Coronavirus dominates every conversation as the world grapples with the magnitude of the Covid-19 pandemic. But policymakers and healthcare actors dare not simply wish for warmer weather or hope to “ride this one out.” Amidst the confusion and chaos lies an unparalleled opportunity to tap into the immense momentum generated by this crisis and usher in transformational changes to the healthcare sector that are long overdue.
The coronavirus crisis exposes the limits of our current healthcare systems in dramatic fashion. For instance, in the U.S., an early response was slowed by issues ranging from approvals for diagnostic testing in hospitals rather than at the CDC, to contamination of testing kits at the CDC and patient eligibility for screenings. As director of the National Institute for Allergy and Infectious Disease, Tony Fauci, previously put it nearly a month ago “the system is not really geared to what we need right now, what you’re asking for [rapid deployment of testing]. That is a failing.” Unfortunately, the legacy of these early missteps may be what slows the country down from reopening, as testing availability is critical for plans to ease social distancing measures.
While these problems are still being addressed, other issues like figuring out who pays for required healthcare services to manage the outbreak could deter people from getting tested or seeking medical care because they can’t afford it, particularly when the first wave of the lockdown begins to lift. No one wants to find out what a surprise Covid-19 bill looks like, and efforts to prevent further waves of spread will need to address the healthcare needs of poorer communities that have been disproportionately impacted.
In Europe, open borders presented their own challenges as evidenced in the outbreak that crippled Italy and spilled across the continent, with travelers returning home from Winter holidays across the Schengen zone and bringing the virus with them. Ultimately, leading to the closure of borders across Europe. Issues such as healthcare capacity and information sharing still abound but deciding who pays for treatment is much less of an issue in Europe’s single-payer markets.
Further, as the French Minister of Economy and Finance remarked recently, “The long-term consequences of coronavirus must be drawn by relocating certain strategic activities.” Local responses require local resources, particularly as parts of the global health products supply-chain slows down. For care delivery this may actually mean relocating certain strategic activities away from large healthcare centers and closer to individuals’ daily lives.
While ultimately, we seem to have avoided the worst-case mortality projections from Covid-19, the direst projections stemmed from a lack of available beds in intensive care units more so than from features of the virus itself. This points to a fundamental structural issue within our healthcare systems: their inflexibility in coping with crises. While we wait for medical product development to run its unprecedentedly expedited course, we still need to use the focus on public health as a catalyst for change in our health systems. In particular, the scale of demands on global health systems could catalyze the following:
Accelerating the Unbundling of the Hospital
The hospital as the “one-size-fits-all” location of care is showing its limits: not enough beds, exposure of healthcare providers, long lines and even a concentration of viral spread. The current hospital model is too costly, with a high administrative burden and ill-fitted IT systems that are often not interoperable with other care providers. Developing access to new points of care that are specialized, efficient, and leverage the latest technology could ease coronavirus care management, and ultimately improve the healthcare experience moving forward.
Instead of having masses of people in the emergency department waiting rooms, distributed points of care like the Ping An Good Doctor (the 1-minute clinic that looks like a photo booth) could be rolled out to handle patients potentially affected with coronavirus. We already witnessed promising initiatives implemented in the last days, such as the “drive-in tests” in Germany or a new relocatable CT solution from Siemens Healthineers in China. In the U.S., platforms like CVS HealthHubs or Walmart Health locations could launch these services into communities with robust public support to incentivize the rollout.
The need for home diagnostics and monitoring is rising as hospitals struggle to meet demand while reigning in costs. Some solutions already exist in the market, such as Ada (personal symptom checker), Infermedica (A.I. powered triage), or Babylon Health (symptom checker & remote service). These could be integrated with public health measures to manage COVID 19. Individual states should push for adoption of digital health solutions (that might piggyback with current efforts) and benefit from the quick-scale mentality that startups bring to the problem.
Empowering Healthcare Consumers
Covid-19 has provided a societal health-related wakeup call. Conversations about proper handwashing, social distancing, and now face covering, have gone viral in ways that in a different context public health officials could only dream of achieving. Beyond disease awareness, the next step is moving to real behavior change. Building off the impressive work in integrated chronic disease management by players such as Noom, Omada Health, and Livongo offers a template for how healthcare consumers could be empowered.
Turning Health Data into Actionable Insights
An enormous body of health data is already available, but a lack of interoperability, the low digital literacy of healthcare professionals, and persisting privacy concerns, together mean that the data potential is far from being realized. Singapore demonstrated the value of data with an ongoing visualization of infection cases, but this is still just a small part of what could be achieved. The fight against Covid-19 is a race against time and the faster that data can be captured and turned into insights, the better chance we have to contain pockets of outbreaks instead of seeing uncontrolled spread. China used its significant surveillance infrastructure to manage its coronavirus outbreak, tracking contacts and enabling verified disease status. This approach is infeasible and problematic for countries with strong data protections, such as those within the EU. However, a modified version of this approach has been proposed by Google and Apple, which would use users’ Bluetooth connections to alert them to possible COVID exposure – but the privacy implications remain hotly debated. But anonymized new sources of data enabled by IoT devices are not being integrated into healthcare systems. The consequence is that readily available insights that could guide health authorities in their work are ignored.
Developing a New Type of Collaboration
Health stakeholders often use collaboration opportunistically to achieve their own goals. But the coronavirus crisis demands coming together to reach goals for the common good. This requires a fundamentally new way of working, one that, in our opinion, holds the key to solving healthcare’s broader issues.
The first step towards a new operating model in healthcare would be the acknowledgment of the limits of our current systems. Rather than simply hoping for warmer days, global leaders should learn the lessons from coronavirus and accelerate the change our healthcare systems need.