The Burden on our Healthcare Systems

Written by on August 3, 2021

 

We can’t escape the rising tide of COVID19 cases occurring in hot spots around the country driven by the Delta variant. There is disagreement on the best mitigation strategies with some places requiring vaccines, some requiring face coverings, as int eh Case of HIMSS in Las Vegas and some outright rejecting any mitigation.

We talk through these issues focusing on the healthcare workers who in some parts of the country are finding themselves back on the front line again with more patients that in the first waves of COVID19 struggling to keep up and having to postpone or cancel care other patients.

We also talk through the rise in Telehealth and what appears to be a permanent rise in this service and what that might mean going forward

 

Raw Transcript

Nick van Terheyden 

Hi, this is Dr. Nick, I’m the incrementalist here with incremental insights for better business better health.

 

Fred Goldstein 

And I’m Fred Goldstein with accountable health here helping employers where the employee health improvement programs as well is working through the current COVID pandemic. So Nick, we really didn’t want to have to get into this again. But once again, delta is just out there and taking over regions of the country. So what do we need to be considering now with this?

 

Nick van Terheyden 

Yeah, I really didn’t want to I was trying to find something else. And you and I both talked about this a lot to see if there was something else that we could talk about, but it is delta delta delta. And it’s, it’s a rising incidence of this particular variant that is highly transmissible, it’s running through our communities, individuals like a dose of salts To be clear, it is the folks that are on vaccinated, the majority of which there are a few of the individuals, very small minority of people that have been vaccinated and still got Delta. And we are just creating more opportunities for challenges down the road, because we essentially will find ourselves with a nother variant that is going to cause more problems. And I think, importantly, we’re impacting the people that just got wiped out, let’s be clear, white out with work and overwhelming dealing of patients coming in, in high risk circumstances with ventilation aerosolization of this, of this virus, and we’re asking them to do it all over again, that seems really challenging to me.

 

Fred Goldstein 

Yeah, so the healthcare workers, obviously, are fairly frustrated, as you as I’ve heard, and we’ve seen from expressions around the country, and rightfully so. And to give you just a sense of this, that, obviously, is some regional variation. The four counties here around Jacksonville, are four of the top five in the nation, for the rate of infection per 100,000.

 

Nick van Terheyden 

Yeah, so those of you watching on TV, what you can’t see is the big bubble that’s around Fred. Living in that world, it’s, it’s truly shocking. And, you know, what do you do about it? Well, we know what the primary answer is get vaccinated. I saw something just very recently that said, we’ve seen a uptick in the number of new vaccinations as a lot of programs attempting to get to that, and we’re also seeing the return of masking and npis as we referenced them. And of course, you know, some resistance. I’ve heard that repeatedly. Well, I’ve been vaccinated, why should I? What is the purpose? What is the incentive to get vaccinated if we all have to mask up again, and, you know, I recognize and understand that, but the reality is that we’re doing it for our fellow citizens, we’re doing it for the healthcare workers, and all of the people that work in the healthcare system. And we’re doing it because we want to suppress this virus sufficiently so that it are the all value drops below one so that we see a decline, we see a reducing instance. And therefore this virus doesn’t have the opportunity to develop a new variant and causes even more problems.

 

Fred Goldstein 

Right. Absolutely. And just a quick point on that the hospitalization rate in Jacksonville is now 150% of the highest point it ever reached any time prior in the pandemic. So it’s clearly impacting healthcare workers inappropriately. And we really need to think about that. So let’s pivot a little bit, Nick, one of the things that occurred during the COVID pandemic was the recognition that people couldn’t go into see their physician. So lo and behold, telehealth explodes, rightfully so. And all of the systems chose to put this in, and we’re now seeing it level out. But it’s leveling out at a fairly substantial rate. I think it’s about 38 times higher than it was at prior to COVID. So people are continuing to use this, but what should employers healthcare systems and others consider as they look to put this type of service in?

 

Nick van Terheyden 

Well, I first of all, ask the question, would you like to have access to telehealth I know I would I did before COVID-19. I always thought that this was a an extraordinarily valuable opportunity to engage with people not to have to get in the car park and go in to an office sit in the waiting room for all these times. So you know, huge potential, but you really want to have this built into your programs. I think your employees are going to insist on it. But from a clinical standpoint, and from an organizational standpoint, you Want to make sure this is integrated into the rest of care? telehealth does not replace everything. I mean, there are things that we cannot do through these interactions that are fantastic for certain things. But it needs to be part. So if I was to dream, it would be, it’s no longer telehealth. It’s just healthcare delivery and how it’s delivered on which channel is used doesn’t matter from an employer’s perspective, make sure that that’s incorporated in so that you have those solutions, seamlessly integrated into the offerings and they’re affordable, and the people delivering the care get appropriately compensated for it.

 

Fred Goldstein 

Absolutely. And I think by integration, it’s it’s it’s sort of taking it down that next level, they need to recognize that typically, this has been a bolt on service, often provided by a third party. And is it actually integrated with the electronic health record that the primary care physician or other spell specialists are using so that they data can seamlessly transfer when someone does a telehealth visit that might not be with their normal physician, oftentimes, practices are putting this in. And, for example, at Mayo, I recently had a telehealth visit. And it was great it was with a physician at Mayo who I’m seeing, but that data needs to then get around to the others. And so ensuring that that’s connected asking your providers and employer if your system is set up that way, and also making sure that it’s it’s meeting the needs of your individuals of your employees. We’re seeing a lot of use of behavioral health in this space, a critical area, which is fantastic to see, this may be one of the key solutions to allow for some anonymity. I haven’t parked my car outside the psychiatrist’s office at the same time.

 

Nick van Terheyden 

Yeah, but and here’s something else for employers to think about in that particular instance, but some folks, the privacy in their own home setting can be a challenge. And we’ve heard stories of people actually carrying out these interactions, not just from a brain health and other areas, but doing so in the car, because that’s the only place that they have privacy. So thinking about that and making sure that people have access to the right resources. And I’m not sure what the answer to that is. But as an employer, if you’ve thought about that, and started to offer some solutions for your employees, and the people that are working for you, I think, you know, we talk about mother and baby rooms in offices. And I know we’re not going back to the offices but you know, that was a response to a circumstance for lactating mothers, maybe there’s another solution around telehealth that we can provide some privacy for our employees. Maybe as they go to the local office. It’s not used for anything else, but they can use it for telehealth console one an idea,

 

Fred Goldstein 

absolutely a great point and need to look at the privacy, the privacy, the privacy on both sides of that equation, where the individual is as well as making sure it provides a safe environment for them to talk about it. So once again, another fantastic week, Nick, it’s been great speaking with you and hopefully at some point, we can move beyond Delta. This is Fred Goldstein with accountable health. If you’d like more information, please reach out to accountable health COMM

 

Nick van Terheyden 

And this is Dr. Nick on the incrementalist here with incremental insights for better business, better health.


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