Becker's Clinical Quality & Infection Control

43 QUALITY IMPROVEMENT & MEASUREMENT 'This is healthcare's Amazon moment': Dr. Stephen Klasko's 5 predictions on healthcare delivery post-COVID-19 By Laura Dyrda H ealth systems have accelerated their digital health, telehealth and virtual care capabilities during the COVID-19 pandemic forcing them to disrupt themselves, according to Stephen Klasko, MD, president and CEO of Philadel- phia-based Jefferson Health. Care delivery will never be the same again, said Dr. Klasko, who was also named the first distinguished fellow of the World Economic Forum and served as co-chair of the Forum's Board of Stewards for the Future of Digital Economy and New Value Creation at its annual meeting in Davos, Switzerland. "is is healthcare's Amazon moment," he said. "If you are a provider and think you're going to go back to your business model solely being based on hospital revenue and not relevant to people who want care at home, I think you will be out of business. If you're an insurer and think you can just be the middle man between the hospital and the patient, you'll be irrelevant. If hospitals believe that innovation can be just this cute little thing that they do in the background but the real business is just getting heads in beds, they're nuts. I think we were always wondering what the big disruption would be that got us to join the consumer revolution, and I think this is it." Here are five key insights from Dr. Klasko about the future of healthcare delivery. 1. ere will be more partnerships between health systems and payers as telehealth accelerates. e COVID-19 pandemic is accelerating the use of telehealth and remote patient monitoring among the general population across the nation. In New York, telehealth visits skyrocketed 312 percent and Renton, Wash.-based Providence reported a 20- to 30-fold increase in telehealth visits aer treating their first COVID-19 patient. Jefferson has been preparing for the eventual- ity of widespread telehealth use, and already had the infrastructure in place when the demand spiked. But health systems and providers aren't the only ones adjusting to the new reality of telehealth as a primary mode of care deliv- ery; payers are adjusting reimbursement coverageand rates to ensure beneficiaries have access to virtual care. Health systems are now devoting resources to keeping patients out of the hospital when possible and allocating the rest of their resources to patients in critical condition. "e COVID-19 crisis will accelerate a disruption in how healthcare is delivered, paid for and perceived that would have hap- pened anyway, albeit more slowly," said Dr. Klasko. "At Jefferson, we had invested early and significantly in virtual triage, telehealth and early AI applications. at allowed us to have the bandwidth to move from 50 to 100 telehealth visits a day to almost 3,000 a day and train over 1,500 physicians and nurses to prepare for the virtual onslaught. is move from hospital centric 'sick care' to person-centric 'health assurance' will ne- cessitate closer strategic alignment between payers and providers." Prior to the coronavirus epidemic, some pay- ers did not have expansive telehealth coverage and others had lower reimbursements than in-clinic visits, making it a challenge for the systems to support a comprehensive tele- health program. In the future, Dr. Klasko says health systems will need to align with payers to provide better care at a lower cost. "Just as hotels did not understand that the Airbnb revolution was not an anomaly, it was a fundamental change in our economy, that 20th century principles of mass production and economies of scale are ceding to mass personalization and rentable scale, hospitals will need to adapt to the 'new normal' of costly 'sick care' giving way to affordable, per- sonalized and preemptive care with genomics, sensors and AI based digital therapies," said Dr. Klasko. "For providers that do not have a payer component, there will need to be new partnerships and creative alignments with traditional payers for either to survive." 2. e combination of increased data gathering and AI will make the society more resilient to disease spread. In the future, people will be constantly monitored with real-time feedback on their health that integrates into their patient records. For example, they may wear a watch or shirt that can measure their temperature and tell them if their temperature increases above 100 degrees, or if their respiratory rate lowers. "I believe we will move from the 'Internet of ings' to the 'Internet of you'," said Dr. Klasko. "At Davos this year, the CEO of a banking conglomerate said to me, 'Twenty years ago the two groups that had escaped the consumer revolution were banking and healthcare. Now you are alone!' Think about how the pandemic would have been handled differently if we had continuous data coming in from patients through their wearables and other sources as it related to temperature, respiratory rate, etc. Or if 3D-printers were as ubiquitous as cell phones. Simply put, in many cases our cars get better care than we do, they are con- stantly sending data to the cloud. In a few years, it will seem archaic to go once a year for a static physical to an office when your T-shirt has been sending continuous data." For example, Jefferson is teaming up with software developers to develop a wearable "The COVID-19 crisis will accelerate a disrup- tion in how healthcare is delivered, paid for and perceived that would have happened anyway, albeit more slowly." - Stephen Klasko, MD, President and CEO, Jefferson Health

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