Updated: May 27, 2020
By Robert Gillio, MD, Chief Medical Officer, Force for Health
Debra Thompson, MBA, President, Strategy Solutions
In his book The Second Curve, economist and health care futurist Ian Morrison quotes his former boss and mentor Bob Amara (paraphrased): “We tend to overestimate the impact of phenomena and underestimate the impact of phenomena in the long run.” These words ring true today as the COVID-19 pandemic impacts communities throughout the US. While the short-term devastation has been enormous, the way people and organizations have come together to support those less fortunate in the wake of this disaster has been monumental and inspiring. Leadership in every community should be asking, “What can we do to capitalize on and sustain collaborative efforts to protect and improve the health of our communities moving forward?”
Sadly, while the coronavirus has virtually monopolized the media for the past several months, a May 8, 2020 Wall Street Journal article indicates that heart disease likely remains the leading cause of death in the US. On April 29, CBS news reported about a North Carolina emergency department physician who suggested that coronavirus outbreak may be leading to unnecessary deaths from other conditions due to fear of going to the ER. We must not only think about what we do in response to the immediate crisis, we must think about these decisions impact those that we serve over the long run.
In the upcoming weeks and months, healthcare, public health and community development professionals will be searching for answers to many questions as we seek to find a “new normal.” For hospitals with missions to “create healthier communities,” the immediate and longer-term questions include:
How do community hospitals survive financially given the devastating financial losses to serve another day?
How can hospitals address the social determinants of health in a manner that achieves a financial return on investment?
How do we address the poverty pandemic and the undertreatment pandemic in our communities as well as the disease pandemic that caused them?
How do we deal with infectious disease as a chronic condition?
How can communities leverage health literacy to prevent further pandemics and mobilize resources if necessary, in the in the event of future disasters?
While these questions and others will beg for answers over the next months and years, we offer some suggestions for solid short-term investments that can achieve effective long-term outcomes. These include:
Invest in remote monitoring for chronically ill patients. New Medicare rules now provide reimbursement for remote monitoring; HIPAA regulations have been relaxed and at least three federal grant programs (FCC, USDA and HRSA) provide resources to support telemedicine. Deploy a portion your furloughed clinical staff to monitor patients with chronic diseases can achieve a return on investment and offer the opportunity to identify and refer patients for needed treatments or emergency intervention.
Create a “Medical Reserve Corps.” What if, instead of laying off staff who were not needed for hospital operations in an emergency situation, these staff members could be quickly deployed to other areas of the country that are willing to pay a premium for medical professionals? This is a strategy that could keep people employed but also generate some marginal revenue for the hospital.
Invest in an IT portal to organize regional assets and coordinate interventions. While this may seem like a daunting and expensive proposition, affordable options exist, such as The Force for Health, that are worth investigating. Encouraging collaborative community investment to make them available can achieve a tremendous return on investment for both the local hospital and the community overall.
The Force for Health tool can:
Act as a platform for gathering information, engaging citizens and tracking individual and program data.
Organize potential donations, such as creating a virtual stockpile of food, medical or protective equipment
Establish a team of health literate volunteers and/or community health workers can promote healthy lifestyles and save valuable time in an emergency situation
Create a community resource that can disseminate information and engage individuals to mobilize for action
Offer educational tools through a virtual learning management system that individuals can access on their smart phones
Augment your wellness activities and health education with the Force for Health GO app and trigger healthier choices, resources, learning, or behaviors throughout the community using locations and images