Health care leaders on how pandemic is changing medicine
Stanford Health Care President and CEO David Entwistle spoke with other health care leaders on how the coronavirus pandemic has challenged their organizations and their communities, and how it could alter health care.
The COVID-19 pandemic has led to an explosion of video visits with clinicians, the rapid rollout of mass-vaccination campaigns and mobile testing for underserved populations — all new approaches to diagnosis and care that will outlive the pandemic, according to three panelists who spoke Feb. 3 at a StanfordMed LIVE event.
The panelists explored the challenges that health care organizations have faced during the pandemic, how they have reacted and what it all means for the future of medicine.
They said their organizations had responded creatively to the crisis.
“What we’ve seen is not only innovation in our medical space at the university, but also in engineering, in public health,” said Johnese Spisso, president of UCLA Health. When experts at the University of California-Los Angeles joined forces to address the pandemic, “we were able to really do everything from 3D printing of [personal protective equipment] to drive-through testing, to really looking at any other types of therapeutics or equipment that could be used to really support the care and treatment in the pandemic.”
Eugene Woods, president and CEO of Atrium Health, noted that while scientists produced results in record time, so did event planners. In the Panthers football stadium in Charlotte, North Carolina, he said, Atrium Health vaccinated 20,000 people over a weekend. “We had shots in arms every 4.5 seconds,” Woods said, adding that Atrium organized the event in just a week. “In the past, that would take us months and months to try to figure out. The speed to execution is an important lesson that we’ve learned.”
All four leaders described a big increase in video visits once the pandemic struck, a development they said can improve access to care for many patients yet also has limits.
“Prior to this, we were only doing about a couple hundred telemedicine visits a day,” said Kevin Sowers, president of the Johns Hopkins Health System. “Overnight, we went from a couple hundred to 6,000.”
But he cautioned, “We have to be reminded that if we are going to talk about health equity, not all of our patients have Wi-Fi at home, not all of our patients have an iPad or a computer or an iPhone.”
Telemedicine “did work for a segment of our population — those that have resources and tools,” Spisso added. “It didn’t work for a lot of our underserved patient population. With those groups, we really had to look at using our mobile outreach vans.”
Even in specialties that would seem to lend themselves to telemedicine, some physicians felt that in-person visits were more effective, Sowers said. Dermatologists had a difficult time seeing well via video, he said, and psychiatrists felt they could assess patients better in real life.
“We have to come up with clinical criteria on how we’re going to use [telemedicine],” he said.
The panelists all noted, however, that they expect telemedicine will survive the pandemic.
“We’ve only scratched the surface of telehealth, and we certainly aren’t going to go back to the way care was delivered before,” Woods said.
As the pandemic led to other crises in their communities — schoolchildren going without free lunches, a need for more housing so infected patients could isolate themselves — the health care organizations formed partnerships with government and social service agencies to help solve problems.
“It was a little overwhelming for a city and a county the size of ours,” said UCLA’s Spisso. “But I think we did learn some really good models that will be able to be implemented in the future.”
Woods said that in April, his organization noticed that residents in some ZIP codes weren’t being tested as much as those in other ZIP codes. They responded by sending testing-equipped vans to those spots.
“We went into those neighborhoods, we worked with the churches and we eliminated the disparities in a very short period of time,” he said. That sort of rapid response to a health care disparity is something he expects his and other health care organizations can continue after the pandemic. “It’s important, more than ever, to really make sure that this is not an episodic response.”
“To paraphrase Martin Luther King, we have a fierce urgency of now,” he added. “But I think it’s important to also think about what we do today and what’s sustainable five and 10 and 15 years down the road.”
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