April 16, 2021
The COVID-19 pandemic has illuminated both the strengths and the shortcomings of Utah’s healthcare system. What lessons can we learn from the pandemic to better support and strengthen healthcare in Utah? What improvements are needed?
These questions, specifically as they relate to Utah’s healthcare workforce, were recently discussed at a session of the 2021 Utah State of Reform Health Policy Conference, titled “Re-envisioning a modern health care workforce.” (Full disclosure: I was a panelist in this session.) While the panel topic was focused on the workforce, some of the biggest takeaways were principles that could and should apply to efforts to modernize the healthcare system generally. Those principles included: (1) improve the patient experience, (2) build on what is already succeeding, (3) fix the basics, and (4) put people first.
Improve the patient experience
One of the silver linings of the healthcare system’s response to the pandemic was the resulting outside-the-box thinking and approach to delivering medical care. Instead of the typical model of the doctor’s visit – congregating healthy and sick patients in the same (or adjacent) waiting areas and using the same exam rooms – the airborne and asymptomatic contagiousness of COVID-19 led providers to rethink things. Patients with symptoms of illness have been directed toward diagnosis and testing methods that keep them away from healthy people: telemedicine, online tools and drive-up testing facilities.
In other words, the changes brought on by the pandemic improved the patient experience by treating the sick while helping the healthy stay healthy. Similarly, any healthcare modernization effort should have improving the patient experience among its top priorities.
Build on what is already succeeding
One panelist voiced skepticism over the concept of modernization in healthcare, saying it brings with it the potential for acting on the idea that nothing in healthcare is working or worth keeping. Instead, we ought to build on what is going well and add change as needed to those successful efforts .
This is an important idea that can get lost in healthcare reform debates. Instead of seeking to radically alter or reform every aspect of healthcare, modernization should begin by incorporating what is already working well, wherever possible. We can build from there to improving the parts that are failing patients.
Start with the basics
One panelist highlighted a coalition effort to better coordinate and share healthcare data so that healthcare decisionmakers can allocate resources and make decisions based on solid information. The need for such a coalition highlights how healthcare is a system in which even some of the most basic components are not functioning at a high level (while others are functioning exceptionally well).
Given the billions of dollars spent on healthcare in Utah – plus modern information technology – it would be easy to think that something as straightforward as data collection and sharing would already be allowing those making important decisions to do so based on the best information. But between barriers such as one-size-fits-all federal privacy laws and the difficulty of driving change in the modern healthcare bureaucracy, one critical principle for modernizing healthcare is not to overlook even the basics.
Put people first
One panelist raised the issue that healthcare administrators and executives (and perhaps leaders more generally) do not understand the experience of front-line healthcare workers such as nurses. This can often lead to a general feeling among those delivering healthcare that those in charge do not understand or respect them.
Because any modernization or change in the healthcare system will have to ultimately be implemented by those front-line workers, this is a reminder that modernization has to put people first – including healthcare workers – in order to be successful. That could take many forms. In some instances, it might mean improving compensation. In others it might mean giving healthcare workers freedom from unnecessary regulatory or administrative burdens. Whatever putting people first may look like in any given circumstance, applying this principle to modernizing healthcare is essential if it is to be effective.
This list of four building blocks for healthcare modernization and reform are not comprehensive. Rather, they represent a good start. They are based on the real-world experience of people working in and observing Utah’s healthcare system, and they are not grounded in any partisan or ideological agenda.
It might go a long way toward getting some beneficial things accomplished in the healthcare arena if policymakers, stakeholders and activists – especially at the national level – could agree to a basic list of nonpartisan outcomes such as this. Grounded in the solid foundation of consensus, there would be genuine hope for overcoming partisan and ideological division and enacting changes in healthcare to improve both health and financial outcomes for patients and their families.
A recent news story pointed out that President Joe Biden has begun his administration with a strong record for getting new federal judges confirmed. Since taking office, he has managed to secure the confirmation of eight federal judges, more than any president since Richard Nixon.
With vision, leadership and sufficient efforts on the ground, we can muster the political will to plant “the Utah way” in the hearts and minds of future generations.
So if a destructive CRT ban is at best a partial policy solution – which may ultimately prove ineffective – what are the alternative (or perhaps additional) policy options that leaders should consider?