Though it affected every health care facility differently, the rapid spread of the coronavirus forced most hospitals to change the way they function. And as the grip of the pandemic begins to loosen, many providers and patients are dealing with how those changes in health care delivery might be applied moving forward.
“The biggest advantage that we had … compared to say, a hundred years ago when we had the previous pandemic, is telemedicine. With COVID, we were able to access that technology; primary care physicians were able to do telemedicine visits from home or from their offices. So it’s easy-access. It’s safe. It’s efficient. It works for certain patients and it’s been working,” says Carlos Quintero, chief quality officer and chairman of the Internal Medicine Department at NCH Healthcare System. “We’ll have to leverage that technology and see how we continue to use that moving forward. Not every patient has a computer or a laptop in our population of patients in Naples, who may be more elderly. So it may be a little bit more challenging, depending on what patient population you’re trying to give telemedicine access.”
Though telemedicine helped with routine doctor visits during the height of the pandemic, Quintero said technology isn’t always the answer when relatives are restricted from visiting their loved ones. In fact, the pandemic may have further reinforced the belief that more direct access to family can lead to better patient outcomes.
“We had to think about … all the ramifications of not having family members in the hospital. We purchased iPads to make sure that [patients] could FaceTime and communicate with their family members, because it’s extremely important for the well-being of any patient that’s hospitalized to be in contact and, ideally, be with their loved ones,” Quintero says. “We had to pivot and learn and realize that it’s not about closing our doors and thinking only about COVID. We have a large population of elderly patients, many of whom have Alzheimer’s or dementia, and they get admitted to the hospital and they are more likely to get confused in the hospital. It’s better (for them) to be with their loved ones and their family members.”
While health care providers used technology to improve patient access during the pandemic, others see long-term changes in how some patients simply access hospitals. For Scott Nygaard, chief operating officer at Lee Health, those changes started in the emergency room.
“For years, we’ve struggled with people using the emergency room as an access point, and I think it’s a pretty expensive, inefficient way to deal with a lot of basic illnesses that could be dealt with in other manners through improved access, including telehealth,” Nygaard says. “Emergency department volume is down 10% to 15% across the nation. So, I hope … we do see that sustained. That’s a benefit to the patient. It’s a benefit to us in terms of improving flow to those who really need to use that level of service.”
Finally, given the many unknowns about COVID-19, many health care providers became the main source of information for the community at large. For Nygaard and Lee Health, that required changes in communication between the public and its staff.
“Things were changing on a regular basis, and we had to stand up a better communication infrastructure. We learned a lot about … ways to engage the community, the physicians and staff to become much more agile and nimble as an organization, in terms of being able to respond to a crisis of this magnitude,” Nygaard says. “We always commented we knew how to do that in a hurricane, but that was maybe a three- to five-day effort. And here we are a year and a half or so into this, and we’re still running our command center today to try to convey the appropriate information.