The coronavirus has turned our world upside down revealing holes in our healthcare system. In this guest post, Vladimir Ljubicic, MD, MBA, clinical lead in the global healthcare business unit at a software corporation that manages business operations and customer relations, explains why we can’t go back to business as usual and what we need to do to change going forward.
As the world slowly came to what feels like a standstill over the last few weeks, we’ve learned – or perhaps been reminded – what’s essential for the functioning of our societies and survival of our families.
Most businesses switched to virtual mode, while some shut down completely. However, there’s one striking exception: Hospitals and healthcare systems around the world went into overdrive to manage the surge of patients and frantically prepare for what may come next.
When looking forward, we need to explore the way we view health care and re-evaluate the way we teach medicine.
When do we go back to normal?
We may never go back to “normal,” and certainly not in the health care.
Once initial “lockdown” measures have succeeded in bringing the number of new infections down to a reasonable level, we‘ll need a gradual re-opening and close monitoring to avoid rebounds in infection rates. This period will likely last 12 to 18 months. But even once the threat of coronavirus is eliminated, health care can’t just switch back to the old ways.
And what about healthcare staff? The virus is taking a direct toll on those we depend on most. In hardest hit areas, many doctors and nurses have succumbed to infection themselves. Others have been distressed by what’s happened to their colleagues and so many of their patients. The question isn’t just how we keep staffing levels adequate to treat coronavirus cases, but how do we recruit, retain, train and pay for all the future demand? What will this do for the overall perception of the healthcare profession in future generations?
A lot has been said about huge pressures already existing in health care – and the heavy toll it’s taking on staff through exhaustion and burnout. This situation is accelerating all these trends. When you combine that with expected future demand and society’s inability to fund health care, we need to think hard about what it takes to keep providing great health care to all citizens and taking care of our healthcare staff.
However, the future isn’t defined by the challenges we have, but by the way we respond to them. This is a real opportunity to evolve health care to the place that is much more sustainable and effective. We must be honest with the challenges in order to address them effectively. So, how do we respond?
The way we deliver health care
For years there’s been talk about the potential of telemedicine and the significant investment in associated technology. The adoption of telemedicine has been gradual and with many hurdles in terms of safety, regulation and compensation. Something quite extraordinary happened within weeks of COVID-19, as more health professionals and patients adopted telemedicine in the 10 weeks since the pandemic started, than in the previous 10 years.
This demonstrates the importance of motivation for providers and patients to change old habits. Suddenly, the benefit of remote communication is an obvious choice. Of course, there are still challenges, and we shouldn’t assume telemedicine’s here to stay until we have all of the technical, regulatory and financial aspects covered.
Traditionally, health care has been cautious in adopting technology, still preferring private installations tailored to specific needs. Cloud solutions and telemedicine were viewed with a lot of distrust. However, today’s customers need fast, out-of-box solutions as much as possible.
The way we teach medicine
One of the areas exposed by the coronavirus is just how critical it is to have specially trained people to provide lifesaving services. This presents two main challenges – it takes a long time to train them and it’s expensive. As our ability to pay for health care will be reduced, at least for some time, and demand in these specialized services grows, how do we address this gap?
The body of knowledge in medicine has grown exponentially over the last 100 years and the way we manage that is by going deeper and deeper in specialized areas. Unfortunately, the core models of teaching medicine still resemble those of early 20th century. Everybody learns everything and once you qualify as an medical doctor, you can specialize in an increasing number of narrow disciplines.
A big challenge in medical education is from start to finish it may take 15 to 20 years of continuous education to be fully qualified for a highly specialized treatment or procedure. This doesn’t scale and is extremely expensive, which translates in the cost of care.
A lot of specialised skills in health care need a much more direct route to qualifications. We know that when focused on certain tasks, people get good at it rather quickly. For many skill-focused services, we need a similar approach, making them far more accessible, affordable and safer.
Do we want to be back where we started?
The situation we find ourselves in with this pandemic is a serious challenge for our societies and our ability to deliver care for people that need it most. If we learn and apply the best combinations of innovation, science and technology, we can get to the other end of this pandemic with net benefits for our health, environment and economy. It’s not how things look now, but just as the virus has expanded exponentially, we need similar responses through our societies.
We won’t be back to where we were before this started, but if we do things right, we may find ourselves in a better place. If anything, the virus has given us permission to be bold and address things in sore need of change.