One hundred years ago, the world experienced a health catastrophe that has been unparalleled – the “Spanish Flu.” The loss of life during that pandemic shook the fabric of our society and delivered major learnings that fundamentally reshaped the charter and the construct of health care systems, globally. Until that time, disease had been considered a result of the natural degeneracy of the poor rather than a result of the environments they lived in. Public health had been all about isolating the elites from the “scourge” of the poor, and thus preventing the spread of disease in the society1. That pandemic did not respect such social boundaries. The biggest structural impacts of the Spanish Flu included influencing governments worldwide to embrace the concept of socialized medicine, and, more importantly, to define the role of the physician as one who not only cures illness but also suggests ways to prevent it. Public health – as we know it today – was born. Roll forward 100 years from today, and we will undoubtedly be looking back at the pain and anguish caused by COVID-19. We may also be looking for lessons from the observed changes that impacted our lives and the healthcare system as a result of the current pandemic. New and important lessons are already emerging, and they have the potential to have a strong bearing on the healthcare system as well as the nature of the interaction of the health care consumer with the system. Here are some of them:
- Heightened awareness of one’s own health: As with COVID-19, so also in many other health situations – in the absence of any pharmacological solution, the best course of action is often to stay healthy. By being active and eating healthy, we can strengthen/balance our immune systems and avoid many chronic health issues. The good news is that a large percentage of chronic issues are either preventable or manageable. A heightened self-awareness of health and self-management will likely become part of the daily lives of a large percentage of human beings.
- Engaging critically with community health: The current crisis has exposed capacity constraints in the health care system that prevent efficient and effective management of an event that impacts a large segment of the population3. It has become evident that the traditional model of “the doctor will see you now” may no longer be the best approach and that health care – including patient-physician interaction – may be better delivered in the community and in people’s homes. Digital health channels offer the health care system an opportunity to provide surveillance and prevention that helps maintain a healthier society.
- Prioritizing the health of health care workers: While the people on the front lines continue to do a tremendous job of taking care of us, who is taking care of their physical and mental health? Through the use of digital health technologies, health care systems may be redesigned to balance the load on the health care worker, potentially reducing unnecessary utilization and fatigue. Digital health technologies can be a great way to prioritize clinical workload while keeping health care consumers engaged.
- Gathering robust longitudinal data: The cornerstone of public health is data – data that can be used to study patterns as well as potential cause and effect relationships in the health of a society. While population health data collection has been going on at the federal level since 19572, data collection and use for individual benefit or society at large continues to be limited – in large part due to the fact that an individual, on an average, spends only a few of the 5000 waking hours4 in a year with the health care system – generating a small amount of point-in-time data.
Many organizations are seeking ways to leverage digital health technologies to improve the quality – and quantity – of data available. With increased geographical mobility of the population and changing lifestyles (including a highly switched-on and digital population), ease of data collection has changed. Use of digital health and remote monitoring technologies have the potential to dramatically expand collection of robust longitudinal data, which may in turn enable prediction and prevention of many health issues. Many believe a health care revolution is approaching; made possible by the exponential growth in technology and technology platforms that have the potential to substantially lower the costs of prevention and intervention. Add to this changing consumer expectations5 of being treated anytime, anywhere, and with adequate cost transparency so that health care doesn’t disproportionately burden the society. This revolution will shift the emphasis of the industry from “sick-care” to true “health care.” Perhaps COVID-19 just accelerated our journey towards the revolution. 1 Spinney, L. (2017, September 27). How the 1918 flu pandemic revolutionized public health. Retrieved June 21, 2021, from https://www.smithsonianmag.com/history/how-1918-flu-pandemic-revolutionized-public-health-180965025/ 2 Blumenthal, D., & Seervai, S. (2021, February 01). Coronavirus is Exposing deficiencies in U.S. health care. Retrieved June 21, 2021, from https://hbr.org/2020/03/coronavirus-is-exposing-deficiencies-in-u-s-health-care 3 Asch, D. A., M.D., M.B.A., Muller, R. W., MA, & Volpp, K. G., M.D., Ph.D. (2012, July 5). Automated hovering in health care – watching over the 5000 Hours: NEJM. Retrieved June 21, 2021, from https://www.nejm.org/doi/full/10.1056/NEJMp1203869 4 Topol, E. J., M.D. (2016). The patient will see you now the future of medicine is in your hands. New York, N.Y.: Basic Books. 5 Topol, E. J., M.D. (2013). The creative destruction of medicine how the digital revolution will create better health care. New York, N.Y.: Basic Books.