The Impacts of COVID-19 on the Healthcare Industry

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Dr. Bridget Calhoun speaks with our enrollment team of the effects that COVID-19 is having on the healthcare industry.

Webinar Participants: 

  • Bridget Calhoun – Associate Dean for Academic Affairs and Research, Chair and Associate Professor
  • Sonali Ibanez – Enrollment Advisor

Transcript

Sonali Ibanez:

Hello, everyone. Thank you so much for joining us today for this webinar. Today we’re going to be discussing the impacts of COVID-19 on the healthcare industry. Today we have with us, Dr. Calhoun, who’s going to tell us a little bit about herself and her background.

Dr. Bridget Calhoun:

Great. Thank you everyone for being here today. I’m absolutely thrilled at this opportunity to share some thoughts about how COVID-19 has impacted our healthcare systems. There have been some advancements made as part of this impact and some other issues that I’m eager to talk with you about. I think the best way for me to introduce myself really is that I’m a clinician first. My undergraduate degree was as a physician assistant. Even since I was little, I just knew I would always work in the medical field. When I became a physician assistant, I started working in transplant surgery at one of those world’s leading facilities at the University of Pittsburgh in transplant surgery. There I had the opportunity to learn a lot. I was working with surgical patients who had chronic organ failure. They had surgical complications plus they were immunosuppressed, so the learning opportunities were quite abundant.

Dr. Bridget Calhoun:

It was then that I was surrounded by amazing research and I realized that I wanted a bigger role in research. So I went back to school and earned a doctoral degree in public health and infectious diseases and microbiology. Through the pursuit of that degree, I really became enamored with viruses and really the ongoing and continuous war between viruses and man. And so that really has given me some unique experiences. I then specialized in HIV as my virus and have worked in the field now of HIV and AIDS research for about 20 years. But during that time, I also became more interested in how the intersections of all these different professionals came together to serve individual patients, but then to serve wider communities, to serve the population as a whole. The pandemic that we’re currently living in is really an interesting time because of the intersection of research and technology and communication and economics and politics and all of those things that we’re seeing play out on a daily basis. I don’t mean it in a negative way or to sound super excited about the devastation that we’re seeing now, but this is a really exciting time to be in healthcare and to pursue employment opportunities in healthcare. So I am super excited to be with all of you today.

Sonali Ibanez:

Perfect. Thank you so much for sharing a little bit about yourself, Dr. Calhoun. We have some questions that I’m going to go ahead and ask you if you can answer those. But I do encourage all of our attendees to go ahead and put any questions that you may have that you would like me to ask to Dr. Calhoun in the chat box, and we’d be more than happy to get to those as well.

Sonali Ibanez:

The first question is, what are administrators expected to do? Basically, how are they working within hospitals and other healthcare systems during this time? Also, what challenges may they face?

Dr. Bridget Calhoun:

Wow, that’s a great questions to get started with. Thank you for those. I think when all of us consider the roles and responsibilities of health administrators, one of the best ways to look at it is to appreciate that these professionals have the responsibility of blending healthcare with many different industries. We talk about human resources. We talk about supply chain of equipment and technology within hospitals. We talk about politics, about what decisions are being made that can impact patient care and how hospitals and patient care environments can be run. We talk about economics, but not just from the spending, but this is a complicated and intricate system where we also have to consider a reimbursement. Healthcare administrators have to know current research and interpret statistics to make decisions. All of this is informing them, but they also have to be true to themselves and realize that, “Wow, there are ethics involved in all of this too, and there’s healthcare law and there’s healthcare policy and there’s quality assurance topics, all of which have to come together to better serve the patients.”

Dr. Bridget Calhoun:

And so, “What are they expected to do?” is a really complicated question because there, the opportunities are just immense. Think of it from a patient perspective, they have to make sure that the best care as possible is being delivered to each patient. And so that has consideration for equipment, making things of modern equipment and having hospital equipment that’s just needed for the procedures or the care that’s needed for their individual hospitals. They also have to ensure that there’s a safe and enjoyable workplace for all employees, right, so that people are interested in coming to work to serve patients and they themselves remain safe. Healthcare administrators also have to anticipate the needs of the community, some of which are the same across the U.S. but some may be very different. One example I often teach about is the emergency capacity in a resort place like Vail or Aspen, Colorado during ski season, right? That’s going to be very different.

Dr. Bridget Calhoun:

The size of the orthopedic team may be different than some other hospitals that may be located in different states, so really anticipating the needs of the community and the people who live there. You’ll find too that healthcare administrators also have to know some statistics about the local community. If you have an aged population, that can have implications and really drive decisions about what resources are available. If you have a relatively young population who are of childbearing years, then you may need larger labor and delivery suites, right, and more capacity for those beds. We really teach our students that you have to be aware of many different industries when you work as a healthcare administrator. But it’s really exciting and it’s an opportunity for people who have foresight and who recognize the importance of having vision for the future so that when things happen such as a pandemic that we’re living in now, not only are you well-equipped to make decisions, but you’ve anticipated some of the challenges.

Dr. Bridget Calhoun:

Healthcare administrators also have to think about training for the future workforce, right, so the placement of students in healthcare facilities, so that they are ready to serve patients immediately upon graduation and join the workforce. Healthcare administrators also have to keep institutions financially viable, right, so that they are able to provide the care that the community demands and needs. What they’re expected to do is a lot, and it’s really exciting. Some of the other issues I think is also about the realization that medical supplies is a tricky topic, because these are supplies that expire. Over the past several weeks, and almost approaching two months now, I’ve heard a lot of people asking about, “Well, why didn’t hospitals have more respirators in the first place? And why is there a shortage now of medical supplies?”

Dr. Bridget Calhoun:

Well, because these don’t have unlimited shelf life, right? We have this situation where even gloves, if they get too old, they rip when you go to put them on. So even something simple as having the appropriate medical supplies in the appropriate abundance, it becomes an issue because so much of what we have is single use only, and we’ve seen that play out now with masks and gloves and some of the face shields that we are seeing our healthcare workers now.

Sonali Ibanez:

Perfect. Thank you so much for sharing that thought with us.

Sonali Ibanez:

Another topic that we’d like to discuss as well is, what are some of the challenges of budget management during times like these?

Dr. Bridget Calhoun:

That’s a great question. There are many challenges, some I already mentioned, that just in terms of getting extra supplies for infection control. We can’t jeopardize our workforce by having them all become infected so we have to make sure we have abundant supplies of those. One of the issues particularly faced by healthcare administrators is the issue of reimbursement. We rely very heavily as for third-party reimbursement in our hospitals and clinics and surgery centers and ambulatory clinics. If we are seeing patients who have either lost their job and no longer have insurance, or we have folks who were uninsured or underinsured in the first place, then that really hits the bottom line of hospitals and the financial viability of those institutions. We also have the situation of capacity and overload within hospitals. When hospitals are overloaded, that can change the ratio of healthcare workers to patients.

Dr. Bridget Calhoun:

I like to think in the United States we have a really good grasp on what are the ideal ratios of either nurses to patients or physicians to number of beds in an emergency room. And so those ratios have financial implications and when we have situations where we’re over capacity, those ratios can change. If we have a nursing workforce that is now over capacity, in terms of patients, we have to ask ourselves, could that impact the quality of care that’s being delivered and could that increase the risk of medical errors and can we have poor patient outcomes? When we have any of those things, we have increased risk of liability and litigation. There’s a constant concern and someone has to be looking at the big picture. That’s what we rely very heavily on our health administrators to do, to take all of this information from a human resource side to medical equipment side to the laws and ethics and put all of this together so that we can best serve the patients.

Sonali Ibanez:

Perfect. Thank you. Though I know you discussed this a little bit, if you could just tell us a little bit more about as to what challenges of resource allocations and equipment reserves are in and how involved do the health administrators get?

Dr. Bridget Calhoun:

Sure. Yeah, very involved. Maybe the best way to answer the question is to give some examples. Imagine that we do get a vaccine available, okay? And imagine that not only do we have to purchase the vaccine, but we also have to figure out how best to mass administer the vaccinations. This is where we see the very important and crucial conversations between administrators and clinicians. There may be a thought that, “Okay, we can have these huge immunization programs. We could just prefill all these syringes, send people out to administer the vaccines and we can serve the most number of people in the shortest amount of time.” Well, in theory that sounds great until we realize that syringes have not been approved and are not approved and won’t be approved anytime soon, at least plastic ones, to actually hold or store vaccines. You have to keep them in a glass vial and draw it up only right as you’re ready to administer it.

Dr. Bridget Calhoun:

So there are these conversations that have to exist and challenges that people may not even realize that is the law and that is standard of care and best practices. These very important conversations have to happen because we may not be fully aware, or one particular person may not be fully aware of all of the challenges that could come with something as simple as administering a vaccine to folks. The challenges are many and long. There are other issues too regarding our healthcare workers serving as vectors of disease, right. I mentioned already that we don’t want our workforce to get infected while at work, but what if they get infected at home and then bring it to work where people are already at high risk for another comorbid condition or other comorbid conditions? The challenges are long.

Dr. Bridget Calhoun:

I think another concern about some of the challenges we’re facing right now is that this is a novel virus. What that means is that we haven’t encountered it before so we don’t have a whole lot of examples to draw parallel conclusions from. That’s really concerning because, as you probably have heard just in the general news and the general media, it remains questions whether or not people develop immunity after they are exposed and infected with this virus, like we see so often with other viral infections. The healthcare workers are learning, the clinicians are learning, the researchers are learning, the virologists are learning, the immunologists are learning. And the population as a whole are demanding answers, quickly and expeditiously. Many of these answers we don’t have, which is why we need people who are innovators and we need people who get excited about the opportunities to work in healthcare administration and public health, so that they can be really the folks who are the thinkers and the innovators, and who can take risks and ask the right questions and have a skillset that allows them to address many different things at once and many moving parts at once.

Sonali Ibanez:

Perfect. Thank you for sharing that insight as well. Dr. Calhoun. One more topic that I want to discuss, and then I’m going to open up to open the floor up to some questions. How do you see the health administration industry adopting or even evolving after this pandemic, COVID-19?

Dr. Bridget Calhoun:

Right. Well, we know just even in the first few months, the healthcare dynamic has changed dramatically, so I see many changes coming down the pike. One of the first that I think all of us can appreciate is the greater need for telemedicine. Telemedicine used to be pretty popular in rural areas and it used to be pretty popular in checking on people with chronic diseases in order to lower readmission rates for hospitals, right, so patients with congestive heart failure, as an example. That is a expensive condition to pay for and these patients typically have readmission rates that far exceed other conditions. We have a very successful model in the U.S. where healthcare providers would do telemedicine visits with them remotely and be able to pretty much assess them in how well they’re doing with caring for their medical condition.

Dr. Bridget Calhoun:

For example, we may ask the patient to bring their pills into the interview, and we can count them to make sure that they are taking them as prescribed, or at least they have the correct number of pills remaining. We ask them to weigh themselves to see if they have extra weight on that would be retained as fluid from their congestive heart failure. So some medical conditions and disciplines within medicine have been quite conducive to telemedicine. But what we’ve seen over the past few months is adoption of telemedicine in medical disciplines that hadn’t really used it before, and so that opens up a whole another important area of health administration, because we have to have servers that are HIPAA compliant, and we have to train healthcare providers how to obtain consent for treatment remotely and what are the laws that may govern me as a prescriber in Pennsylvania evaluating a patient in Florida. Is that permissible? Can I cross state lines if I don’t have a medical license in that individual state?

Dr. Bridget Calhoun:

So many of the changes that we’re saying is the adoption of technology that was existing but I think all of us would agree was under-utilized prior to this pandemic. That’s just one example of how things are changing. We also see the demands or patient’s demands have changed, right? Patients are now seeing that there’s an attractiveness to having visits remotely because then they don’t have to go to where other sick people may be, or they don’t have to potentially be exposed, whether it’s COVID or influenza or any other infectious disease that’s communicable from person to person. So I think the adoption of telemedicine by the general population is also being… or is also evolving. There’s incredible growth in this field, just as that simple example.

Dr. Bridget Calhoun:

I think another change that we’re going to see as a result of this is how we can make decisions and anticipate mass responses, whether it be a natural disaster or whether it be a act of terrorism or now we see this as an infectious disease. How do we best mobilize immediately a larger workforce and how can we implement and very quickly establish patient care environments that they may not have existed before? A great example there is many of us have seen the tents that went up in Central Park in New York City. Who would have thought six months ago that that’s where we would be today? And so so much has happened so quickly that we’re now better equipped to mobilize huge workforces very quickly. And so there has to be best practices in there so I think we’re going to see changes and improvements in our ability to respond to mass medical emergencies.

Dr. Bridget Calhoun:

We’re also seeing differences in collecting biological samples, right, and how do we transport biological samples? Because if we’re testing people while they’re seated in their car and they drive through a testing facility, even if it’s a makeshift one in a parking lot, what do we have to do to protect the viability of those samples so they can be properly tested, but also to protect the public that people aren’t exposed because something happens to those biological samples en route? So lots of changes. We now see hospitals having to change what used to be very long, existing policies, something as simple as how many visitors can be inside a hospital or a hospital room. Right now we have people who are, in some cases, definitely ill and they have no one around them, or they’re delivering their first baby and can only have one person in the room. In terms of looking at what policies have changed within hospitals, I already mentioned the ratio of nurses to patients, but now we’re looking at the visitor policy and checking the temperature of people who are coming in and out of the hospital, and so lots of changes.

Dr. Bridget Calhoun:

The other area where we’re seeing is how can we project how we best care for people of different acuity, right? Because while this pandemic is occurring, there are still people who need regular vaccinations for polio and for shingles. So how do we balance delivering preventative care while we’re still delivering acute care, while we must deliver emergent care, while still providing chronic care? A lot of moving parts here, and a lot of opportunities for people who see this as an exciting time to really demonstrate your ability to be creative and to be a forward thinker and to really positively impact the entire healthcare system in the United States, which is certainly one of the best in the world, but not the best, not yet.

Sonali Ibanez:

Perfect. Thank you so much. Yeah, that’s really, really great that we have a model in place now and that administrators are thinking of how to further improve on that quickly and more efficiently. We did have a very popular question come in, Dr. Calhoun, that I’m going to go ahead and ask you before we go ahead and wrap up. Do you think that the U.S. will be better prepared for this type of situation if it were ever to happen again?

Dr. Bridget Calhoun:

Yes, absolutely. I’ve been talking mostly about the clinicians and healthcare providers, but let’s not forget the incredibly important workforce of people who are collecting data right now, people who are analyzing data right now, and then the people who will draw conclusions based on the data. And so we see journals right now that are having special issues, that the entire issue of a medical journal is dedicated to COVID-19. It may be things like workforce issues, or it may be things like immunity, or it may be things about the virus itself, or it may be about [inaudible 00:22:46] targets, or it may be about who’re the greatest risk. A lot of data is being generated at this time and when we know we have good data, good, reliable data that has been interpreted appropriately, we’re better prepared for next time.

Dr. Bridget Calhoun:

As a public health person who teaches public health related topics, we always talk about the possibility of a pandemic. We talk about how we can try to contain, and we talk about contact tracing, and we talk about notifying partners or those who may have been exposed, but we never really talked about it on a scale this big. It was always in theory. Theoretically, how would we do it and how would we handle it and how would we have home stay orders? But it was theoretical, and now we have it as a real example, similar to how we’ve learned from the AIDS epidemic or similar to how we learned about SARS or the bird flu, or several other examples of recent infectious disease threats that we now are better equipped to handle, and that we’re better equipped to anticipate in the future.

Sonali Ibanez:

Great. And yes, I completely agree with you. Thank you so much for sharing all of that and answering some of these questions for us, and just to give us a better insight as to what would it looks like for our healthcare industry during this time. Though I do highly encourage students who are interested in our programs, who have further questions or concerns, to definitely reach out to an enrollment advisor like myself. The phone number is on the screen. Please feel free to call us and we’ll be happy to discuss any questions or our programs and see if it’ll be a great fit for you. Our Master’s of Health Administration program is a great program and we do offer three different concentrations for you to choose from. That’ll be all today. Thank you so much for being here today, Dr. Calhoun.

Dr. Bridget Calhoun:

Oh, you’re so welcome. I’ve really enjoyed it. Thank you.

Sonali Ibanez:

You’re welcome. Well, have a great day everyone and thank you for joining us.