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Dr. Eric Eskioglu, executive vice president and chief medical officer, Novant Health | Jun 10, 2020
Anyone hearing the term “blockchain” will be forgiven for thinking it had something to do with a cryptocurrency such as Bitcoin, or a fintech you might want to bank with. In a recent survey, healthcare professionals worldwide ranked it behind other technology trends in importance that included digitalisation, AI, big data, IoT and 3D printing.
It is important to remember that for consumers, healthcare is an essential need and not a discretionary service like retail goods such as clothing and dining. We can expect to see many changes due to COVID-19 in the coming weeks, months, and even years in how we deliver healthcare. The job of everyone who works in healthcare – not just physician and nurse leaders – is to recognise the need for rapid transformation and having to work tirelessly to make it happen.
The seismic shift to telemedicine
Overnight our children, ages 5-24, from kindergarten to graduate school have become the Zoom-Generation. This is also becoming the “Zoom-Generation” of healthcare (albeit not exclusively through the Zoom platform). With Telemedicine quickly becoming preferred and one of the safest ways we can interact with patients during the pandemic, we’re seeing a rapid cultural shift in providers’ attitudes.
Patients are also embracing it. With social distancing here to stay who would want to go to a brick and mortar clinic and sit close to other patients and risk getting infected if they don’t have to?
Now imagine, a patient who under “normal” circumstances must embark on a 1-hour roundtrip journey and wait for at least another 15-30 minutes to see a provider for 15-minutes. Patients will start to ponder as to why they should go through all of that extra travel time. Telemedicine is here to stay. A certain percentage of patients in areas such as psychiatry, endocrinology (including diabetes), and dermatology are expected to drive the biggest transformation.
Touchless patient interaction is the new norm in ambulatory clinics
There will still be a need and place for traditional in-person ambulatory patient visits. In the next couple of months, this will be stratified and will take shape depending on the patient’s clinical needs. There will be a further transformation in brick and mortar clinics with touchless check-in, drone medicine delivery, social distancing, and many other precautions that will replace current processes that are rapidly becoming outdated. Also, in the not-too-distant future, this will include wearable devices and smart clothing, which have receptors where patient’s vital signs can be remotely measured, and trends observed even before they come into the clinic. Opportunity to shift inappropriate use of ERs
During the COVID-19 pandemic, most patients with emergency conditions such as stroke and heart attacks, unfortunately, avoided ERs in fear of getting infected. We witnessed ER volumes having gone down, which is a worrisome trend. However, one overlooked aspect is the inappropriate use of ERs by a subset of patients who access this as the only venue of healthcare. In previous years attempts to discourage this pattern of behaviour have largely failed. The COVID-19 pandemic has created a narrow window of opportunity to calibrate patients’ perceptions about ERs allowing us to align these patients with more appropriate venues of care. This will help our efforts for preventive care and population health while at the same time driving down healthcare costs.
The demise of inpatient acute care is overly exaggerated
Although we will be scaling up our ability to give remote care, we will also re-evaluate the decades-long drive to reduce brick and mortar acute care, including hospitals.
We will still need beds, especially in the face of unexpected events such as a pandemic. In the future, hospitals will be driving not toward reducing but toward the ability to quickly scale. Hospitals of the future will have the ability to flex up in beds and ICU capacity with less than a week’s notice. Due to already existing shortages of physicians and nurses, reliance will increase on telemedicine, advanced practitioners, and AI, which will also anticipate the length and type of acute care needed for each patient. Hospital at home concept will also start to mature as a transition from hospital to home.
Prior to this pandemic, we all have known that hospitals are full of sick people and inherently carry the risk of getting infectious diseases. These are collectively called HAIs (Hospital Acquired Infections).
In the midst of fear and uncertainty of the pandemic, however, we have seen an extreme, dangerous avoidance of seeking in-person care due to fear of getting COVID-19. Stroke, heart attack, and cancer patients, in great numbers are neglecting their care. Post COVID-19, we will need to both assure and provide the public with the cleanest and safest environment when they come into a hospital setting to alleviate their worries about getting an infection. Safety and quality of patient care given at any healthcare setting will be even more scrutinised and prised. Precision medicine will accelerate 3D Printing
Witnessing how easily worldwide and national supply & chains can be disrupted, there will be more on-demand production of materials such as PPEs, implants, and even ventilators using 3-D printing. This will involve obtaining proprietary designs from vendors and producing them on-site. OEM’s way of doing business will change. In non-emergent times, healthcare systems will adopt being able to personalise 3D implants based on a patient’s characteristics. This will allow for the acceleration of precision medicine and even more partnerships with other previously unthinkable industries.
Having been in healthcare for over 21 years, including being on the frontlines as a Neurosurgeon and partaking in roles as a Physician Executive, the discussion here reflects the author’s personal opinions. This is a three-part series which will be followed by Industry Trends and Social Trends.
Dr. Eskioglu will be speaking on ‘Healthcare Transformation – Post COVID-19’ at Omnia Health Live on Wednesday, June 24 at 19:00 GST. Register for free to learn from him and other leaders in healthcare.