Even before Covid-19 struck the United States, health care costs were skyrocketing and hospital finances were shaky. These facts placed both providers and patients on a collision course, which our current pandemic has amplified.
In many parts of the country, the coronavirus has forced clinics and hospitals to slow or stop nonemergency services temporarily. Now that many are back up and running, patients continue to stay away for fear of getting sick. This has resulted in huge losses for large health care institutions, which the American Hospital Association projects will reach $323 billion by the end of 2020.
From any crisis there is, however, always a silver lining. Rethinking the way in which the healthcare system is organized and how people pay for services has never seemed more important and more obvious. Still, few organizations are thinking big enough or broadly enough. Covid-19 represents not just a chance to improve incrementally but is a wake-up call for the entire healthcare industry to do something entirely different and create something that is less confusing and more effective.
Rather than letting this opportunity go unanswered or holding our breath waiting for the tunnel to end, we should push ourselves to change behavior permanently, challenge conventional thinking and embrace change. We can take a lot from the way the high-tech sector innovates by creating a hypothesis, rapidly testing it and pouring on the resources to go fast based on what is working.
How the industry has responded to the need for face shields, gloves, masks and ventilators is a great example, though on a very fundamental level. Someone had the bright idea that personal protective gear could be made more cheaply by idle industry or even at home with a 3-D printer. It has been great to see how many people outside the healthcare industry have responded. Massive amounts of material have been collected and all without a standard procurement process. I have even read with joy that some hospitals have discovered that CPAP machines — typically used to help people with sleep apnea enjoy a good night’s rest — can be commandeered to ease Covid-19 symptoms.
It is a good start, but there is a lot more we could do. Let’s take telehealth. Physicians have rapidly embraced this model as a major way to see patients with the pandemic raging. Most providers used to believe that telehealth was a poor substitute for face-to-face interactions. Now we are finding that this underutilized tool has a place in the doctor’s toolbox and patients like it. What if we actually embraced this idea further and flipped the model on traditional patient practice? What if 80% of the patient-provider interaction were done through telehealth?
If performed on a large enough scale, widespread shifting to telehealth could fundamentally alter the way the entire health care system operates. Hospitals and clinic practitioners will be able to use telehealth routinely and on a much more integrated basis, opening up an array of new possibilities, like in-home follow-ups after surgery or regular chronic condition check-ins. Embracing telehealth more broadly could even allow providers to work with patients on their whole health journey, rather than only in crisis moments or when they have specific concerns.
We know that the global pandemic has people working from home more than ever before and is forcing them to consider carefully where they live and why. I know specific examples of people who have made major relocation decisions because their employer no longer (at least for now) needs them to come into a specific office. This will create sticking points for physicians trying to follow up on the care they are providing. A smart, simple investment in a whole approach to telehealth will put some providers ahead of the game once the global pandemic recedes. This will also cut costs.
While many health systems — particularly rural, underfunded ones — are desperately trying to be creative with costs in order to stay afloat, there are ways in which shifting to virtual care can be more cost-efficient. Office space would be less of a consideration, with no need for waiting rooms or a high number of exam rooms, and administrative staff could also likely be reduced.
Given the volatile nature of this crisis, it’s impossible to predict what shape our health care systems will be in one month from now, let alone a year or decade from now. But it’s time for us all to focus on what appears to be working and move full speed ahead.
Jaja Okigwe is chief executive officer of First Choice Health, a Seattle-based physician- and hospital-owned company that serves more than 1 million customers in the Northwest.