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The post-pandemic patient: a catalyst for health system change

Article

COVID-19 has altered expectations for health care delivery

One of the many long-term effects of COVID-19 is its impact on our health system. It is no exaggeration to say that the pandemic has forever changed health care.

Diverting resources to address COVID-19 has placed an unprecedented burden on our health care system and immense pressure on health providers and staff over an extended period. The prolonged disruption and barriers to accessing care demanded rapid innovation and introduced new technologies and approaches that have profoundly changed the way we deliver care to patients.

But now another development is increasingly shaping the future direction of health care: The emergence of the post-pandemic patient.

Our entire society experienced rapid and sustained behavioral change as new measures were implemented to contain the virus. Many of them were completely new to us and yet they quickly became “the new normal”; e.g. social distancing, mask wearing, engagement with digital technologies, telehealth visits, and both rapid and polymerase chain reaction (PCR) testing.

The lasting legacy of some of these measures has radically changed the perspectives, needs and expectations of patients. This is increasingly evident in the clinic and is exerting further pressure on the health care system and on front-line clinicians.

During the height of the pandemic it was necessary to rapidly adopt digital and virtual/telehealth services, which became fundamental to the continued delivery of care during periods of lockdown. With the pace of everyday life slowly returning to normal, post-pandemic patients are recognizing the advantages of this new approach to care and have grown accustomed to the convenience and real-time access of digital health services.

Virtual care, for example is an incredibly accessible way to receive health care in a format that is comfortable for many patients and convenient for providers. It can be especially valuable when patients are immunocompromised or are unable to travel to the hospital or doctor’s office.

Alongside virtual care, the rise of patient portals and applications, screening tools, and direct messaging with providers has put health care at the fingertips of digitally literate patients. Almost overnight, asynchronous communication has become widespread and expectations have shifted accordingly. Post-pandemic patients expect their doctors to be “always on,” and available for questions at their convenience. They want answers, fast.

There are of course many benefits to this new digital care ecosystem when it comes to convenience and more efficient resource allocation. But the demand for real-time information has put significant pressure on providers as they try to deliver for patients both digitally and in-person.

Further, the introduction of COVID-19 testing during the pandemic put diagnostics into the public consciousness almost overnight. Before the pandemic, many people had never used or were even aware of over-the- counter diagnostic tests.

Fast-forward two years: PCR and rapid tests are now part of our everyday vocabulary and testing has been integrated into our lives at many levels. Not only have the process and practical elements of testing become habitual, but for many people, the reliance on immediate testing for peace of mind has created a much different expectation of the role diagnostics play in health care.

I’m seeing this first-hand in my clinic. Patients are requesting testing for all types of things like vitamin D, cholesterol and thyroid stimulating hormone, often just for peace of mind rather than due to symptoms or a known risk.

And while it’s exciting to see patients more engaged and informed about their care, doctors also have a huge opportunity to educate patients on the varied role diagnostics play in informing their care.

Adapting to this new normal presents multiple challenges for providers who are already stretched thin and navigating uncharted territory. But rebuilding the health system is not just the responsibility of the clinical community. All health stakeholders have a role to play.

I started by introducing the post-pandemic patient as a driver of change. So what does that mean for our health system? In essence, the pandemic has resulted in a more informed and engaged patient population that is fueling further digital transformation of health care. If we can embrace the opportunities this presents and continue rapid adaptation, the outcome will be a healthier and more accessible system for all.

Dr. Levy is chief medical officer for Foundation Medicine.

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