While the COVID-19 pandemic forced healthcare into a reactionary crisis state in 2020, 2021 offered an opportunity to rethink traditional care delivery models. Divergent views on vaccines, powerful COVID-19 variants and ongoing capacity issues have shown that providers, and the technology companies that support them, will need to continue to evolve in order to serve patients effectively.
As we look towards 2022, experts at Wolters Kluwer Health, a clinical technology and evidence-based solutions provider, outlined their predictions for next year and what they think it will take to properly equip providers to deliver the best care everywhere.
Building trust in an age of digital information overload
Digital health investment in 2021 has focused mostly on technology innovation and workflow improvements. What I’m seeing in the digital health space is akin to the implementation of EMRs, which really focused on the technology itself and not the content inside, which creates the experience for both clinical users and consumers. What’s missing from digital health strategy, and what providers will need to focus on in 2022, is increasing access to high-quality, evidence-based health content that consumers and providers alike can trust and understand. This ease of access is crucially important to overcome the infodemic of COVID-19, with an influx of misleading and rapidly evolving information we’ve seen expand across all areas of healthcare. Effective, engaging digital health requires more than the right technology, but a full-fledged experience that informs and motivates consumers towards evidence-based action.
Jason Burum, general manager, Healthcare Provider Segment, Clinical Effectiveness, at Wolters Kluwer, Health
More compliance, less burden
The pressures of COVID-19 spurred USP to issue interim guidance that provided flexibility for compounding pharmacies, but 2022 is likely to represent a return to stricter compliance. In September, USP issued a Notice of Intent to Revise (NITR) for both USP <797> and USP <795>. With COVID-19 cases continuing to surge across the country, I anticipate hospitals and pharmacy staff in 2022 will increasingly rely on expert solutions and technology to automate and standardize compounding operations in accordance with best practices and the latest compliance requirements. Burnout and technician shortages are happening in pharmacies too and software tools will help alleviate burdens pharmacy staff face right now.
Annie Lambert, PharmD, BCSCP, Clinical Program Manager for Compliance Solutions for Clinical Surveillance & Compliance, Wolters Kluwer, Health
Pitting AI against HAIs
Data show that while hospitals have allocated more resources to infection prevention and control efforts to contain the spread of COVID-19, it has largely come at the expense of controlling other far too common healthcare-associated infections (HAIs). It’s true that a larger volume of sicker patients at higher risk of infection and sepsis have been admitted to the hospital over the last year, but the CDC concluded that 2020 increases in HAIs were also a result of lacking surge capacity and other operational challenges. Looking ahead to 2022, as hospitals take aim at controlling all HAIs in addition to COVID-19 with more resilient care teams, they will be looking more closely than ever at AI-powered technology to support proactive and real-time monitoring of patients to empower staff with quick risk identification abilities and opportunities for earlier clinical intervention.
Mackenzie Weise, MPH, CIC, Infection Prevention Clinical Program Manager for Clinical Surveillance & Compliance, Wolters Kluwer, Health
Telemedicine grows up
Contrary to some news stories, telemedicine will prove resilient well past the pandemic and will establish itself as a permanent, significant fixture in the healthcare ecosystem. In 2022, I expect healthcare providers themselves will strengthen and formalize training to research and promote telehealth best practices to their clinicians. It’s already happening, and I expect to see specialties like mental health and urgent care shifting to a predominantly virtual model in 2022. Ultimately, I believe that the rise of telehealth will drive more dialogue around modes of access as an issue not only of tech but also equity in the years to come. This in turn will have big impacts in the future of medical practice.
Vikram Savkar, vice president and general manager, Medicine Segment of Health Learning, Research & Practice
During the pandemic, nearly every healthcare provider in the country had to execute a rapid, unplanned switch to telemedicine for the majority of their consults and activities. According to one study from the RAND Corporation, there was a 20-fold increase in the rate of telemedicine utilization after March 2020. For the most part, this transition was executed well and successfully, but only due to heroic levels of creativity and dedication by clinicians in every field.
With few established practices to rely on, it fell to each hospital, each department, each clinician to more or less invent ways to conduct virtual consultations in dermatology, cardiology, oncology, and more. There was much trial and error, but a commitment to rapid learning meant that the community as a whole was able to achieve a reasonable level of healthcare delivery quality to patients via the web.
Now, however, it is clear that telemedicine will be a permanent and sizeable segment of healthcare delivery; some estimate that more than 20% of healthcare from 2021 onward will be virtual. As a result, every aspect of the healthcare ecosystem must move out of an “emergency” mindset when it comes to telehealth and focus on establishing scalable, sustainable processes that ensure that a steady shift to telehealth drives equity, access, and quality. Healthcare providers themselves are actively engaged in this effort, and medical schools also now need to evolve to reflect this new normal.
Medical schools have incorporated some telehealth training into their programs in recent years, but it has tended to be ancillary. Now, it will be critical for telemedicine training to be incorporated more structurally into core curricula. What is being called “webside manner,” for instance, is significantly different to “bedside manner” and needs to be taught explicitly ?— in both a classroom setting and during clerkship rotations, as well as residencies.
Clinicians need to be taught how to establish rapport with patients whom they don’t see face to face, how to assess possible domestic abuse threats when the patient may not be able to speak freely, and how to gather emergency contact information in case there is a critical event during the consult for which the clinician needs to call emergency services. They also must learn how to take advantage of the unique opportunity that telehealth presents to closely observe and document social determinants of health by, for instance, asking patients to show the contents of their refrigerator. And they must be taught how to navigate the “digital divide” and ensure that patients without access to broadband or smartphones aren’t consigned to a lower quality of telehealth care.
The pandemic has shone a critical light on every aspect of the medical ecosystem, revealing which systems were adequate and which were not – in a way that only a global crisis could have done. There has been widespread discussion since the start of the pandemic, concerning changes to public health systems, medical supply chains, medical education, telehealth infrastructure, and more. Less often discussed, but just as disrupted by the pandemic, is medical research communication.
Encompassing peer-reviewed scholarly journals, books, websites, conferences, point-of-care devices, and more, the medical publishing ecosystem is a critical connection point, ensuring that clinicians and healthcare leaders around the world have access to current information about new and emerging treatment approaches.
Looking Beyond the Journal
The pandemic generated needs that went well beyond the comfort zone of this traditional set of tools. Even in the fastest scenario, a journal article once submitted takes months to reach readers and is preceded by additional months of research. This ultimately means that a hypothesis that a clinical researcher is exploring will take half a year or more to progress from concept to readership. In the early months of the pandemic, front-line clinicians could not wait six months to consider therapies for their COVID-19 patients. They needed to act immediately.
In the absence of peer-reviewed research in the early months of the pandemic, clinicians turned to preprint servers, case reports, and even social networks – through which they were able to receive real-time advice from fellow clinicians in other hospitals and other countries on “what was working and what was not.”
Now that a year has passed, there is a substantial body of peer-reviewed, well-established work on COVID-19 in traditional journals, and we can expect to see the global community’s therapeutic and public health approach returning to traditional research-based foundations for the remaining years of pandemic response. But the need that the onset of the pandemic revealed – for much faster and less formal channels of information sharing to sit alongside the more traditional channels – cannot be “put back in the bottle”. The need must be addressed with new systems, new technologies, and new approaches – so that the global community can be better prepared for future crises.
By Vikram Savkar, vice president and general manager of the medical segment, Wolters Kluwer’s Health Learning, Research, and Practice business.
The COVID-19 crisis has placed a burden upon every aspect of our society. But nowhere is the burden more immediate and urgent than across the hospital sector. As the number of patients requiring critical care in a short period of time grows into the hundreds of thousands and perhaps beyond, clinicians are confronted with the mission of handling a challenge whose scale far exceeds our standing capacity.
The medical community is rising to that challenge with personal heroism. Every city and town has stories of clinicians who are prepared to work around the clock, despite having inadequate supplies and a high possibility of contracting the very disease that they are treating. If there was ever a time when the average person took their community’s medical infrastructure for granted, that time has now passed.
We will always, those of us who are living through this period, remember the many healthcare professionals and first responders providing COVID-19 care who “ran toward the fire,” as the saying goes, when the rest of us did our part and remained locked away from it. I am hopeful that we will come through this crisis stronger, as the many lessons learned from this pandemic are addressed by health systems, hospitals, and governments.
And in fact the disruptions of COVID-19 at present extend even beyond our hospitals to every other aspect of the medical world as well, including medical schools. Some of these disruptions are temporary, some long-lasting.
Since my company, Wolters Kluwer, works closely with most of the medical schools in the U.S. as well as in many global markets through our digital and textbook solutions, and we are in daily touch with most of them to help them navigate through this turbulence, we have insight into what these changes may be.