The pandemic changed health care, and there's no going back

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it’s part of the story coming year, Nerdshala has an eye on how the world will continue to develop in 2022 and beyond.

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If the pandemic has taught us one thing, it’s how to take our health into our own hands.

We’ve become our own triage nurses, analyzing sore throats so diligently that, at another time, would have been considered a bit obsessive. We have been asked to monitor our temperatures and even become citizen public health surveyors with the help of COVID-19 tests at home. But one day (hopefully soon), the consequences of leaving the house with a sore throat won’t mean we’re risking someone’s life. Soon, our physical health will remain a core part of our well-being, but we will shake the neurosis of an epistemic mentality – hopefully, given our newfound sensitivity to public health and our desire not to harm others in the process.

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But will our health care system?

“The pandemic has accelerated a lot of changes that were kind of lingering in the background,” says Matthew Eisenberg, MD, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. Eisenberg studies how neoclassical economics (“supply and demand”) is applied to health care. While COVID-19 “catalyzed” many changes – and inequalities – are already budding in health care, he said, it will depend on policymakers as well as the health care supply and demand cycle as to whether sticks and what No.

Telemedicine: a thing of the past, or the future?

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Video-call-as-doctor-visit was not a tool created because of COVID-19, but the pandemic has transformed it from an obscure practice into a new way of delivering health care. Importantly, policy changes made during the pandemic helped remove some of the barriers to telemedicine access, and helped providers pay for it.

Private insurers as well as public payers (ie Medicare) eased their policies on telemedicine reimbursement for health care providers due to COVID-19. As more health care providers get paid for telemedicine (which gives them an incentive to provide it), there is a greater supply for patients, Eisenberg says.

“Before the pandemic, the only way a Medicare provider would be reimbursed for telemedicine would be if a patient was in a rural area where they could not physically travel to a provider,” he says. “Still, they had to go to a specialized facility and do telemedicine on the computer of an outpatient facility.”

Even through computer screens, there are barriers to accessing health care. Before COVID-19, some patients, depending on where they lived and what medical condition they had, would need to drive across state lines to reach a specialist (for which many patients had time and money is not required). Relaxation in interstate license laws The pandemic has allowed people to connect with a doctor miles away, and even fill a prescription across state lines.

Dr. Megan Mahoney is a family medicine doctor and chief of staff at Stanford Health Care. Stanford Health Care, Together many other providers And organizations, have advocated loosening restrictions when COVID-19 is no longer a public emergency, and emergency rules no longer apply.

“We’ve seen that there are states where there isn’t even a single pediatric endocrinologist,” says Mahoney. For example, these specialists treat children with diabetes. “We have a whole team of pediatric endocrinologists.”

But to participate in telemedicine, you need an internet connection. Mahoney called the bipartisan infrastructure bill, which has a $65 billion budget to increase Internet access to rural communities and help families pay their Internet bills, a “tremendous” help in health care access. In the new virtual health landscape, access to broadband is a “social determinant of health,” she says. Some policies and benefits implemented during the pandemic to help families access the Internet, such as emergency broadband benefits, were temporary. As broadband continues to shape itself as a public good, its relationship with health care access will only strengthen.

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slip into your doctor’s dm

In addition to telemedicine, the pandemic gave us virtually unlimited access to our doctors’ inboxes through the patient portal. According to a report published in jama, which looked at instant messaging data between patients and their providers from March 2020 to June 2021, showed an increase in the number of patient messages, despite fewer patients seeking care in some specialties.

“The huge demand we are seeing is a testament to the willingness of patients to have this new channel of care,” says Mahoney.

Even older patients, whose relationships with technology sometimes deteriorate, are messaging their doctors and adopting telemedicine, she says.

“That was what inspired and accelerated the change,” Mahoney says. When elderly people, who were originally reluctant to use telemedicine, were forced to use it to seek care during the lockdown, “it helped them overcome that hurdle.”

“What I have seen is the digital divide that, while we need to be aware of it, can be overcome and adequately addressed through additional education,” she says.

Some of that education for patients requires medical assistants to perform technical support roles. According to Mahoney, in addition to taking blood pressure and temperature when patients come into the room, they also need to make sure patients are comfortable signing into their patient’s account and feel comfortable with technology.

Changes in the patient-provider dynamic, and more direct access to care, are needed to maintain a system that can help people intervene early and hopefully prevent emergency room visits, Mahoney says. Is.

Many of the messages Mahoney is receiving from patients include correcting misinformation that patients have heard about COVID-19 — the type of preventive, education-based work that the current health care structure “doesn’t support,” She says. For example, maintaining a more intensive patient-doctor messaging system would require providers to pay for their time consulting with patients. It also requires online communication in the patient’s language – a barrier for many people in the US who do not speak English or speak it as a second language.

“I am hopeful that health care can keep up with this devastating change,” Mahoney said. “It has to be done.”

There are arguments against telemedicine as the end all. Dr. Thomas Nash, an internist in New York City, told The New Yorker June 2020 report Although telemedicine “is doable… I worry that it will delay a good test, and get in the way of deeper conversations between people and their doctors.” Telehealth’s informal setting may be less likely to raise major issues that would normally be detected in routine in-person exams, such as high blood pressure, says California Healthline Reported, And it’s more difficult to build an open relationship with your doctor through a screen than it is when you’re sitting in his office.

But it also holds that there was a losing relationship between people in the first place. As of February 2019, a year before the pandemic began, approximately A quarter of all adults and half of all adults under 30 According to a report by the Kaiser Family Foundation, she was not in a relationship with the doctor. It is also a group that shows a strong preference The target audience is for telehealth, and for pre-pandemic care-on-demand services, including Noorx, which allows people to get birth control Prescriptions and other medicines online, sister sites Hims and Hers, Curology and more.

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great vaccine race

Scientists impressed the world by moving fast to develop highly effective COVID-19 vaccines in record time – less than a year after Pfizer and BioNTech’s vaccine doses, with Moderna’s authorization right behind it The first round was available to eligible adults in the US. The country went into lockdown. According to nature, the fastest anyone developed a vaccine for mumps was in 1960, and it took four years from development to approval (Pfizer’s vaccine for people age 16 and older was approved by the U.S. Food and Drug Administration). have full approval by the administration, while Moderna and Johnson & Johnson have emergency use authorization). While much remains to be desired about how vaccines are distributed and accessed by populations in countries outside the US (only 8.9% of people There has been a coronavirus shot in low-income countries), an estimate from Yale School of Public Health The report said the vaccines have saved nearly 279,000 lives and prevented 1.25 million hospitalizations as of early July 2021.

One reason vaccines were developed so quickly was that research was already underway on the technology they used (mRNA vaccines were developed using information). HIV research) While global society has shown that we can be very efficient at producing effective and safe vaccines, don’t get your hopes up so high that it will happen again rapidly, says Michael Urban, an occupational therapist and university program director. . new Haven.

“The thing people need to remember is that the federal government put tons and tons of money into this development,” says Urban. “Globally, not just the United States.”

One reason for this is that…

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