According to some estimates, the Covid-19 pandemic has already killed nearly one million people in the United States alone. After a brief, vaccination-induced respite, the delta variant is producing more than 1,000 deaths per day—nearly 50 per hour. The pandemic has brazenly highlighted how urgently the American healthcare industry needs change. The 33 million Americans lacking health coverage face grave danger. Overburdened hospitals and short-handed medical staff have been stretched far beyond their reasonable capacities. And the operational inefficiencies that make American healthcare expensive and inconvenient have become mission-critical liabilities.
There are, however, also some significant silver linings to be recognized here. The healthcare community, government, and the tech industry have introduced new models and methods in the name of Covid management that have accelerated progress in the industry by as much as five years. We have seen an unprecedented alignment of public interest and financial incentives. And many of these new approaches have permanently changed the American healthcare landscape for the better. As tragic as Covid-19’s impact continues to be, I predict that historians and public healthcare policymakers will look back at these trying times as a watershed moment in the repair of American healthcare.
1. Telemedicine and the rise of an omnichannel delivery model: Prior to COVID, only 1% of all ambulatory visits were conducted via telemedicine. Despite years of predictions about the coming telemedicine adoption, uptake of telemedicine offerings rarely approached double digits within any defined cohort of patients (health system employees, for example). With shelter-in-place mandates on the rise, however, government and payers relaxed the restrictions on telemedicine and asynchronous chat in order to give patients the care that they needed safely and conveniently. The viability and value of telemedicine endured trial by fire, with nearly 70% of all medical visits handled remotely at the height of the pandemic. We learned that not only does telemedicine work at scale, but it also gives doctors privileged visibility into a patient’s home environment and behavior. The capability to immediately assess social determinants of health empowers doctors to act in a preventive, instead of reactive way.
Use of telemedicine as a treatment modality increased 3,800% compared to pre-COVID. This staggering growth will continue to expand, until telemedicine ultimately surpasses face-to-face interaction. Given this acceleration in patient expectations, in the future most ambulatory visits will likely begin with asynchronous chat, and at least half of those will end there. The remaining patients will be transferred with the touch of an app to a telemedicine visit or the next in-person appointment. This will have positive, long-lasting effects on both the accessibility and cost of American healthcare.
2. The improvement of operational efficiency:
Even where in-person visits are necessary, the pandemic has forced positive changes to the operations of outpatient facilities. According to a 2018 Vitals report, before Covid, 30% of patients left a doctor’s office without seeing a provider due to unreasonable wait times. One in five patients switched doctors for the same reason. Since Covid arrived, new methodologies have been applied in the name of infection control like online check-in, QR code registration, and digital geofencing that identifies when a patient arrives. These tactics, while intended to reduce transmissibility of the virus, also continue to drive major operational efficiencies for both patients and providers.
In clinics and urgent care centers across the country today, many patients now go straight to their appointed examination room without ever touching a piece of paper or interacting with a human gatekeeper. These measures reduce both the labor and lag-time responsible for so much of the cost and inconvenience of outpatient visits. While it took a pandemic to align financial incentives with service demands, now that this technology has been successfully deployed, we should expect the resulting operational efficiencies to stick around long-term.
3. Consumerization and digitization of healthcare:
We also have Covid to thank for a major role-reversal in the patient-provider demand dynamic. In 2017, the average wait time to see a doctor in America was 24 days—a 30% increase since 2014. In any other service category, this would be unthinkable. Just look at how ride sharing companies transformed the taxi industry. Today, consumers simply pull out their phone, press a few buttons, and a ride is moments away.
Largely due to the pandemic, this shift of influence has finally come to healthcare. Tech giants like Amazon, Apple, and Google are dogpiling into the healthcare industry to drive consumer-focused innovation. Young patients, unwilling to wait for weeks, or even hours, to see a doctor, are beginning to vote with their feet. Thinking of not offering comprehensive telemedicine? Think again—88% of patients today say they prefer telemedicine for non-emergency consultations.
These improvements will not end when Covid does
The list of positive healthcare trends accelerated by Covid-19 goes on: The FDA got therapies to market quickly and safely; the medical products community learned how to extend and fortify supply chains to meet spikes in demand; faster models of vaccine development emerged with the support of the federal government; medical researchers adopted Silicon Valley’s “open source” mentality, publishing reams of proprietary Covid research for anyone to learn from and build upon; Investment in digital-first healthcare doubled from $7.7 to $14.6 billion in 2020, and is on course to more than double again in 2021; and mRNA vaccines entirely shifted the paradigm of disease prevention.
The positive repercussions of these developments are hard to overstate, and we can only expect the acceleration of progress to continue. The real challenge will be driving interoperability within this omnichannel healthcare landscape to fully leverage the value of digitized care. Ensuring that the data from asynchronous text, telemedicine, and in-person visits is optimized will mean the difference between an evolution in the existing paradigm of care and a complete healthcare revolution. Either way, financial model comparisons predict a massive reduction in the cost of care—a critical fix that has been sorely needed for far too long.
Covid-19 exposed serious weaknesses in the American healthcare system, and has taken an unfortunate personal and economic toll on the entire world. But in the end, I do believe that our healthcare system will emerge more accessible, affordable, and effective because of the progress spurred on by this pandemic. And ultimately—that will save many millions of American lives.