Electronic Health Reporter

By Ryan Van Wert, MD, CEO and founder, Vynca.

As a physician entrepreneur with a background in critical care, I view the COVID-19 pandemic from a unique perspective. COVID-19 has compelled the healthcare industry to evaluate areas that are successful and those that must be altered to improve care delivery for both clinicians and consumers. This time of contemplation is an opportunity to move healthcare forward for the benefit of everyone.

In addition to providing many lessons for the healthcare industry, the COVID-19 pandemic has exposed some particularly vulnerable areas, revealing five valuable teachings.

Five Insights from the Pandemic 

• The need for more palliative care providers: The pandemic brought to light the shortage of palliative care providers in America. Some hospitals reacted to the abrupt wave of patients by staffing palliative care physicians in the ED. These hospitals leveraged the experience of palliative care physicians to engage patients in goals-of-care discussions, enabling their patients to have increased access to goal-concordant care. Others offered further palliative care support through telehealth to bridge the gap between onsite clinician resources and demand. Palliative care will continue to be in high demand throughout the pandemic and moving forward, and there must be a considerable effort to encourage more providers to join the specialty.

• A stronger emphasis on end-of-life care planning: COVID-19 has illustrated the importance of proactively initiating end-of-life conversations with patients and their loved ones to achieve patient-centric value-based care. It is also critical for these wishes to be documented in a clear and easily accessible manner, as the traditional way of completing advance care planning documents with pen and paper is no longer sufficient. Hospitals and health systems need to integrate digital advance care planning documentation into their EHR systems to ensure that these documents are available to all clinicians, patients and their selected caregivers when they are needed.

• The fragile state of fee-for-service revenue: Many health systems still depend on procedures, imaging and infusions to account for a significant amount of their top-line revenue. While this pandemic is a particularly acute case, it has revealed the fragility of these revenue streams. Risks to an organization’s fee-for-service revenue, such as competition in the market, losing a physician specialty group and more, always exist. There is hope that the exposure of this fragility will drive further engagement in value-based initiatives – at the very least to help prevent disruptions of fee-for-service revenue in the future, but in the end, because these reimbursement models can provide higher quality care at lower costs.

• The importance of prioritizing public health: Much more could have been done to prepare for COVID-19, in terms of preemptive and continuing investments in public health. Moving forward, the connected global community must prioritize preparation, so we can successfully respond to future public health emergencies. 

• Greater investment in supply chain infrastructure: COVID-19 has uncovered deficiencies in the U.S. healthcare supply chain. Though some health system executives tried to say the concept of just-in-time supply chain is not effective in healthcare, the truth is just-in-time supply chains can be effective during unexpected incidents. To be successful, they need significant planning and investment in supply chain infrastructure, and COVID-19 exposed some of these preparation shortcomings.

 Three Ways Healthcare Will Change in 2021

 With vaccines being distributed globally, some of the alterations the pandemic has made to the healthcare landscape will have a lasting impact, while other changes may not be as permanent. Below are three areas that will look different in 2021. 

• Disruption of traditional healthcare models: COVID-19 drove rapid engagement with digital technologies and virtual/remote models, as telehealth was the only safe way for many patients, especially those with chronic illness, to see healthcare providers. To ensure people still had access to care, restrictions were eased around reimbursement, as pre-pandemic barriers to adoption were linked to payment/reimbursement, and not the state of the technology. As a result, there was an uptick in telehealth consults, and the 1135 waiver enabled Medicare to cover for more classifications of virtual visits, such as home telehealth consults across the country – not just in rural regions. Still, the actual reimbursement landscape is going to be far more complex than people predicted at the onset of the pandemic. For example, some healthcare facilities are no longer able to receive a facility fee when delivering services by telemedicine. This presents a challenge for health systems that have invested considerably in brick-and-mortar infrastructure as part of an expansion strategy. Still, it creates an opportunity for truly impactful disruption in the space with new methods of care delivery, often outside of traditional healthcare models.

• Changes to how and where healthcare is delivered: COVID-19 has also created significant cross-over between how and where healthcare is provided. For instance, many non-traditional organizations began providing self-pay COVID-19 tests. The last couple of years have created some interesting dynamics that could be a spark for bigger trends like clinics opening in retail pharmacies, for example. 

• A stronger emphasis on consumerism in healthcare: As healthcare costs continue to increase, and consumers are responsible for more of these expenses, individual’s expectations for excellent customer experiences, cost transparency and selection are also going to rise. As it relates to advance care planning, health systems with a streamlined approach to this can deliver an outstanding customer experience for people with serious illness facing a particularly hard time in their lives.

While the pandemic has impacted the healthcare industry in every care setting, it has also brought to light opportunities for the industry to make real progress. As we aim to make our public health infrastructure stronger, COVID-19 has provided an important moment for us all to reflect on what we can do to improve in the coming years.