How care teams can provide high-quality, personalized care during periods of physical and social isolation.
In early March, when the term “social distancing” entered our everyday conversations, hugs and handshakes transformed from gestures of warmth into conduits for the spread of disease. The COVID-19 pandemic has either eliminated or at least drastically reduced non-necessary physical contact outside the home—with work, with friends, with everything.
We’re seeing the profound effect of this across the medical industry. Patients who had scheduled elective surgeries are being told to push them back, while our community clinics (including mine) are asking that patients with acute symptoms call first—especially if they are experiencing fever—before showing up.
In this new, unexpected (and seemingly ever lengthening) period of mandated isolation, we are limiting ourselves from the intimacy of human connection more than ever. And unfortunately, this necessary isolation can take a toll on our mental health. While there is limited data on this, one study compared the effects of prolonged isolation on early mortality to those of smoking 15 cigarettes a day.
The irony, at least for the healthcare industry, is that in the years prior to COVID-19, we’ve been adopting technology to supplement, or even replace, in-person human interactions. Often for good reason, as many parts of the country are deeply affected by provider shortages, care-access challenges or other issues. Remote monitoring, telemedicine, AI-driven diagnosis algorithms can all instantly bridge rural gaps and work at scale. Yet unfortunately so many of these technologies have, at least so far, fallen short of providing high-quality alternatives to in-person care.
If anything, the coronavirus outbreak has really shown that we need our healthcare communications technology to do more for us. As physicians, we’re overseeing care not only for patients’ adverse, acute physical issues and ongoing chronic disease needs, but also for their psychological wellbeing. We need to let our patients know they’re being taken care of—that they’re not alone—even when they are physically (and socially) distant. And we need to do this while continuing to keep ourselves and our staff safe from danger and contagions like COVID-19.
I recognize the temptation to help at any cost; as a young EMT and then later working as a doctor in countries like Haiti and Uganda, I’ve exposed myself to the same infectious risk that we see happening in New York and across the world. But this seemingly selfless act is ultimately self-defeating. The patients we treat today expose us, and that means we might help fewer patients—or none at all—tomorrow. So, we need to better support and arm frontline care teams with both better equipment and better clinical information.
Getting More Insight to Reduce Risk
As we seek new ways for technology to help our patients connect to us—to overcome this risk of physical touch—we then must balance the physician’s need for safety with the patient’s often urgent need for care.
This is where technology can help us provide the best, most personalized care possible during this time. We can fill this physical gap with software-derived insights and knowing our patients’ healthcare needs, from their medication dosage to their chronic-disease challenges to their risk of suicide or depression. We can leverage new algorithms to predict dangerous behavior or assess health risks and make us more aware of the social determinants of health (SDOH)—all to create a better care environment.
This is where collaborative health networks, as one example, can be critical. These networks cull data from multiple—often disparate—sources, so physicians and other healthcare providers have precise and clinically-relevant information at the point of care. Doctors are notified automatically in their workflow if patients have underlying issues such as a history of substance-use disorder, shelter insecurity or any complications that could undermine care delivery. As a result, patients benefit from a more personal (and safer) medical experience.
Care collaboration is particularly critical with COVID-19. Since the outbreak started, we’ve seen public health teams and epidemiologists work closely with broader provider communities. For example, in Washington state, the Department of Health attempts to interview every patient with a positive lab test and provide public health recommendations. Public Health – Seattle & King County shares COVID-positive results with emergency departments across Washington state. Sharing this information with patients’ care coordination teams helps alert providers when patients under their care have a positive test result.
New forms of Physician-Patient Relationships
What can we take away from this example, as we venture further into uncharted territory? How do we find the best technology solutions to help keep us and our patients safe, even as we mourn the loss of tangible human interactions?
There are no simple answers to these questions, but if there is a silver lining to this epidemic, COVID-19 will force us to more quickly adopt new approaches to safe, personalized care.
For example, we can increase our usage of technology solutions like telehealth and engage in virtual consultations with patients—while following age old best practices in listening and proactively engaging with patients throughout the encounter. This can help our patients who are experiencing acute distress but also need guidance and emotional support.
And we can explore other ways to communicate vital information to providers on the front lines—in urgent and emergent-care settings—so physicians are equipped to make better and more personalized medical decisions. We can leverage these networks not only to recognize which patients are at high risk of social isolation, but to coordinate care with multiple providers—including public health, therapists and social workers.
Caring for the physical and emotional wellbeing of patients is central to our job as physicians and health leaders. While we need to maintain a safe distance from many of our patients as we navigate this historical pandemic, we can still deliver care that is compassionate, personalized and humane. We can leverage the best of technology to provide the digital equivalent of human touch, making a big difference for patients who need our care—and our compassion.
Ben Zaniello, MD, MPH is an infectious disease physician and the chief medical officer of Collective Medical.