Our modern healthcare system has faced few challenges like those posed by the COVID-19 pandemic, which over the course of the last year has brought about a dizzying series of changes, some unwelcome, but many of them long overdue. And as the vaccine rollout continues to progress, it’s natural to ask, where do we go from here? Will this altered landscape remain, or will we go back to the way things were before?
As an Emergency Medicine physician who has delivered care on the frontlines of this pandemic, I can say definitively that we can’t go back.
Here are three ways that COVID-19 has changed healthcare forever:
1. The Fast-Tracking of an mRNA Vaccine
From March to December 2020—nine months—that’s how long it took researchers to develop and receive FDA approval for not one, but multiple vaccines against the SARS-CoV-2 coronavirus that causes COVID-19. If that sounds impossible, it should have been—the previous record for producing a new vaccine from scratch was four years, held by the mumps vaccine developed in the 1960s.
How did it happen? Generous funding and collaboration, to be sure—as well as a streamlined review employed by the FDA. The FDA regulatory review of new medicine has historically been counted in years, not months. But perhaps the most important factor is the victory of scientific advancement itself. The use of mRNA has upended the paradigm of what’s possible in vaccine development, showing that acceleration is possible without compromising safety or quality. With diseases such as malaria, tuberculosis, and pneumonia still in search of vaccines, this breakthrough has permanently changed our perception of what is possible and how quickly R&D can deliver.
2. Telehealth Comes to the Rescue, and is Here to Stay
The urgent need to keep patients safe with virtual appointments gave telehealth the push it needed to move from “want to have” to “need to have” for virtually every medical system. Survey results from Doximity indicate that when 2020 data are tallied, more than 20% of all medical visits will have been conducted via telemedicine, representing $29.3 billion in medical services.
One of the strongest forces pushing adoption came from CMS, the governmental body overseeing Medicare and Medicaid, which radically changed reimbursement policies to make virtual appointments reimbursable at the same rate as in-person appointments, solving a problem that had long limited adoption. And along with the new rules came $300 million in telehealth funding.
Additional incentives include COVID-19-related government initiatives such as Hospitals Without Walls, a new healthcare delivery model that allows hospitals to provide patient services at other healthcare facilities and sites, making it easier to deliver modern healthcare to remote and underserved populations. Other regulatory changes fueling wider and more enthusiastic adoption include the ability of physicians to see patients in other states beyond the one they’re licensed in, and the fact that patients do not need to have a prior relationship with a doctor before choosing to consult virtually.
Medical organizations have thrown their support behind the move to telehealth, with the American Medical Association (AMA) launching a module of support services and a playbook of best practices to help physicians and staff facilitate adoption. While the changes were originally temporary, in December, CMS announced the new rules would be made permanent, a sure sign that the pace of telehealth adoption will only increase.
3. Newfound Appreciation for Big Pharma
Pharmaceutical companies, long painted in a negative light for high prices, lack of access, and slow pipelines, suddenly found themselves in the role of heroes as they raced to develop vaccines and new treatments. The image revamp was a step in the right direction:
- In its annual survey conducted in September 2019, Gallup found consumer confidence in the pharmaceutical sector at an all-time low, with 58% of Americans expressing negative views, largely due to high drug prices and the opioid crisis.
- A year later, the same poll found pharma critics at 49% with 34% holding a positive perception, up from 27% the year before.
That’s still a long way to go, but in its Global Pharma Study 2020, Caliber suggests that the COVID-19 pandemic has brought about a greater recognition of the importance of pharmaceutical research and development, and has brought about a more balanced image of the industry as a whole.
The shock to the system that was the COVID-19 pandemic served as a catalyst to accelerate changes that were already in motion, as well as to identify a host of foundational problems in need of redress. And keep in mind, COVID-19 itself may be with us for quite some time—when surveyed, 86% of physician respondents said that COVID-19 was definitely or likely to become endemic. Whether the virus itself sticks around, the impact it has had on our healthcare system will persist well into the future. Taken together, I’m confident that the U.S. healthcare system will continue to advance and rise to meet whatever challenges lay ahead.
