How transformative change could rise from the virtual ashes of the COVID crisis

Some hospitals and health systems are beginning to see the light at the end of the tunnel when it comes to hospitalizations for COVID-19, Providence St. Joseph Health Chief Clinical Officer Dr. Amy Compton-Phillips said in a live HIMSS webinar yesterday. But the challenges to come could be even more overwhelming – both as hospitals prepare to open while continuing to fight the pandemic and as they think about the future of healthcare.

“Act I was all about what do we do in a crisis,” Compton-Phillips said. “Act II is ‘How do we live with COVID?’ It’s the new abnormal. It’s not done yet, it’s just that most of us are over the peak of wave one. And now we have to figure out how we care for people in need while we live with COVID in the background. Act III will be what happens next – what’s after the waves finish and we actually have a way to prevent COVID and not just treat it?”

As much as it might seem like these acts need to be taken one at a time, Providence’s approach is that it’s important to start thinking about Act III now – because right now, the urgency of the situation makes transformative change possible.

“It’s a really challenging thing,” Compton-Phillips admitted. “We’re asking people to innovate when they’re exhausted, and that’s a tough combination. We’re not just asking them to go back and do what they’ve always done, because we know that patients with ongoing hypertension don’t want to go to a hospital where they could get COVID when they know that their care could be managed through telehealth. So we’re not just turning it back on, we’re asking people to reconfigure how care is delivered while we’re turning it back on and while we have exhausted staff.”

But as hard as it is, Compton-Phillips said, history shows us that it’s possible – and that the opportunity for transformation is huge.

“If you look at Europe after WWII, Europe was destroyed,” she said. “We have to reconfigure our healthcare system; their healthcare system was in piles of rubble. And yet out of that they built a healthcare system that is very focused on delivering great health and great care for the vast majority of the population. So we know it’s possible. We think that’s what’s really helpful when trying to imagine the art of the possible is to have a destination in mind.”

Providence’s vision of that destination started with a series of videos the organization had commissioned before the start of the crisis, imagining what healthcare could be like in 2030. Now, she says, they think that vision can come quite a bit sooner.

Some of the tenets of that vision are more remote care, more personalized care, a system that works for minority and low-income patients by taking into account social determinants of health, and holistic care that includes mental as well as physical health.

As for how we get there from here, Compton-Phillips said they’re focusing on four key elements in the short term: prioritizing patient safety, working with government and private payers to push for reimbursement for telehealth and in-person care, doubling down on value-based care, and “decoupling health from geography” by pushing states to enact license reciprocity.

“As we’re thinking about how can we use this moment to start moving around the pieces of the healthcare system, the vision that we have in our mind here at Providence is that we want to make sure patients understand that we know them, that care is going to be personalized and centered around the way that they want to receive it, that we’re going to give world-class care no matter where they go, and that we’re going to make it simple, easy, and affordable,” Compton-Phillips said.

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