Medicare eligible Americans have borne the brunt of coronavirus. Some of the immediate impact on Medicare Advantage plans is obvious. They are covering telehealth and paying for acute hospital stays.
But there are longer term implications, too. Their risk adjustment scores are thrown off by the lack of visits. Certain supplemental benefits (think gym membership!) no longer sound so healthy, while others (meal delivery) become super valuable.
Purposeful –aiming to meet the objective of educating children in person while keeping them and staff members safe
Timely –coming at the end of the school year, with updates promised over the summer
Evidence based –relying on the latest medical and public health guidance and the experience of schools abroad
Appropriately detailed –with enough specifics to guide decisions that need to be made now without being overly prescriptive
Circumscribed –acknowledging and accounting for issues of racism and disparities without purporting to solve every problem
Balanced –recognizing that we are living in the real world (such as it is!) and that COVID-19 is part of it. None of the measures (hand washing, masks, staying home when sick, social distancing) on their own will prevent the spread, but taken together they have and will
I’m not an easy grader, so my A for this assignment is real. I have publicly criticized Massachusetts’ reopening plan and its testing plan for being vague, non-evidenced based, and irrational. Privately, I’ve admonished the local school system for its defeatist attitude toward COVID-19.
The plan doesn’t set a cap on the number of students in classrooms
COVID-19 testing is not mandated
Daily temperature checks are not required
It mandates only 3 feet of social distancing even though officials have been telling us 6 feet
Superintendents need to develop 3 sets of plans (in person, hybrid, virtual)
No clear guidance on whether state should go back to in-person classes when school reopens
Doesn’t adequately address challenges of urban schools that serve children from disadvantaged backgrounds and have limited space
Racism is not connected to students’ mental health in the plan
It doesn’t say how many students can ride the bus
People don’t like the idea of wearing masks all day
The report itself anticipates and addresses these criticisms. The Globe notes some but not all. Here is the reasoning
Number of students isn’t capped because the relevant constraints are adequate space between desks and proper behavior. If a room is larger it can accommodate more students. The report encourages use of new spaces like libraries and cafeterias
No one in the country (or world?) is seriously suggesting testing all school age kids. It’s expensive, slow, unpleasant, impractical and unnecessary. Maybe there will be cheap, spit tests at some point. They can be used if the need is real
Daily temperature checks produce too many false negatives and false positives, offering a false sense of security and causing students to miss school when they don’t need to. These checks are good for other illnesses, like the flu where fever is a good indication of active infection, but it’s of limited use for COVID-19
There’s no magic in 6 feet. Three feet seems to work fine in other countries’ schools, especially in combination with other measures, like wearing masks. Schools with 3 feet of distance abroad have not had outbreaks. Kids aren’t going to be safer out of school
Superintendents need to develop plans for different scenarios. Of course they do! If they just developed one plan it would have to be for remote instruction only. Is that what we want?
Of course the guidelines can’t be definitive in June about whether students can go back in September. But the goal is to get as many back as possible. To make that happen requires everyone to behave well over the summer (adults, especially!)
Although the plan isn’t going to eliminate disparities or solve racism, there are extra funds to help all schools and especially those with extra needs. And the best way to reduce disparities is with kids in school. Disparities widen (as I’m sure they did this spring) when normal routines are thrown off. For extra space, the guidelines suggest working with local community centers, libraries, etc.
Kids will need to wear masks on the bus. If the bus is crowded then buses will need to be added or kids will need to get to school in other ways. They can keep windows open, too.
It’s true that people don’t like wearing masks all day. The guidelines call for mask breaks and make special mention of how to work with people with breathing or communication problems. If we all behave there’s a good chance we can take our masks off sooner rather than later.
Notably, these guidelines are endorsed by people who know what they’re talking about and have children’s interests at heart. The healthy approach is to work within the guidelines to plan a return to in-person classes this fall. We should continue to challenge the guidelines and expect them to be updated as we learn more and as the situation on the ground evolves.
Meanwhile, we can all contribute to a safer back-to-school scenario by continuing to follow public health guidelines that are knocking the virus down in Massachusetts. The lower the level of community spread, the safer any reopening plan will be.
Thanks to COVID-19, the era of decentralized trials is now upon us. In this podcast interview, Adaptive Clinical Systems‘ Temitope Keyes and I discuss how trials are changing and what clinical data infrastructure is needed to make them flow smoothly.
Changes are underway in clinical trials right now as a result of COVID-19
The imperative for “frictionless clinical data.”
Ensure optimal performance in the new environment
New data sources and endpoints that will be employed
Hospitals need to perform elective procedures to make money, but with the first wave of the pandemic still in process and a second wave possibly on its way, patients are in no rush to return. In this interview, eVideon CEO Jeff Fallon opines on what’s ahead.
Hospitals are currently preparing for a “second wave” of non-COVID-19 patients who were forced to delay care – but even though restrictions are easing, people may continue to stay away. How do you think this will impact hospitals? Patients?
Hospitals will surely welcome their revenues turning north towards normal as this begins. But it’s clear that many will still be concerned about the risk of infections. I read a new survey by the Society for Cardiovascular Angiography & Intervention, which showed that 61% of Americans over 30 years of age are more afraid of COVID-19 than a heart attack, and that 36% consider just going to a hospital risky behavior. With those kinds of stats in mind, hospitals are facing a new complexity in the level of trust with patients who so urgently need this delayed care. Patients will be looking for visible signs that the new normal for hospitals is tuned for their protection in a near post-pandemic reality. Things like ubiquitous PPE and hand sanitizer, hyper-clean environments, and use of new technologies that reduce risks of contagion will be vital evidence that gives confidence to the worried.
How can provider organizations persuade patients it is safe/important to start coming back in for elective procedures and routine treatments?
Many hospitals have developed tremendous marketing competencies and I expect they’ll do an amazing job in telling their communities about the important preparations they’ve made for this new normal. Those marketing messages are an essential start but even more important is the visible, tangible evidence of the commitment to safety when patients come back to the campus for care. They’ll surely tell two friends who tell two friends and so on as the slogan goes. Visible investments in new care tools like telehealth and virtual engagement solutions that enable excellent and thoughtful care from a healthy distance are examples of this. Touchless digital whiteboards that present vital information dynamically updated in the room is another.
What role will digital engagement platforms have in helping providers communicate effectively with patients returning for care?
The usual face-to-face communication comes with risks which have become front page news during recent months of this pandemic. Digital patient engagement platforms enable patient understanding of their clinical condition through delivery of personalized video education and now live face-to-face communication via video visits. Now more than ever the ability to effectively educate and communicate from a safe distance is vital for hospitals that seek to deliver higher quality, more satisfying care than ever before even in a post pandemic world. But the urgency for this reaches a new high as worried patients return to healthcare campuses for the vital and necessary care they have put off while remaining in place.
How will the bedside experience be different for patients post-pandemic? How can hospitals ensure the safety of patients and providers?
Virtualization of many common processes like patient meal ordering, nurse rounding, patient feedback, room controls like temperature and lighting are a necessity post-pandemic. The mandate for satisfaction and quality of care isn’t going away, so the hospitals that thrive post-pandemic will be those that excel at using these kinds of digital tools to maintain high performance while minimizing potential for exposure. Visitation policies might never be the same again. But the urgent need for us all to feel closer to those we love only increases when health and lives are at risk. So the need will remain very high for virtual visits between hospitalized patients and loved ones who can’t enter the hospital or even for doctors and nurses to stay at a safe distance while they consult with those hospitalized patients and their families who may be anywhere in the world.
How is eVideon helping hospitals improve patient engagement and education both inside and outside the hospital?
eVideon’s core value proposition for decades has been to enable nurses to better engage patients in their own care through strong interfaces to core healthcare IT tools like the EMR. This has always been about automatically prompting patients to complete personalized video education prescribed by the care team for that patient based upon admission details. This virtualization has always afforded the nursing staff high levels of efficiency, but the pandemic made very clear that with this efficiency comes a newly-important safe distance. But we’ve also just launched eVideon HELLO, a virtual visit tool that enables hospitals to provide low cost video visits for their patients without the need for app downloads or account setups which have too often turned the nursing staff into tech support for business conference calling apps. Finally, we brand HELLO for hospitals so the patients clearly know who is making this incredibly important patient experience tool available to them.
What are your recommendations for hospital executives who would like to support patients in managing their care during this time of crisis?
Go all-in on digital health tools that drive patient engagement. One doesn’t have to look past the front page of any newspaper, let alone the healthcare press to see that the businesses, (“brick and mortar” or otherwise) thriving through this pandemic are those leveraging strong digital strategies, and that will continue. And though the pandemic pushed digital/virtual to become a global business necessity, the delivery of care will not escape digital transformation after the virus abates. Hospitals that invest now in thoughtful digital health strategies will be best positioned to help nervous patients return for delayed care and they’ll be the providers of choice even beyond those who worry. Finally, new digital capabilities enable hospitals to meet more patients more efficiently wherever they are physically, emotionally or clinically; and that’s a smart digital strategy for today and forever.