The role of technology in rebuilding US healthcare
The U.S. healthcare system is in trouble. Although the COVID-19 pandemic drew national attention to healthcare in America and helped people see the value in the systems put in place, it also caused dramatic setbacks and losses.
Closed clinics, cancelled elective surgeries and an overall lower patient volume resulted in $202.6 billion in revenue losses between March and June, with an additional $120.5 billion in losses expected until the end of 2020. This brings the expected total of lost revenue in 2020 to $323.1 billion.
These figures are staggering, and they could dramatically impact access to, and quality of, care for individuals across the U.S. Unfortunately, as the country experiences a second—and larger—surge in COVID-19 cases, more healthcare appointments could be cancelled, leading to an erosion of public trust in the healthcare system. In order to increase the quality of patient care, healthcare providers must regain lost revenue with creative, technology-driven solutions.
Decrease missed appointments
One of the biggest factors in healthcare losses are missed appointment times. Appointment no-shows cost the U.S. healthcare system more than $150 billion a year, and can cost individual providers $200—and 60 minutes—per unused time slot. In an effort to make up for lost revenue, ensuring that patients show up for scheduled appointments will be essential for healthcare providers. A simple way to do this is to meet a patient on their terms.
Typically, appointment reminders come in the form of emails or phone calls to patients. If a patient is away from their home, these reminders can be difficult to access. Switching to services that allow for text message reminders can increase the rates at which people will actually read those reminders.
Surveys have shown that SMS text message open rates are as high as 98 percent, whereas email open rates are around 20 percent. They are also more convenient, as they can be accessed and read anywhere. By switching to text messages, appointment reminders are less likely to be missed, reducing the rate of no-shows and increasing revenues.
Unfortunately, reminders may not work for everyone; there could be last minute changes, causing a patient to miss their appointments. That’s why it’s important to plan accordingly. This can be done by integrating walk-in appointments with regularly scheduled appointments. Most consultations are scheduled for around 30 to 60 minutes, yet many issues can be solved in less time. These extra minutes, along with the extra time from no-shows, can be used to take walk-in patients. Scheduled appointments remain a priority, but time and money can be made up by accepting walk-ins as well.
Unfortunately, access to healthcare services still remains a barrier across the country. According to a study, 3.6 million people in the U.S. cannot obtain medical care due to transportation barriers. During the height of the pandemic, these issues were addressed with telehealth and virtual appointments. To increase revenues, expand access to healthcare and improve patient care, doctors need to consider continuing these services even after the pandemic is under control.
By integrating video conferencing tools and increasing patient satisfaction by using video call-back queues, patients can receive the same quality care no matter where they are. Video call-back queues allow individuals to join virtual waiting lines for their appointments. After joining, they can hang up to complete their own tasks or enjoy their day.
They receive timely text updates about their place in line and expected wait time. Once it’s their turn to be served, they can go online to see the doctor. This reduces the barriers caused by lack of access or transportation issues, and it can improve patient care and satisfaction by allowing for timely appointments.
People don’t enjoy waiting in lines, especially for scheduled appointments. Unfortunately, this has become a common occurrence for patients. Typically, people need healthcare because they are sick, and sitting in a crowded waiting room can heighten anxiety, especially during a pandemic. Virtual queue management systems can help mitigate these problems.
Queue management systems allow patients to wait for care from the comfort of their own home—or while they go about their day—instead of staying in a waiting room. They receive updates on wait times and will be notified when it’s their turn to see a doctor. If they are delayed, they can move back in the line for a little extra time, instead of losing their place entirely. It also allows healthcare providers to manage lines and redirect patients to nearby locations where wait times are shorter. By decreasing wait times and improving the waiting experience, crowded waiting rooms can be avoided and patient satisfaction can be increased.
Another simple way to improve service is to provide flexible scheduling options. Although 77 percent of patients think that the ability to book, change or cancel appointments online is important, only 2.4 percent of appointments are self-scheduled by patients. By giving the power of scheduling to the patient through online services and flexible scheduling apps, people will be empowered to take control of their health. It can also help to decrease missed appointments as they can choose and change their appointment times.
Recovering from the pandemic
Patient care should always be a priority for healthcare providers. But with high revenue losses, the healthcare system may be forced to close clinics or reduce availability of appointments. This will increase barriers for access and decrease patient care, which could have a dramatic impact on human health.
Technology and data-driven solutions can help hospitals and clinics begin to recover by allowing for safe and accessible healthcare. Not only is this important to help recover from the pandemic, but it will be important for improving public trust in the U.S. healthcare system.
Long haul Covid, the brain and digital therapies
It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain.
Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain.
What is long Covid exactly?
Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.
How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!
When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover.
If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus.
The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.
What symptoms does this cause?
These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.
In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.
This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.
How does long-haul Covid affect mental health?
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.
How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.”
We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain.
We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and running half marathons again.
At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response.
The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival.
What digital therapies or apps are proving effective at treating long-haul Covid?
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy.
What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.