One significant development we’ve seen during the pandemic has been the use of telehealth. Are there other innovations that will make the health care system better equipped with regard to access or cost or any other area?
L.M.: I do think that telehealth is a radical transformation and, if we do it correctly, a very welcome and value-improving transformation in health care delivery. Through the entire month of February, in our adult delivery system here at Stanford, we did roughly 1,000 virtual visits. In the latter part of March and April, we were doing upwards of 3,500 virtual visits a day.
We’re discovering that things we never thought we could do virtually, we actually can do very, very well. Let’s say a person is being referred by a primary care physician to a cardiologist. For the cardiologist, the more important part of that initial evaluation is the history. That can be done through an interaction like this, virtually, just as well as it can be done in person. The value proposition is this: By doing the first visit with the cardiologist virtually, the cardiologist has a pretty good picture of, well, this person needs a stress echocardiogram or this patient needs a number of other tests. Or maybe they don’t. And then the patient makes one visit to have the tests and see the cardiologist. In the past, it would've been two or more visits. That improves the efficiency of care delivery. It ultimately will improve the outcome, and it makes for a much better patient experience.
We also have the opportunity now really to create the digital home; to leverage digital health in ways that have been a challenge in the past. Every other aspect of the economy has been radically transformed by technology; the way we order goods and services, the way we perform financial transactions. But, prior to COVID-19, I have to say there was quite little in the way of fundamental changes to health care delivery. I think COVID-19 is now showing us the type of changes we can obtain.
What social behavior changes will persist beyond this pandemic? Lanhee, will there be public policy decisions stemming from these changes?
L.C.: With respect to telehealth, it’s been a rapid transformation and I think it’s been a good change. We’re leveraging technology to reduce the number of visits, but still ensure that people are getting access to good health care. Now, some of that development has been premised on some temporary policy changes that have allowed for telehealth to be reimbursed at levels comparable to in-person visits. Those policies will come to an end unless Congress and the administration move to make them permanent. So, there will be some effort under way to try and do that, to ensure that some of the gains we’ve captured do not get lost.
Also, telehealth is wonderful, but it does not necessarily address some of the equity concerns that were raised earlier. It could make them worse if, for instance, you don’t have access to a high-speed internet connection.
In education, the idea that distance learning is a solution that works for everyone is simply not true. My kid’s school district includes families that are quite well off and families that are not as well off and there have been tremendous differences between how students have experienced distance learning. And so, I would be hesitant to say that those shifts we’ve seen in the educational system are either long-lasting or desirable, quite frankly. There are huge inequities that have developed and huge challenges in the educational system that I hope do not continue past this pandemic.
Telework is going to continue in some industries but not others, in some geographies and not others. I don’t think we can expect those changes to be universal in our country. Regional and state-by-state differences are just part of the American design and are going to dictate differences in behavior by employers too.
L.M.: I agree. The challenge will be to look at where we need to have a better national infrastructure to respond to crises such as COVID-19. Early on, we weren't prepared in testing. We weren’t prepared in terms of what we thought would be a dramatic and sustained need for increased ventilators. So we’ll need to balance.
The very fabric of our country is based upon this balance between a national, and state and regional governments, and we’ll need to address how that is represented in responses to public health crises. We really will want and need to see more national leadership. A virus doesn't know the difference between a county line or a state line. In most cases, our ability to limit its spread internationally requires some new thought with regard to policy in the public health arena.
What would you say is the biggest misperception of COVID and how as a society can we address it?
L.C.: In the short run, the biggest misconception is that we can pretend like this thing doesn’t exist anymore. We may not need to completely reorient our lives, but we do need to make some changes and to adapt. The thing that worries me is the notion that somehow we can go back to business as usual, today. I just don’t think that that’s reality. In fact, it’s going to hinder our ability to eventually to go back to life as normal when that does happen.
L.M.: I think Lanhee stated it really, really well. This virus is going to be with us. Our lives are not going to return to the way they were in January for a long, long time. We are, every day, defining what the new normal is. I hope that our values, our principles, as a society, as a nation, continue to drive us in the direction that will, one day, make our children, our grandchildren, look back and say we did a good job managing through this crisis, that we got through it as a country and as a people and, ultimately, as a world group of citizens.
As CEO of the Americas and U.S. Senior Partner, Nik Deogun advises clients on business critical communications issues including mergers and acquisitions, shareholder activism, IPOs, crisis and litigation, and corporate reputation matters. Nik joined Brunswick from CNBC where for nearly 9 years he held several senior management and leadership roles, including Editor in Chief and Senior Vice President, Business News.
In addition to being a Senior Counselor at Brunswick Group, Lanhee Chen Ph.D., is currently the David and Diane Steffy Fellow in American Public Policy Studies at the Hoover Institution and Director of Domestic Policy Studies and Lecturer in the Public Policy Program at Stanford University. Chen is also an Operating Partner at New Road Capital Partners and serves as a Senior Adviser to and member of the Aspen Economic Strategy Group at the Aspen Institute.