID-19 have either exposed or reinforced fragilities in healthcare delivery across systems worldwide. The experience has demonstrated insufficiencies and inefficiencies across the spectrum of care, ranging from capacity to access and quality of care and from the application of digital health solutions to the availability of supplies and medications.
It has also accelerated innovation and expanded opportunity for transformation – to address these weaknesses in a way that allows for a sustainable redesign of care delivery. Agile care delivery is the future state of healthcare and will enable health practices to be flexible, adaptive and responsive to new information or changing trends, continuously improve processes to deliver more value, and effectively adopt new technologies to enhance care.
The strategies to achieve it will need to involve and interact key system components, including infrastructure, workforce development, and both patient-centric and business-centric digital technologies that will complement the development of a sensing and responding system.
COVID-19 has forced a deeper consideration of healthcare delivery beyond the individual patient focus to a broader lens that looks at implications within and across communities, regions and countries. Adaptive approaches need to stretch across both infrastructure and care delivery design.
Flexibility in physical infrastructure design to accommodate for epidemic and pandemic scenarios can help shape spaces to isolate ventilation and reduce clinician exposure, to accommodate larger emergency triage requirements, and adapt for additional patient care when needed with flexibility in space and resources and adaptability of human capital.
It is important to note that the first signals of a healthcare emergency are low-acuity symptoms that have the potential to balloon into a pandemic. So, appropriate care delivery design and the assignment of distinct care models closer to communities are key health management strategies.
Embedding a health system within a community, physically and with significant support from a robust digital infrastructure, will allow for improved access, locally focused health services, and more efficient and appropriate referrals to tertiary settings. It is a strategic move away from a hospital-centric approach to a patient-centric approach.
Q: What needs to be done in existing hospitals and health systems in the U.S. to effectively prepare for future outbreaks that will ultimately support global health improvements?
A: To prepare effectively for future pandemics or emergencies, health systems need to be strong and responsive to the health needs of their local populations; they need to be resilient and nurture resilience in populations, as well.
This shift from fragility to resilience is not linear. As with any system change, it will require both the identification and understanding of complexities and interacting risks, and the design of strategies to strengthen the absorptive, adaptive and transformative system capacities.
Existing hospitals and health systems need to focus on optimization to prepare for future outbreaks. Leveraging innovation to improve quality of care and access, and address health inequities across population groups and underserved communities is key. Driving value-based design and embracing risk-sharing models will support integrated care, improve cost efficiencies and align outcomes.
Optimization also requires agile planning for dynamic disaster response to changing surge levels, activation of critical resources, supply chain management, staff education and support, transformational initiatives, infection control processes, business continuity and infrastructure readiness.
The shape, barriers and pace of change will be different around the world. Markets such as the U.S. will likely see slower changes due to its legacy investments and the cost to overhaul, whereas emerging markets are more receptive environments for transformative change. They can take the innovations available today, develop leapfrogging solutions and accelerate the development of their healthcare systems.
Changes at the policy level would also need to lead or keep up with innovations. They would need to embrace digital disruption, for example, as an acceptable parallel approach to care delivery that can extend across geographic boundaries, particularly with the likelihood of future pandemics. Cross-border knowledge-sharing is another key area that needs stronger policy support.
Vaccine passports are being introduced as a monitoring and preventative response to COVID. Perhaps in the context of a pandemic, physician practice passports could be considered as a tool to enable the cross-boundary sharing of expertise without the same national licensing constraints.
Q: What role will digital health and telehealth play in the structuring and building of a healthcare system resilient to pandemics and other shocks in the future?
A: Digital health solutions have been offering improvements in healthcare delivery in varying degrees and momentums worldwide – expanded access to care options, reduced demands on facilities, reduction in healthcare costs, better quality of care through efficient allocation of resources and improved patient experiences.
COVID-19 interrupted this pace not by changing the trajectory for digital health solutions, but rather through acceleration, innovation, investment and mobilization.
As part of the digital infrastructure required to support effective care delivery, digital technologies have a plethora of applications that provide both patient-centric and business-centric solutions, such as preventative and promotive healthcare, patient monitoring and program management, and electronic health record systems.
This is where integration and interoperability become very important to ensure collaboration and communication between different systems and operations. Both patients and providers benefit with safe, secure and seamless access to patient information and vital data.
Digital technologies also have a key role to play across the continuum of care with blended applications and support across pre-acute, acute and post-acute care. One example of this is telehealth. It is patient-centric technology that has served as a critical tool in COVID response and will continue to play a substantive role in healthcare transformation.
Supporting health systems as a virtual care technology – consultations at the primary care level up to tele-ICU at the tertiary care level – and offering seamless interaction with referrals, diagnostics and pharmaceutical needs, telehealth as a tool will improve the overall care journey for the patient and offer significant cost efficiencies for providers, payers and patients.