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Three years on, how COVID-19 has changed health care


Today marks three years since the first COVID-19 case was confirmed in the United States. Of course, the pandemic has caused enormous pain and loss, but it has also ushered in big changes in how health care is delivered in America. Telemedicine and advances in in-home care now allow patients who would have previously been hospitalized to receive treatment where they live. The rapid development and deployment of COVID vaccines may mean that vaccines for other diseases will gain approval at a much faster pace. But the pandemic has also shed new light on health care inequities facing people with limited incomes and often people of color.

Here to talk through some of these issues is Eugene A. Woods. He's the chief executive officer of Advocate Health. That's a large network of not-for-profit health care systems based mainly in the Southeast and the Midwest. It's headquartered in Charlotte, N.C., and that's where we reached him. Eugene Woods, thanks so much for joining us.

EUGENE WOODS: Michel, it's great to be with you.

MARTIN: So let me start with telemedicine and at-home care. And look. It's hard to predict the future, but do you think that this has been a permanent change in how health care is delivered outside of a typical kind of doctor's office visit?

WOODS: I really do, Michel. And I think what we've shown in the darkest days of the pandemic is that we can care for people who are really, really sick safely in the comfort of their own homes. Three years ago, for most of the country, telehealth was mostly a futuristic thing, and now it's a reality. We've actually done at Advocate Health over 3 million virtual visits with our patients and found the outcomes actually are just as good as when patients are in the hospital.

MARTIN: I was going to ask you about that because you can absolutely see where, you know, having access to telemedicine makes it a lot more convenient. But are the outcomes the same or similar enough?

WOODS: Yeah, I think, you know, we're very obviously very specific about what the admission criteria are for somebody that goes to the hospital at home versus the actual physical hospital. But we have shown that we can take care of patients very safely and well at home. And I think so far, we've seen about 6,000 patients in our hospital-at-home program. And it's going to save us in the future building a new hospital. The care that we will be able to provide in people's homes will be much more affordable and, to your point, much more convenient. And the outcomes, we think, are going to be very good as well.

MARTIN: But what about nursing? I mean, you know, there's one thing to sort of see a physician who's going to put your care plan in motion. But beyond the hospital-at-home model, is there a way to apply that to nursing?

WOODS: Absolutely. In March of 2021, we launched a pilot program, and we called it our Virtual Nurse Observation Program. And it's really a revolutionary care model. So it allows a nurse to monitor a patient via a camera in a remote location. And you think about the nursing shortage that we all know about. Well, one virtual nurse can monitor multiple patients at a time and alert the bedside team if they see a patient that needs assistance or care. But it allows us to extend our clinicians. And we know there's a national shortage of physicians, of nurses, of lab techs and respiratory techs, etc.

MARTIN: So you can see where people might be concerned about that. So let's hold that thought for a minute and kind of go back to that question at the end of whether people really are getting the kind of monitoring that they should be getting if you have people doing that. But so let's hold that thought for a minute, and let's talk about one of the other things that I think people kind of intrinsically have absorbed, but they may not think about - is that the urgency of the pandemic allowed for vaccines to be developed and rolled out in record time. And we're not just talking about vaccines. We're talking about effective vaccines, OK?

WOODS: Yeah.

MARTIN: So how has this affected vaccine development for other illnesses, or has it?

WOODS: It's unlocked a new door of scientific possibilities going forward. That messenger RNA methodology, which essentially teaches the body to make its own medicine, isn't new. It's been used for HIV and Ebola. But the COVID application was new. And now we're learning that it could have many more applications going forward. Recently, we're on the cusp of a vaccination using messenger RNA for RSV, which is that respiratory disease that's going around.

MARTIN: So we've talked about some really positive developments that have arisen out of the sort of the tragedy that was COVID-19. On the other hand, you know, COVID-19 shed light on health care inequities that were already there. Given, you know, where you're located and given the diversity of the people that your network serves, I want to - just talk to me about that.

WOODS: The pandemic laid bare for all to see the significant inequities that have always existed, as you say, but just weren't in the news all the time. I think it really brought it to national attention. And right now, we have an opportunity to step back and look at the lessons learned, what's worked and how we really work to solve health care inequities. At Advocate Health, we're committing, as a new organization, $2 billion to address health inequities. And we have a national center of health equity that we are developing in Milwaukee. So we believe that health care delivery systems, working together with government and public officials, can take the lessons learned from the pandemic and really begin to make real progress on disparities.

MARTIN: But do you think that we will? I mean, is there some accountability that requires that to happen? For example, when you talked about the kind of the virtual nursing model, you can kind of see where...

WOODS: Yeah.

MARTIN: ...That could widen inequities instead of narrowing them. I mean, you can say, oh, great, one nurse can monitor, you know, five different rooms. Well, that's like saying, one teacher can monitor five different classrooms, but that's the kind of thing that people with means would never tolerate. You know what I mean? They would never tolerate. They still want one teacher in a class with 15 kids. So the question is, do you think that - what is your - what gives you confidence or at least hope that these innovations will actually reduce these inequities instead of just maintain or widen them?

WOODS: If we looked at the hospital-at-home program, we had 30% of those that we cared for were people of color. And actually, we were able to reach into other corners of the community that might not have had access, transportation and so forth, and maybe had family situations that required them to stay in the house together, let's say. And we were able to show that our data allowed us to reach more people, not less.

MARTIN: Looking to the future, what gives you confidence that these changes will improve equity and not just, you know, maintain the status quo or, in fact, worsen it? - and you're saying based on your experience.

WOODS: Our experience is we were able, for example, to host the largest, most successful mass vaccination events in the entire country, where we had 30,000 people vaccinated in one weekend, and we had a shot in arms every 4.5 seconds. How were we able to do that? The only way that we were able to do that is because we partnered with businesses. We partnered with the government and elected officials. And my confidence is the relationship that we've built during the pandemic - if we continue to build on them, then I think that's really the core of solving the inequity challenges and, quite frankly, the societal and change challenges that we face that require all of us working together in the same direction.

MARTIN: That's Eugene Woods. He's the CEO of Advocate Health. It's a large not-for-profit health care system headquartered in Charlotte, N.C., and we reached him there. Mr. Woods, thanks so much for joining us and sharing this expertise with us.

WOODS: Thank you. It's great to be with you. Transcript provided by NPR, Copyright NPR.