By Steve Burrill, vice chairman, US Health Care Leader, Deloitte LLP
This week we wanted to share with you one of the insightful blogs from our colleague in the US on the impact that COVID-19 is having on their healthcare system; and which first appeared as a US Center for Health Solutions ‘Health Forward’ blog on 28 May. While the image of empty hospitals, healthcare job losses and funding challenges aren’t things we expect to see in the UK, the description of the reality of the past three months for healthcare staff on the front-line, and how to address the growing backlog of deferred medical services, does resonate. Moreover the main thrust of the blog, on the four key areas of healthcare that COVID-19 is likely to change in the ‘future of health’, is something we do expect to see happening across the UK and Europe and, likewise, we expect this to happen much more quickly than we might previously have predicted.
We are all keeping up on the news and are all painfully aware of the number of people, locally and around the world, who have been infected with COVID-19. We have seen images on TV of exhausted nurses, physicians, and other first-responders as they try to care for a crush of severely ill patients at hotspot hospitals. We continue to hear concerns about shortages of personal protective equipment (PPE) and ventilators. This crisis is very real.
During a Dbriefs webcast on May 12, I talked about some of the things we haven’t seen on TV. We haven’t seen the thousands of hospitals in the US that have become virtual ghost towns. We haven’t seen how volume has completely disappeared for many hospitals and other acute care facilities. We haven’t heard much about the health care jobs that have been impacted. Health care jobs have typically remained stable during past economic downturns. That isn’t the case this time around. The health care sector shed 1.4 million jobs in April.1
Many of our health care clients are still in the respond phase of the pandemic. They are responding to infected patients while others are responding to a growing financial crisis as their facilities remain largely vacant. For them, the recovery phase is still on the horizon.
The dynamic for our health plan clients is completely different. More than 40 million people in the US have filed for unemployment benefits, and many of them have also lost their employer-sponsored health coverage. Most health plans are experiencing significant enrollment shifts as members transition from employer-sponsored insurance to COBRA, Medicaid, or subsidized coverage sold on the public insurance exchanges, as my colleagues Jim Whisler and David Biel noted in a recent blog. Health plans are also anticipating a bump in services as the sector moves from the respond phase to the recovery phase. How the growing backlog of deferred medical services is addressed—combined with changes in health coverage—will likely be complex.
Four key areas that COVID-19 will likely change
COVID-19 has accelerated where we saw health care moving over the next 20 years. Our perception of progress tends to be linear, but the reality of change is exponential, and it is occurring faster than anyone could have predicted. The future of health will likely focus on wellness, prevention, and the efficient management of chronic disease. I don’t know if the future has moved ahead by five years or 10 years, but we are already seeing glimmers of a future that we thought was much further out. Here are four areas that I expect will shorten the path to the future of health:
- Virtual health: The pandemic has led to rapid adoption of virtual care and has helped some patients and physicians stay connected, as we have noted in recent blogs. Virtual care includes video chats, phone calls, texts, and emails. Sometimes, a simple conversation is all that is needed. Prior to the pandemic, we estimated that broader adoption of virtual care was still three or four years away. While consumers were receptive to the idea of virtual care, physicians were more skeptical, according to our surveys. Almost overnight, virtual care has become an essential component in health care. By necessity, we have embraced it, and we expect it will be the norm for some types of clinical after the pandemic passes. This might be one of the few silver linings from COVID-19. I have had two virtual visits myself recently. And you know what? They worked…and I didn’t have to leave the house.
While virtual health has helped keep patients and physicians connected, not all care can be provided virtually. If I have chronic knee pain, it needs to be evaluated. I can’t have virtual surgery to fix it. How do we get people to reschedule the medical services they deferred? The first step is to make sure they feel safe returning to a medical facility. The ability to test, trace, and contain the virus will be essential for getting everyone back to work. Deferred care—which some news outlets erroneously refer to as elective care because it’s not necessarily urgent— is the next significant step health plans, health providers, and the public should address. These services will catch up, but it might take some time.
- Inventory management: The pandemic has also highlighted some of the challenges with the way hospitals and health systems manage their inventory. Over the past decade, most facilities have been using a just-in-time (JIT) system to manage their supplies, which means medical inventory is intentionally limited. While JIT is effective most of the time, this experience has taught us that health facilities should have a system to respond to unexpected surges in demand.
- Interoperability: In early March, the US Department of Health and Human Services (HHS) released final rules for interoperability. The rules establish standards and requirements for application programming interfaces (APIs) to support patient access and control of electronic health information (EHI). The ability for physicians, hospitals, health plans, pharmaceutical companies, and consumers to seamlessly share data can bring us closer to the future of health that Deloitte envisions. Allowing the consumer to own and control their health information changes the game.
- Empowered consumers: The last piece of the puzzle is really about the empowered consumer. COVID-19 has pushed consumers to become more empowered when it comes to their health. With limited access to the people who typically help us make health decisions, we are more actively controlling our care through apps and websites. Some of our health system clients have introduced health apps to help them evaluate and manage their conditions.2 I feel like I have become more empowered over the past few months…and I have gotten really good at navigating health care apps.
This month, the Center for Health Solutions will publish new research that looks at how clinical leaders intend to ramp up non-urgent procedures again. Once our health systems begin to see light at the end of the tunnel, it might be time to start capitalizing on some of the areas I outline above—brush off the strategy and financial documents and begin accelerating toward the future of health.
1 Healthcare loses 1.4 million jobs in April as unemployment rate hits 14.7, Modern Healthcare, May 8, 2020
2 Not sick enough for the hospital? There’s a COVID-19 app for that, TwinCities Pioneer Press, May 5, 2020