As has been said — the world is always different after a pandemic.
Cocoliztli Disease once changed food production.1 The Black Death impacted the dynamic of land ownership.2 The Spanish Flu gets “credit” for helping to end to World War I.2 While it will take some time to understand long-term changes following the coronavirus (COVID-19) pandemic, experts at Harvard suggest that our pre-pandemic developing trends, such as the development of a cashless society, the increase in remote work, and the decline of brick-and-mortar retail, will become more permanent more quickly.3
From a healthcare perspective, the rise of tele-health and various Internet of Medical Things (IoT) quickly became evident due to clinical necessity and is now also being accelerated by convenience. The global consulting firm McKinsey & Company projects the IoT business will be worth $6.2 trillion by 2025. Meanwhile, augmented reality, a 3D interactive experience in which objects in real-world environments are enhanced by computer-generated perception is already being used in healthcare facilities across the world today, for applications spanning education to surgical visualization.
Depression and anxiety are expected to increasingly impact younger generations. Wearing masks in public to some degree may become ongoing, code. The realities of the “new normal” have begun to show and will become more evident as vaccines are rolled out in early 2021.
ADVANCE recently asked clinicians and industry professionals, including those who identify themselves as futurists, or those who specialize in exploring predictions and possibilities based on present trends, to gauge how they see healthcare being impacted by the current pandemic from a variety of standpoints.
Brandon Seigel, president of Wellness Works Management Partners, Madison, WI, says that all relative research points towards a growing divide between value-based healthcare and patient-based healthcare. “There is going to be a continued trend in automation, efficiency, and optimizing the patient care experience through technology,” he said. “The focus of 2021 is going to be on capitalizing on patient data analytics and disruptive marketing in catering to patient’s health dispositions through artificial intelligence (AI). All data on health, wellness, and even our genetic pool is being tracked, analyzed, and positioned so that new innovation, brands, and healthcare trends are being directed to those that align based on data analytics. Tele-health is here to stay and, moreover, we will see urgent-care facilities continue to grow into a primary care role and utilization of tele-health will serve the purpose for office visits while urgent care will be primarily for testing centers.”
Patrick Gauthier, director of healthcare solutions at Advocates for Human Potential Inc., Sudbury, MA, believes healthcare in 2021 will be defined by health equity. “The structural and systemic racism and the inequities in health are can no longer be tolerated,” he said. “Social determinants of health have been embraced and political and legislative determinants of health are next. Physician groups and hospitals will continue to grow together. Partnerships between technology players like Amazon, retail players like CVS and Wal-Mart, and health players like insurers will continue. Bigger often equates to stability.”
Steve Pacicco, CEO of MatrixCare, Bloomington, MN, expects collaboration to replace competition for the sake of reducing hospitalizations. “Home care agencies and care facilities will be working together to keep people healthy and in the lowest acuity care setting possible. With a range of providers working toward this common goal, post-acute could function more like pre-acute care, helping patients avoid hospitalization and the high costs that come with it.” Nick Knowlton, chair of the board at CommonWell Health Alliance, agrees. “The large volume of remote patient interactions that have occurred throughout the pandemic has accelerated the need for interoperability between acute and post-acute care settings. Not only will this remain critical in order for data to flow throughout a patient’s care journey, but to ensure providers get appropriately reimbursed for their services. This will remain a critical issue for 2021 with more sweeping efforts to connect historically siloed systems.”
According to Paul Bailo, PhD, MBA, MSW, a professor at Columbia University who lectures about the future of healthcare, the mobile exam accentuates the “ME” of healthcare delivery. “The future of medicine is ‘me,’” he said. “Executed, diagnosed, and cured by ‘me,’ the owner of the mobile application held in my own hand. I will be the first line of preventive medicine, not my doctor. My mobile application and extensions will be connected to me by me and interpreted by me, i.e. the application. It will be only a matter of time before my app writes my prescription to CVS. My ‘always on’ wearable device will analyze the chemicals in my perspiration and offer real-time information. I will know I will be sick before I get sick. No Insurance? No problem, I purchased the app online. Health insurance will be issued by the technology companies.”
April Summerford, MS I/O, PCC, a certified healthcare coach by the International Coach Federation, believes that healthcare will become extremely precise due to the ongoing democratization of advanced testing coupled with personal health technology. “No longer will patients be treated the same as their neighbor with a similar diagnosis,” she said. “They will be treated as an individuals thanks to the disruptive affordability of genetic, hormone, and microbiome tests now and in the future. Patients will walk into a conversation with their doctor with advanced observations from bio-tracking, not just their account of symptoms. This will give doctors hard data to work with before pulling tests. Healthcare won’t mean wasted time at the doctor or dentist’s office, but instead a perfectly timed consult with preloaded information. Many people may never walk into an office lobby again.”
Julie Austin, a futurist who has spoken internationally on the topic of innovation, and CEO of the consulting firm Creative Innovation Group, Los Angeles, CA, believes patients will become more comfortable with tracking their own health and connecting with providers online to discuss results. “Medicine will be targeted, molecular, customized, and digital,” she said. “We know from COVID-19 that different people react in different ways. This is where customized medicine and ‘smart’ antibiotics will help us prepare for the diseases that will hit us in the future.”
Of course, the advancement of IoT and virtual healthcare will bring with it the need for more regulations and laws, as well as threats of cyber security.
“New laws promoting more relaxed movement of data come into conflict with laws like HIPAA that impose restrictions on the movement of health information,” said Tom Hiney, director of technology at FTI Consulting, Washington, DC. “We’ll see increasing pressure to pass federal privacy legislation, which has the potential to further complicate the regulatory landscape. In 2021, companies will face some challenges in tracking varying laws and rationalizing between these competing imperatives.”
Boris Goldstein, co-founder and executive chairman at Brain Scientific, New York, NY, sees an immediate shift to technologies that allow for faster and more reliable testing techniques, alongside the use of AI for the secure transfer of patient data. “COVID-19 put a spotlight on the outdated and inefficient EEG testing protocols,” he said. “Disposable technology made a significant impact to ensure brain scans could occur safely during the pandemic. Now, brain e-tattoos implanted in the forehead will be the next wave of innovation for neurology. The advancement will allow for long-term monitoring capabilities and uninterrupted data collection from patients with neurological conditions. Clinicians will be able to identify brain wave activity beyond the clinical setting with no impact to the patient’s daily life.”
Aaron Bours, head of marketing at Hyro, New York, NY, a company that assists health systems in the deployment of conversational AI, such as chat-bots, virtual assistants, and voice assistants, says COVID-19 has acted as a catalyst for digital transformation in the industry. “The spike in patient volumes to health systems’ digital channels caused the cutting of much of the red tape that would otherwise prevent the adoption of newer technologies,” he said. “Patients have moved online, and they’re not moving out.”
Conducting Clinical Trials
Not coincidentally, the processes for clinical trials has been forced to evolve during this time of pandemic, says Gail Trauco, BSN-OCN RN, an oncology nurses of more than 40 years, founder of the patient advocacy group Medical Bill 911, and host of the podcast Healthcare 911.
“Onsite monitoring visits were restricted at all major academic centers and hospitals. Previously, qualification visits, initiation visits, monitoring visits, and close-out visits were conducted in person. But healthcare institutions were forced to generate new procedures during the pandemic to meet trial needs. Patients are [now] able to speak with their provider remotely to discuss health, adverse events, and medications. Medications are prepared remotely in approved, equipped pharmacies and investigational medication is delivered by pharmacy courier. Logistics for this type of operation resembles a ‘MASH dispatch unit.’ Remote nurses are also dispatched to a patient’s home to obtain additional lab draws and/or to assist with obtaining trial-specific data collection. Clinical trials have a bright horizon post-pandemic.”
Emerging Emergency Response
In the context of public health, the need to respond to emergencies and disasters has also needed some transitioning. Organizations such as Project HOPE, a global health and humanitarian relief organization that empowers local healthcare workers to save lives, are expected to be especially critical in handling incidents that affect larger populations. According to its officials, Project HOPE was the first global health organization to respond on the ground in Wuhan, China, when COVID-19 occurred and has since distributed more than 11 million pieces of personal protective equipment, provided training for more than 85,000 health workers, and reached more than 150 countries. Rabih Torbay, president and CEO, has been featured in Forbes4 on this topic and has spoke at the Meridian Summit.
Similar to the projected long-term mental health aspects of COVID-19, chronic behavioral health will be important to monitor and care for appropriately, according to Tim Robinson, CEO at Nationwide Children’s Hospital, Columbus, OH.
“Moving forward, pediatric hospitals need to focus on education and advocacy to transform children’s mental health,” he said. “Children’s hospitals will increasingly address overall well-being. We’ve seen a stark focus on racial inequality in our country and in our health systems. One of the most important predictors of overall health is a child’s zip code. Pediatric hospitals should work to define and implement interventions to improve overall outcomes, regardless of where or how children receive healthcare, and should focus on caring for best outcomes for children’s overall wellness, from infant mortality, to kindergarten readiness, to high school graduation rates. Children’s hospitals must engage directly with our juvenile justice system to address inequities in healthcare delivery.
Children’s hospitals can help lead a movement by continuing to embrace value-based care and allowing children to get the high-quality care they need, when and where they need it. There will be an increasing need for new models of care underscoring the importance of accountable care organizations.”
Facility Design & Workflows
Officials at the global design and architecture firm HKS anticipate a “hospital within a hospital” model for infectious diseases to safely accommodate all patient types. To avoid contamination, elective surgery will have separate entry points away from the emergency department. Medical staff will have their own entrances.
The appearances of where healthcare delivered is also expected to change, even in residential homes. Lucas Werthein, head of technology at Cactus, New York, NY, a design innovation firm that designs and builds new experiences, products, and services, believes healthcare will recalibrate post-COVID. “We anticipate a heightened focus on the integration of personal health data and responsive technology within the home,” he said. “With health and wellness taking main priority, we may see an expansion of personal health data and biomarkers that primarily were poised to reimagine hospital environments now merge into residential spaces. Rather than gathering health data from a doctor’s office, your home may now provide you with up-to-date health markers portrayed through responsive, visual technology — whether that’s through an LED screen or even envisioning health data as art.”
Eric Dusseux, MD, MSc, MBA, CEO at BIONIK Laboratories, Toronto, believes the role of physical therapy in particular will be impacted by the use of assistive robotic technologies. ”With secure cloud-based data networks and machine learning, we can collect and analyze anonymized patient data from rehabilitation robotic devices to provide detailed dashboards and in-depth reports to clinical staff and hospital management teams,” he said. The access to this new information will improve work conditions for therapists and enlarge access to this robotic rehabilitative technology for positive patient outcomes moving forward.”
- Learn JR. These 4 Pandemics Changed the Course of Human History. Discover. 2020. Accessed online: www.discovermagazine.com/health/these-4-pandemics-changed-the-course-of-human-history
- Johny S. How pandemics have changed the world. The Hindu. 2020. Accessed online: www.thehindu.com/news/national/analysis-how-pandemics-have-changed-the-world/article31345176.ece
- Powell A. What will the new post-pandemic normal look like? The Harvard Gazette. 2020. Accessed online: https://news.harvard.edu/gazette/story/2020/11/our-post-pandemic-world-and-whats-likely-to-hang-round/
- Segal E. 3 Ways To Ensure Your Crisis Management And Communication Plans Will Work. Forbes. 2020. Accessed online: www.forbes.com/sites/edwardsegal/2020/10/12/3-ways-to-ensure-your-crisis-management-and-communication-plans-will-work/?sh=76fd9de6398e