The Jefferson Health telehealth team has been calling themselves the “Night’s Watch,” a reference to the “Game of Thrones” border army. And they’re right—telehealth has tackled the first battle in the war against COVID-19.
In January, Jefferson’s telehealth program helped up to 50 people a day who used its app for medical emergencies. In the past week, calls were approaching 3,000 a day. Equally important, our investment in telehealth, beginning in 2014, means we can help people who have concerns unrelated to COVID—without forcing them to travel.
COVID-19 has taught us two things. We need intensive-care units and a surge capacity for crises. But we also need to help people at home.
Thanks to COVID-19, “healthcare with no address” has gone from a nice futuristic idea to being critical to the future of the industry. Delivering sophisticated healthcare outside of hospitals is the future for our industry and the transformation that will build a new system of “health assurance” for all. For years, healthcare has escaped the consumer delivery-at-home revolution. I always have lamented that we can shop online in our pajamas, but if we need to see a doctor, we have to listen to a dozen options on the phone to get an appointment the following week. As one of my colleagues correctly put it, “In healthcare we have ‘Star Wars’ technology in a Fred Flintstone delivery system.”
That harsh assessment, while true, will be viewed as a vestige of the past—pre-COVID-19.
This is the key to the transformation: We have the technology to make healthcare, like banking, seamlessly accessibly from anywhere.
A great example is Jefferson’s partnership with Nuvo, a company that allows for high-risk pregnancy testing at home. The standard care is to come into the hospital, monitor the baby for a couple hours, and then have a physician or nurse “read the strip.”
Obviously, in the midst of our current viral scare, that is an ominous proposition. But we should use the post-COVID period to ensure that such technologies are encouraged and reimbursed appropriately, because after all, as Upton Sinclair said, “It is difficult to get someone to understand something when their salary depends upon them not understanding it.”
A CEO of a major financial institution remarked to me, “Twenty years ago the two most nonconsumer-friendly aspects of our society were healthcare and banking. Now you’re alone!”
We have taken this to heart and as a result are modeling a healthcare system around a concept called “health assurance.” This concept recognizes that people want to live productive happy lives without healthcare getting in the way.
The idea of “health assurance” recognizes that costly “sick care” will give way to affordable, personalized and preemptive care with genomics, sensors and artificial intelligence-based digital therapies.
We should never again use the word “telehealth” just as we don’t use the word “telebanking.” It’s just that 90% of banking went from the bank to the home. Much the same will happen in healthcare.
Most importantly, healthcare with no address could be a revolution in providing the highest level of care directly in communities and neighborhoods that need it most—a revolution for tackling social determinants of health. Pregnant patients in vulnerable communities are often the last to have testing done, because they cannot afford child care. Being able to do testing at home is a personal and societal game-changer.
We have to stop looking at health as a static event. Your car may be constantly monitored while it is in the garage, but humans think they can drive to a doctor’s office and get a “snapshot” of their health at one specific point in time as part of a yearly physical. Health assurance means that AI, digital sensors and genomics constantly monitor your health and notify you and your caregiver when there is a problem.
And finally, COVID-19 reminds us of the need to support the surge capacity of powerful intensive-care services that save lives. This crisis emphasizes the importance and heroism of the caregivers throughout the country who care for the sickest among us. Hospitals and intensive care will always be a necessary complement to health assurance and will be in every sense of the word life-saving.
There is nothing positive or optimistic about large enveloped RNA viruses such as the coronavirus. This is a trying time for our nation and the world. But this acute phase and acceleration will end. While the war against the virus may be won with drugs and vaccines, the war against a healthcare delivery model stuck in a time capsule based on a financial and delivery system rewarding “sick care” has just begin.