The Corona State of Healthcare
Everyone has been impacted by the recent Coronavirus and is also watching the additional impacts around them. There has been a lot of press coverage 24/7 on the multitude of downstream implications on our health, finances, and the way we live.
However, there has not been a lot of in-depth coverage of the long-standing impacts of the Coronavirus on our healthcare industry and how we obtain healthcare. We have seen the tired and worn-down healthcare workers, and have heard a lot about PPE and respirators, but there are several implications that may not be widely known and understood.
1) This virus is not widely understood – there is no cure (yet).
The best scientists are working on grasping the virus and how it manifests in order to mitigate the impacts. However, it continues to surprise us.
We still have yet to understand fully why a 90-year-old may recover from the virus, yet a 44-year-old may succumb. Additionally, many individuals are asymptomatic, making the contagion of the virus worse.
Most recently, after it was initially thought that children were immune from symptoms, some children suffering from the virus also experienced pediatric inflammatory syndrome. There is no official cure, treatment, or vaccine for this disease.
The treatments like Gilead’s Remdesivir that have been tried have produced improvement in outcomes, but not dramatic results. The rush for the vaccine that is underway and the recently announced White House’s Warp Speed program have led to 100 potential vaccines in development.
Moderna announced May 18th, 2020 that their mRNA vaccine had positive Phase 1 results, using a novel antibody technology. We are not sure when and how effective these will be.
It is likely that pervasive testing will lead to answers. Testing remains in limited supply and is confusing to patients. There is testing for active Coronavirus and testing for antibodies. There are also a variety of tests out there.
Additionally, a negative result does not ensure you won’t be positive tomorrow, and a positive antibody test does not necessarily mean full and lifelong immunity. In short, there is a lot more to learn about this virus.
2) The impacts on healthcare systems and providers are multi-faceted.
Immediately with the outbreak of the virus, healthcare systems and providers were faced with the double whammy of having to care for a very sick, high-intensity patients and having to shut down a large portion of their traditional business. This created a financial crunch for all providers.
Additionally, you had physicians on the front lines, over-worked and experiencing inordinate stress, and other physicians who had to shut down their clinics without revenue. All of the non-urgent visits and procedures like joint replacements, hysterectomies, colonoscopies, mammographies, and any routine check-up or non-urgent sick visit were cancelled. These are the backbone of established provider organizations. Physicians and healthcare workers personally experienced their own mental health impacts from being overworked or unpaid.
Some of the larger health systems and provider organizations have demonstrated their ability to be nimble and pivot during these difficult times. They quickly secured PPE, launched or expanded telemedicine programs overnight, got creative in the use of technology and new protocols to treat COVID patients, and launched strong communication programs to their patient populations.
Other independent practitioners, clinics, or smaller groups, on the other hand, experienced a large financial impact. The CARES Act provides $50 billion in U.S. government funds to help providers recover. The demand for healthcare is permanently changed based on what procedures and services are absolutely needed and worth paying for.
3) COVID-19 will change the delivery of healthcare permanently.
Before COVID, the healthcare industry was in the process of shifting toward community wellness and population health, while still economically dependent on expensive, invasive procedures and treatments.
The shift to value-based care, driven by the government, employers, and insurers, was a large focus of provider organizations nationally. The goal was lower-cost, quality care that would lead to positive health outcomes. Digital health and telemedicine have become important tools to accomplish this goal.
Population health and human behavior can be complex. Although digital health and its related venture capital investment has been of interest since 2012, there was $7.4 billion in investment in digital health startups in 2019. COVID accelerated innovation, implementation, and adoption of these technologies.
Telemedicine companies like Teladoc will be used as a platform for physicians and provider organizations to connect with and deliver care to their patients. While this does not work well for all specialties and diseases, it appears to be widely adopted and accepted by physicians and patients during COVID. Remote medicine will likely continue to be a preferred mode of care for certain patient encounters.
Buoy Health is another company focused on symptom-checking and diagnosis using a web-based, AI-powered tool. There is also a rise in the digital health companies like Livongo focusing on management of chronic conditions like diabetes and hypertension, which can involve intensive and expensive care and will likely continue to market to providers and patients as disease management solutions.
The trend away from expensive, intensive medicine toward remote medicine and digital health are likely to accelerate and continue – as well as the related venture capital and private equity investment. Consumers have learned that not all visits to a clinic are necessary – and in the era where all things are digital and instant, this is likely a preferred model for many.
4) Our mental health and wellbeing has become a priority.
As everyone has experienced significant impacts from this pandemic, we have been forced to address our overall health and mental health needs head-on. Whether it be a job loss, income loss, working remotely, or home schooling, these are all significant stresses and a change in the way we live.
The mental health of everyone has been impacted - and we are forced to face head-on how we are coping mentally. As a result, we have begun to open up about our vulnerability and our need for mental health self-care. This is a very positive outcome of COVID, because the mental health impact of this virus has not fully manifested at this point and will last for years.
Suicide, substance abuse, domestic abuse, and even divorce can all be results of individuals' inability to cope with serious circumstances. Until the economy recovers and we begin to adapt to a new way of living, the mental health ramifications of the virus will continue.
The good news is the Coronavirus helped us reduce the stigma of mental illness and health, and there was already a focus in this area with the rise of digital health start-ups like Meru Health, Calm, and BetterHelp, which are focused on direct-to-consumer solutions to get and maintain mental health support.
More and more, individuals are learning how to not only take care of their physical health, but have begun to make mental health and wellness a priority. This trend is likely here to stay as it is now “okay to say” how you are feeling. This is a very positive outcome.
Overall, the Coronavirus has introduced significant scientific, clinical, and financial challenges that will permanently change the ecosystem and the way we live our lives. Although there have been negatives, how we manage our health and mental health and obtain services will be more innovative and efficient going forward.
This will be driven by the consumer and patient, based on the impacts of this virus. The biggest change for the consumer is that they now are at the forefront or in the front seat of their health – whether it is wearing a mask or identifying a healthcare need and a service provider.
This is a real positive that has been lacking in value-based care to date. Providers will have to shift or accelerate their current efforts in order to meet the new demands from consumers.
[Related: Artificial Intelligence vs. Human Touch]
Mathilde Leary is the Managing Director of HealthePorte.
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