What Will Never Be the Same Again in Healthcare?

Trusted advisors share their perspective on what will never be the same again in healthcare.

This article appears in the May/June 2020 edition of HealthLeaders magazine. 

"Overcoming this threat means being changed by the experience." 
—Gary S. Kaplan, MD, Chairman and CEO, Virginia Mason Health System, Seattle

The healthcare industry’s vocabulary has avoided the word “never.” The COVID-19 pandemic has tossed aside squishy, non-committal words like “iteration” and “evolution” and replaced them with “permanently” and “over.” Healthcare leaders are facing a very different healthcare world because of COVID-19.

HealthLeaders Exchange program director and editor Jim Molpus reached out to 17 trusted advisors to get their perspective on what will never be the same again in healthcare. The responses were passionate, diverse and hopeful:

Very little will be the same again in healthcare.

I expect very little will be the same as it used to be after this pandemic is behind us. This crisis is altering—perhaps permanently—how and where providers interact with their patients and with each other, how providers approach their work, and how health systems respond individually and collectively under intense pressures. Stay-at-home and physical-distancing directives have thrust a new telemedicine into the spotlight for giving patients more choices to be seen when and where they want to be seen.

A nice-to-have service before the pandemic, virtual office visit capability is now elevated to a must-have care delivery option. This will fuel a burst of competition as providers race with urgency to expand virtual care access. I am hopeful the lessons learned during COVID-19 will drive innovation that transforms care quality, safety, efficiency, preparedness, and patient satisfaction. I am often asked if my organization, and our nation, will weather this healthcare crisis. The answer is yes, and we will be stronger. But we also understand that overcoming this threat means being changed by the experience.

Gary S. Kaplan, MD
Chairman and CEO
Virginia Mason Health System
Seattle, WA

The Status Quo will never be the same again in healthcare.

Executives are likely to encourage employees working from home. Significant savings can be realized by eliminating expensive commercial space and allowing employees to work remotely. Remote workers are happier and more engaged without brutal commutes.  As appropriate, employees can now watch over their young children, take care of older or sick family members, attend important events, and enjoy a higher quality of life. It will be hard to bring everyone back from home once they have demonstrated improved productivity, wellness, happiness, and its ultimate impact on the bottom line.

Sarah Richardson
VP Change Leadership, IT
Optum
Los Angeles, CA

Processes will never be the same again in healthcare.

Hospital operations will never rely so heavily on human processes again in the future. The days of relying on huge teams of humans to accomplish routine mission-critical process are over. Health systems will hire AI workers to take on critical "keep the lights on" processes and shift their human workforce to focus on quality of care delivery.

Sean Lane
CEO
Olive
Columbus, OH

Day-to-day hospital operations will never be the same again in healthcare.

From social distancing guidelines to how we greet one another, the way we manage the day-to-day operations of healthcare will never be the same. Small conference rooms will make people uncomfortable; handshakes will be frowned upon and face- to-face meetings will be replaced by Zoom and GOTOMEETING. Losing the human connection will be a concern that everyone will think about … but I am confident that new ways of communication and operations will evolve to ensure that the human contact is not lost.

Beverly Bokovitz, DNP, RN, NEA-BC
Vice President & Chief Nurse Executive
UC Health
Cincinnati, OH

Healthcare spending will never be the same again in healthcare.

The U.S. will emerge from this pandemic with WWII levels of debt. The trillions in debt will require healthcare spending to be on a different trajectory. There are a few levers of change that can be pulled:

• More preventive care, but that does not appear to be solving the cost problem so far.
• How we behave: what we eat, use of drugs/alcohol, etc.
• Deliver less care: Other countries invest less in certain services than the U.S., such as knee/hip implants, spine fusions, cardiac caths, proton beams, etc.
• Deliver healthcare like we deliver other services, with as much globalization and technology as possible, and the human touch has been ratioed to those paying a premium.

Neil Carpenter
Vice President of Strategic Planning
Array Advisors
Washington, D.C.

Our collective sense of health and security will never be the same again in healthcare.

For most of us, health, or the lack thereof, is personal. We suffer alone with heart disease, cancer, or possibly dementia. COVID-19 is different. It touches the national psyche. Whether young or old, white or black, each of us and our family is at risk. COVID-19 presents a unique opportunity to rethink what we want from our healthcare system. As Americans, we tend to focus on the new and novel, a cure for cancer or some other esoteric disease, while ignoring ancient foes like bacteria and viruses, mundane public health concerns. What are we willing to give up in order to get a safer future for all of us?

Alan Pitt, MD
Professor  
Barrow Neurological Institute
Phoenix, AZ

Health systems' relationships will never be the same again in healthcare.

With their team members (Did we keep you safe? Were we transparent and selfless?); with their communities (Could you count on us? Were we prepared?); with their patients (Did we show compassion even under extreme duress? Did we let a loved one die alone?); with technology (Had we already invested in reliable platforms for telemedicine, robotic process automation, virtual care, and more? Were we playing catchup, with too little too late?). Every crisis creates challenges and opportunities with relationships. A chance to make bonds stronger and more permanent, or the loss of what once was and what might have been. The COVID-19 crisis is an extreme example of this reality. 

Ronald Paulus, MD
Former CEO
Mission Health
Asheville, NC

The Status Quo will never be the same again in healthcare.

Society's acceptance of status-quo healthcare as acceptable is over. We now know that a suboptimal public health and healthcare system can bring our entire world to a complete stop, result in a needless number of deaths, and put our wonderful healthcare workers in unnecessary danger. Our collective demand for prioritized investment, higher standards, and embrace of innovation will become the norm. Leaders will be on notice.

Marcus Whitney
CEO & Co-Founder
Health Further
Nashville, TN

Hospitals will never be the same again in healthcare.

Emergency preparedness will be a differentiator. One in four will face insolvency unless a federal bailout keeps them afloat. Telehealth will be mainstreamed. Workforce safety will be a testy issue. Consolidation will accelerate. Insurer’s leverage, uncompensated care, and physician disaffection will heighten. And capital portfolios will be adjusted to rationalize investments more strategically.

Paul Keckley
The Keckley Report
Nashville, TN

The Hospital administrator-clinician relationship will never be the same again in healthcare. 

As someone with friends on both sides of the aisle, I believe COVID-19 has strained the relationship to the point where clinical leadership will now demand greater accountability over hospital operations and emergency preparedness. There has always been a fascinating dynamic between business-minded hospital strategy versus day-to-day patient care. However, during times of extreme duress, the clinicians on the COVID-19 front lines have disproportionately borne the brunt of the pandemic. I think there will be some tough but necessary conversations about emergency supply storage, hazard pay, sick pay, or relocation benefits to avoid family contamination moving forward.

Andy Mychkovsky
Healthcare Strategy Consultant and Creator
Healthcarepizza.com
Washington, D.C.

Speed to innovate MUST never be the same again in healthcare.

This crisis has revealed the unquestionable need that we commit to human experience at healthcare’s core for those we serve and those who serve as human beings caring for human beings. It too has shown us it does not and must not take us months or years to innovate to ensure the best in care. Innovations in process, protocols, and products should no longer be stuck in extended analysis and review. We can identify, analyze, and act to address opportunities quickly and must do so in a new healthcare world that will require a delicate blend of agility and compassion.

Jason Wolf
CEO
The Beryl Institute
Nashville, TN

Face-to-face physician visits will never be the same again in healthcare.

In the face of this pandemic, we condensed a planned 18-month rollout of our telemedicine program to just nine days. We went from zero telemedicine visits in October, to a handful of doctors being trained and us all being very excited when the first video visit was conducted in November, to where we are now: nearly 3,000 telemedicine visits a day, about half of which are video visits. These are conducted by more than 800 providers across primary care and specialty care lines. This is working well for all involved. So, I don’t think we will ever go back to the old way of seeing and treating patients.

Chris Van Gorder
CEO
Scripps Health
San Diego, CA

Business strategy will never be the same again in healthcare.

Healthcare organizations will think about business strategy in terms of anticipating disruption versus reacting to disruption. Leaders will be thinking through their strategies as a collection of unique scenarios to be more agile, bold, and forward-thinking. Two important elements will become the foundation of many healthcare strategies—people and partnerships. Organizations that put their people at the center of strategy will engender trust, loyalty, and gain a competitive advantage. Partnerships with traditional and nontraditional healthcare organizations will be the key amplifier for growth. 

Jhaymee Tynan, FACHE
Assistant Vice President, Integration
Atrium Health
Charlotte, NC

Public Health will never be the same again in healthcare.

Most healthcare leaders and practitioners have a belief system grounded in science and rationality and use these when committing to improving the system, at least within their vision of what is possible. It is too easy to forget that the political system which regulates public health and funds local health departments does not share or assume this thought process, and oftentimes unqualified individuals are elected to oversee and fund public health. We cannot afford any longer to assume government is doing its job to ensure adequate public health. Perhaps now the time is right for combined political pressure from the AHA, et al., to form public interest coalitions to lobby for change at all levels of government.

Mark Herzog, FACHE
Consultant and CEO, Retired
Holy Family Memorial
Manitowoc, WI

Supply chains for pharmaceuticals and essential medical equipment will never be the same again in healthcare.

The COVID-19 pandemic has shown us critical deficiencies in the supply chain of essential drugs, even as basic as medications for sedation. Even with certain drugs formulated within the U.S., the APIs (Active Pharmaceutical Ingredients) are sourced from foreign countries. Most of the generic drugs in the U.S. are also sourced from Asian countries. Cost alone cannot dictate the supply chain—the proximity and accessibility will be factors that will have to be dealt with. This scenario holds true not only for pharmaceuticals, but also for medical devices and medical gear for clinicians. The next pandemic which hits us globally could very well be more potent, both in terms of its mortality and infection rate, and plans to rectify the supply chain deficiencies have to be addressed immediately.

Jay Srini
Chief Strategist
SCS Ventures
Pittsburgh, PA

Being taken for granted will never be the same again in healthcare.

The assumption that while the world turns, few consider healthcare until they are in need. Into the future, our world will recognize the significant impact that healthcare can have on ALL areas of our lives. Into the future, we will become much more important and relevant.

Britt Berrett
Program Director
University of Texas at Dallas
Dallas, TX

Telehealth will never be the same again in healthcare.

Telehealth’s rapid scale up has been critical in the public health response to COVID-19. Now, telehealth has reached its tipping point, with consumers unlikely to revert to the previous reality once we are beyond the pandemic. Looking post-pandemic, telehealth will be critical to addressing access to care issues and helping mitigate the clinician shortage. For the former, providers must figure out sustainable pricing models that hold clinicians and patients accountable. For the latter, they will need to determine which clinicians should deliver what types of care services via telehealth and which ones should be elevated to higher levels of practice elsewhere on the continuum.

Steven Shill
Partner and National Leader
BDO Center for Healthcare Excellence & Innovation
Orange County, CA