By MacKay Jimeson
April 23, 2020
It’s an unsettling time. Can we still seek a silver lining?
Hundreds of millions of us are more or less stuck in our homes—forced to reevaluate the way we relate to work, the government, to one another, and to the world at large.
This pandemic also presents time of transformation. A crisis tends to shed light on systemic failures and opportunities for improvement.
Some would say the status quo has been particularly rocked by COVID-19 in the health sector. In this time of crisis, we see government remove barriers very quickly.
In the months that follow the pandemic, the traditional policy debates will return—but a more informed public will need to be clear on what changes we expect from our government leaders.
Here are the top four life science and health tech opportunities that must be addressed in post-COVID-19 America:
1. Removing Barriers to Delivering Telehealth.
Telehealth has grown increasingly popular over the past several years. Yet, many professionals have struggled to integrate telehealth into their daily practice.
States and the federal government placed barriers to delivering these electronic consults and virtual visits. Providers who want to deliver telehealth care across state lines must be credentialed in every state—and at every hospital—where they work. This is often a challenging, time-consuming process.
The lack of reimbursement models for telehealth is another barrier. As of January 1, however, Medicare has developed new payment codes and guidelines for telehealth services. The American College of Physicians is also in the planning stages of creating telehealth resources for internal medicine specifically. These are designed to offer guidance on reimbursement and other regulatory issues that should be addressed in the near future.
That said, the COVID-19 pandemic has forced governments to loosen many of the historical telehealth barriers. In March for example, Congress expanded the number of Medicare beneficiaries that can use telehealth at home.I’ve spoken to many telehealth companies who all say they’ve seen a surge in the use of their services over the past two months.
2020 is poised to be the year the scale tips toward the rapid adoption of telehealth. States and the federal government should insist telehealth is covered and reimbursed like a typical office visit. They should also establish policies that allow qualified medical professionals to work across state lines. This move would be more efficient and cost-effective for the health care professional, but also has potential to better service areas of high need—including rural communities and vulnerable patient populations.
2. Using Blockchain to Effectively Deploy Medical Equipment, Information and Personnel.
Last week I was on a call with one state government official who praised blockchain technology to locate vital supplies and reallocate resources to avoid shortages that so many hospitals have faced.
Blockchain has been a buzzword for some time, but its practical use is becoming increasingly obvious. It adds trust and transparency to the procurement process. The technology is a distributed ledger of sorts, which stores encrypted data that users can access with permission. This data cannot be changed or destroyed; it’s essentially a living receipt of the supply chain. Blockchain allows companies to share and verify data safely, as well as move supplies quickly without the costly middleman.
The potential for blockchain goes well beyond hospital procurement. It can offer a more secure way to protect patient privacy and share information with appropriate and responsible parties. Blockchain creates an incorruptible and decentralized data log that conceals an individual’s identity, all while allowing healthcare professionals to share information quickly and safely. This level of privacy protection and data sharing also has positive implications for drug development and medical innovation.
The pharmaceutical supply chain can also benefit from the added transparency of blockchain in the drug supply chain. The technology can help track medicine from point of origin to patient and every step in between. This will help protect patients from counterfeit and contraband medicines, as well as unsafe generics.
Estonia has been an early adopter of blockchain technology. Today nearly all of the country’s healthcare billing, health information, and prescription information are handled through blockchain. Hopefully, the more traditional developed economies will quickly follow suit.
3. Speeding up FDA Approval of Vaccines, Medicines and Diagnostics.
Many public health officials are saying we will need a vaccine before we are able to fully return to a life that is close to normal. The biopharmaceutical industry may never have looked so important.
The public may also get an interesting lens into the high-stakes drug development and cumbersome regulatory processes.
At a meeting with health officials, top scientists, and drug developers in early March, President Donald Trump asked, and I’m paraphrasing, why it would take so long to create a vaccine. The media, predictably, rushed to criticize him and missed the point. After all, wasn’t the President asking the same questions so many at home are wondering too?
Since then, public health officials have said it will take 18 months. Before anyone gets frustrated, it should also be stated that a vaccine approved in 18 months would be outstanding. That would see the clinical and regulatory process working at a record pace.
The FDA has been asked to operate in real time for years, but progress has been slow. As it relates to COVID-19, it has been suggested that the FDA could consider a real-time review. This would mean regulators would work with drug developers to evaluate a clinical program as the data comes available, rather than taking the traditional approach of waiting until a clinical trial and regulatory submission are completed.
The FDA is known to resist political pressure, and some would argue that they do not factor public health into their decision making. That said, it does seem the FDA is learning that it must move faster.
After some early stumbles that prevented academic and commercial labs from developing COVID-19 tests, the agency has become more open to accelerated approval. In recent weeks, the FDA revised the protocol for allowing labs to start testing before the review of their validation data.
This sense of urgency should not end with the pandemic. After all, health is and always will be essential to the patient. Critics will say we sacrificing safety for speed, but that doesn’t have to be the case. It should really mean that our health regulators are also investing in improving patient care by seeking continuous process improvement, so better treatments are available faster.
4. Addressing the Misallocation of Healthcare Labor.
While it may seem we have a shortage of doctors, nurses, pharmacists, or other healthcare professionals in the U.S., it is really a misallocation of labor.
The medical industry imposes far too many restrictions on certain practitioners, keeping these individuals from practicing at the top of their licenses and therefore creating shortages.
Demand for healthcare services will not decline anytime soon, pandemic or not. Patients are also seeking greater convenience. These trends are currently taxing the existing healthcare systems, which means we must become even more comfortable breaking down the old silos in medicine. This may also mean we need an enhanced scope of practice that further empowers nurses, nurse practitioners, physician assistants, and pharmacists.
The pharmacist, for example, offers a lot of interesting possibilities. Already, they have increasingly become a vaccine provider. Now, what vaccines they may administer will vary widely by state. States that have more restrictions on pharmacists’ ability to provide vaccinations may negatively affect public health and increase healthcare costs.
Shockingly, New York State recently decided that pharmacists will not be allowed to administer a COVID-19 vaccine once approved by the FDA.
Meanwhile, nearly nine out of 10 Americans live within five miles of a pharmacy. This makes them a convenient option, but also a well-positioned community healthcare provider. They frequently offer extended hours without the need for an appointment.
And so, it is time to rethink the traditional silos of healthcare administration. Federal licensure options, however—and greater reciprocity among states—will make it far easier to deploy skilled healthcare professionals as the need arises. By developing a system under which medical professionals are compensated appropriately for positive health outcomes, we can continue moving in the right direction—during and after COVID-19.