Becker's Hospital Review

28 Executive Briefing Sponsored by: I f theres a silver lining to the coronavirus pandemic, it's that we've finally opened the door to new care paradigms — and opened minds to new possibilities. While we'd never wish for a pandemic to galvanize change, what's happening now in healthcare is exciting. And it's just the tip of the iceberg of what the future holds. Our healthcare delivery system is transforming before our eyes, from hospital care to doctor's office visits to urgent care clinics and specialist consults. The sharp lines between our services blur as we merge, layer and integrate these disciplines into a new whole. Contrary to popular belief, no "new normal" will follow the pandemic. COVID-19 is effecting change in areas where we've long needed it but have struggled to gain traction. For years, forward-thinking hospitals have worked to scale their virtual care programs and extend more services into their communities. Our response is changing acute care drastically, forever, and mainly for the better. In this article, I share some of the new paradigms that are emerging before our eyes. Putting patients front and center As a healthcare consumer, you've likely only experienced medicine under a provider-centric care model. Everything about our healthcare ecosystem — from our hospitals' physical layout to the skills we teach and learn in medical school — supports a narrative in which patients travel to providers, whether it's in a primary care setting or emergency medicine. With a little help from the pandemic, patients are now turning this paradigm on its head. A few years ago, consumers showed relatively little interest in telehealth. However, as they adopted it at unprecedented rates during the pandemic, they quickly appreciated its convenience and timeliness. Today, patients report high rates of satisfaction with virtual care and say they intend to continue using it. Given this shift, health systems would be wise to embrace the emerging patient-centric paradigm. For me, this shift is both welcome and long overdue. However, as hospitals race to expand their virtual care programs, I believe a few words of caution are in order. Care continuity To promote the long-term health of our communities, delivery systems must be able to integrate episodic and long-term care, whether delivered via telehealth, in the emergency department, or in the doctor's office. This requires a redesign of our infrastructures with an eye toward integration. The virtual care boom of 2020 has exacerbated healthcare's endemic fragmentation. Many patients are bypassing their established care teams and instead turning to third-party telehealth services. While many organizations can provide episodic care via telehealth (acting much like an ED or urgent care clinic), they're poorly equipped to manage chronic and complex conditions. Patient navigation We also must consider how patients will navigate these new high-tech, low-touch systems. This is a tall order considering how many patients get lost in our current high- touch system. I recently followed up with an older woman I'd seen in the ED for wrist pain. Four days later, she was running into issues scheduling follow-up appointments with her primary care physician and a specialist, and her pain was worsening. There was no one to manage her care between these visits other than me through a series of follow-up calls, guiding and helping her navigate so she wouldn't fall through the cracks. These are just some of the dangers of the fragmented healthcare system we currently have. While we must evolve our system to accommodate virtual care, we must also ensure it's integrated sufficiently to manage and transition patients across multiple care teams. I highly doubt patients will fare better under virtual care unless we build touchpoints to monitor their progress and promote seamless hand-offs between providers. Solutions might include telenavigation programs, which pair at-risk patients with support staff serving as links between the patient and the healthcare team. From disruption to innovation: Lasting changes to care delivery By Theo Koury, MD "We need to keep focused on what's best for patients and ensure that virtual care models are integrated for a well-coordinated and positive patient experience." Theo Koury, MD, President, Vituity

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