Moving healthcare from the theoretical to the personal
While technology is a tool that can aid the care delivery process, it’s easy to run the risk of losing the important focus of the patient-clinician connection.
As a science, healthcare can be pretty theoretical, until the moment it becomes personal.
There’s no great time to catch COVID, but I have been glad that it’s now and not two years ago, when there was so much that wasn’t known about the virus, how it was transmitted, how to protect against it and how to treat it.
This is a truism that we tend to forget. It’s easy to get caught up in statistics and analytics, population segmentation, evidence-based medicine and trendlines for revenue, and believe that data, and data alone, constitutes medicine. Those are crucial tools for clinicians that have the potential to make medical care better. But they are only tools. They don’t span that last mile, that connection that links the caregiver to the patient.
I gravitate toward the theoretical in healthcare as a writer who has covered the industry for more than three decades. It’s easy to think in terms of trends and stories and forget the personal component. Especially over the past two years with the pandemic, there’s a certain detachment that occurs in writing about the healthcare response, the healthcare impact.
That was refocused for me Sunday morning, when I got a text message containing a link to my positive COVID result. Then a double-slap the next morning, when my wife got her positive result.
I’ll quickly mention that we’re both doing well. We’ve been both vaxed and boosted, have generally been very careful about wearing masks and keeping distances from people in public settings. It appears that our first return to church in two years (a distances ironically maintained because of COVID concerns) was the point of exposure. But a large number of protected, previously uninfected people seem to be catching this latest variant quite frequently.
Timing is everything
Those were dark days of fear and hyper-caution, with surges in patients who had serious infections and declined rapidly as clinicians tried treatment protocols on the fly. There wasn’t enough protective medical equipment, no vaccines, no drug regimens, no knowledge of how best to position patients. We’ve learned much in terms of treatment, transmissibility and public response.
Now, it was interesting to be on the patient side to see what has been achieved. My first indication of infection was a home test, with the process starting through scanning a QR code that came with the in-home kit. Scanned it with a smartphone, filled out personal information within the resulting app, took the test and registered the results (which looked very faintly positive, but not overly conclusive).
The next day, symptoms were progressing, so to a local chain drug store for another test. Results were back within 48 hours, communicated via a link in a text sent to my phone. Within 24 hours, I received a call from the Illinois Department of Health, seeking more information about my symptoms, contacts who may have been with me over this time, instructions and offers of assistance.
Results also wound there way back to our primary care physician, who has talked to my wife (whose symptoms have been slightly worse). And we have a wealth of solid information to rely upon in terms of past research, current trajectories for those infected and more. So, while it seems crazy to have caught this after two years of hiding in my basement, I have no regrets for the care and caution we took – and it amplifies the need to be careful and respectful of the science going forward.
Those less fortunate
My thoughts also turned to those healthcare workers who lived in the personal hell over the past two years of a non-theoretical work environment. Driven by their desire to provide loving care for others, they returned to their work/war zones day after day, sacrificing close personal contact with their own families and risking catching the virus themselves. Many did, and hundreds, perhaps thousands, died as well.
And there’s the reality that the nation’s death toll from the coronavirus has now topped one million people in the U.S. That’s unfathomable personal sorrow for countless families. While many thousands died early on because of a lack of tools, the toll has been amplified by willful non-compliance and ignorance, fanned by politicization and destructive misinformation.
The result – nearly one out of every 300 of us has perished. In the early days, there was shock that some experts had predicted that the country could experience 300,000 deaths, and we figured that we knew too much to have the toll eclipse the half million who perished from the Spanish Flu in 1918. Horribly, we managed to exceed both these markers.
And just talking of numbers veers us back to the theoretical. Each loss was, and is, an individual person, leaving a grieving family, an unfulfilled life. Even our chance to spend final moments with dying patients was co-opted, with often goodbyes having to be done through Internet connections, with sorrow expressed on tablet computers and smartphones.
And typically, it was the hospital nurse and staff who held the hands of the dying as they passed. It’s no wonder that these caring individuals are now suffering from post-traumatic stress disorder from the unabated trauma of the last two years, and they’re seeking a change of scenery for their profession, or leaving it altogether.
And I think of the service workers in various roles who couldn’t do their jobs in their basements, but worked amongst the public in retail stores, grocery stores and pharmacies. I thought of this as I carefully traversed the aisles of a local grocery store yesterday, wearing my N-95 mask – but realizing that these workers didn’t know which of the patrons around them was carrying coronavirus and which were not.
Even as sickness reminds of our deep desire to have healthcare be personal, when we go back to healthy, it’s easy for it to become theoretical again. You can see that in the pandemic burnout that now makes us susceptible to future variant waves.
Healthcare can become other things beyond just personal and theoretical. The worst is when it becomes political, a negotiating point or a position for those from one political persuasion or another. Politicized healthcare completely subtracts the humanity, the person-by-person impact of what healthcare is intended to do.
Healthcare is not just a political/economic construct. Money is the fuel for the system, but much of the political debate is about whose ledger healthcare expenses wind up on – that’s an irrelevant discussion, because the costs of healthcare services are borne by a society irrespective of who ends up paying the bill.
Providing healthcare is prone to become abstract and theoretical, something done in big buildings where patients come in sick and (generally) leave healthy, as part of some disembodied process. It’s meant to be personal, person-to-person.
Think of how you would like to receive bad healthcare news (that day is coming someday, whether for you or a close family member). No doubt you’d like to hear it from a personable, empathetic, loving care provider who ministers to your emotional needs, not just your physical needs. With all the extension of human care afforded by virtual care, remote patient monitoring and other technologies, it’s still this personal care that we deeply crave.
I recently saw a video of a company applying automation, robots and artificial intelligence to a fast-food operation. It was very slick – robots flipping burgers, submersing French fries and AI predicting surges in crowds for lunch. That’s one way to deal with a shortage of workers in that industry segment.
That’s not a vision for healthcare – as much as automation and robots could do routine tasks, healthcare is still a human-to-human connection. Technology, finance and other supports must ensure that care is personal. Never political. Not just stopping at the theoretical, but ensuring the personal.