David Lubarsky, CEO, UC Davis Medical Center
There is an old Chinese proverb that says: “When the winds
of change, some people build walls, others build windmills. It is a good reminder that every crisis presents not only challenges, but also opportunities.
Change is always difficult, and nothing is as motivating for change as a crisis.
Since the onset of the pandemic, dramatic choices and many opportunities have arisen in healthcare. The pandemic didn’t introduce digital health, but it certainly accelerated its adoption. Three of these changes are radically reshaping the landscape of healthcare right now.
1. Create “hospitals of the future”
One of the lessons of the pandemic is that hospitals need to be more flexible in their ability to adapt to patient care needs. The hospital of the future will need to deliver superior patient outcomes with increasingly sick patients and with greater provider efficiency while becoming more sustainable and focusing on improving health equity, of race and gender.
At UC Davis Health, we’re building one of the largest of these hospitals — with 1 million square feet and a budget of $3.75 billion — with an opening date of 2030. What will make it different, at cause of the pandemic is that more than 2/3 of the rooms will be adaptable according to acuity and can be converted into intensive care rooms, if necessary.
Future hospitals will need to be smarter, with AI-based technology helping providers even more – not artificial intelligence but “augmented” intelligence. It will be essential to provide a better patient experience – closer to a hotel than the current noisy healthcare setting, which is not only more pleasant, but reduces stress, which improves healing. He will also need to be prepared to deal primarily with higher acuity patients, as inpatient care with low acuity will all but disappear over the next decade. People who need to be hospitalized will likely need longer stays for more complex surgeries or more aggressive treatments that cannot be given on an outpatient basis.
To balance the patient load regionally, academic medical centers like ours will need to work closely with partner community hospitals to increase the level and amount of care they provide locally, while we focus on patients who require more advanced services. These types of partnerships are a different type of triple win in healthcare because they are better for patients (care closer to home), community hospitals (increased enumeration), and regional academic medical centers (increased overall patient acuity using this facility at its highest level). purpose and income generation).
Another vision is to design hospitals and health systems to better respond to the social determinants of health. These inequalities have for too long put too many people at greater risk of poor health and fewer opportunities to improve their quality of life. Our hospital is a community-based institution, and now we’re greatly amplifying what we were doing before. We work to uplift people in our surrounding neighborhoods, with job training, local hiring and continued sourcing of local products, and local volunteerism to improve children’s education and be part of community solutions focused on charities like Habitat for Humanity.
We are doubling down on our core health mission and eliminating health disparities, and ensuring that our surrounding communities are treated with CLAS (culturally and linguistically appropriate services), have expanded access to necessary health care and social services, and that we capture the necessary demographic data in our EMR so that we can further track and address any implicit bias or unfair effect felt in underserved communities.
2. Reduce provider burnout with AI and digital health
Everyone seems to agree that digital and virtual health, remote patient monitoring, home diagnostics and other advances in connected healthcare will rapidly become more sophisticated and expansive in the post-pandemic world. Deloitte’s 2022 Global Healthcare Outlook states: “A collision of forces – a global pandemic of historic proportions; exponential advances in medical science; an explosion of digital technologies, data access and analytics; informed and empowered consumers; and a shift from caring for disease to prevention and wellness – is proving to be the catalyst for the clinical, financial and operational transformation that health care has long promised the world.
“Future hospitals will need to be smarter, with AI-based technology helping providers even more – not artificial intelligence but ‘augmented’ intelligence”
It can hardly be said that there is a collision of forces in favor of change unprecedented to date. Unfortunately, most technological changes to date are seen as creating more work for healthcare providers, not less. A new avalanche of unfiltered data is certainly not useful. However, these many forces may, with the advent of AI-based algorithms, finally deliver on the long-awaited promise of supporting lower-value work, so that vendors are finally able to work at the peak of their license. – by doing only the things that only they are capable of doing.
Multiple healthcare systems connected through a digital link, with proactive AI suggestion capabilities, will be able to optimize patient data flow and monitor far more than any single provider. This can free up patient and provider to have real health conversations, improving the experience for both, and delivering even better outcomes with better costs, as this report notes.
While we’ve all heard of the virtual health explosion, let’s emphasize its new scale and growing speed: Since the start of the pandemic, providers have rapidly expanded several new offerings, and our industry is seeing 50 to 175 times more number of patients via these tools compared to before.
While it’s likely that the future of healthcare will be dominated by algorithms, that’s not a bad thing. On the contrary, like other industries, we will be able to move to care interventions by exception or clear indication. It’s archaic the way we treat patients, as if they need regular visits like an auto mechanic for vehicle checkups. This switch will be the equivalent of the patient’s “engine warning light” indicating that there is an exception – something out of the ordinary – and that discussion with the healthcare team is necessary.
Additionally, this change will alter the demand, reducing the appointment burden on the care team, as well as the data and analysis burden of reviewing dozens of pages of records. For example, the University of Colorado eliminated post-operative visits except when really necessary. Here at the University of California, we are working to reduce and hopefully eliminate in-person pre- and post-op visits, replacing them with remote video visits that are more convenient for both patient and provider. .
3. Rising patient expectations
The driving force behind this increasing rate of change is that ultimately patients are not just patients. They are also often daily consumers of multiple other services (health and non-health related), and the vast majority of these services are now easy, convenient, consumer-centric and available through their phone or computer.
We’ve long looked at patients through the lens of “every person’s health journey is different,” and that’s still true. But patients are also citizens of the digital revolution, and healthcare organizations must recognize this fact and refine their services to improve each patient’s encounter, creating a personalized healthcare experience that not only meets their medical needs, but also to their consumption expectations.
For example, research from Rock Health and Stanford Medicine found earlier this year that more than half of consumers track their personal health stats with a digital cell or mobile phone. The vast majority of these patients want their healthcare provider to ask about their health data — but most providers don’t. Although not diagnostic, patients tracking their data on fertility cycles (reason #1), heart rates, hours slept, and exercise times provide valuable discussion on fertility ramps. providers dialogue about healthier lifestyles, irregularities, and better healthcare – while providing a better patient experience at the same time.
Change is coming – faster than ever
Even before COVID-19, healthcare was becoming increasingly personalized, “inside out” (tailored at the cellular or even genetic level of the patient) and “always on” (integrated into people’s lives via the Internet of Things, including data acquisition and download, such as AppleWatch EKG and pulse oximetry modules.
Patients expect care to be available when and how it’s best and safe for them. This includes virtual care, home prescription delivery, remote monitoring, digital diagnostics and decision support, and self-service apps.
Innovations in care models that can provide a more efficient and satisfying experience for patients and clinicians could also help bend the cost curveAs health care is the industry most adverse to change in the country, a technological disruption happens no matter how hard you fight it or how little you want it. The winds of change are only getting stronger, so let’s spread the sails and get started!