Upheaval: Healthcare Boards Embrace Pandemic-Driven Change
By Jena Abernathy

The COVID-19 pandemic upended the healthcare industry and accentuated its shortcomings. But the pandemic also catalyzed innovation, forcing healthcare boards to orchestrate change with speed, agility, and flexibility.

Now, board members face a new challenge. Build on the momentum created by two years of COVID-driven innovation and adaptation and address a new set of strategic imperatives:

  • How can we enhance the health and well-being of individuals and populations, with special attention to the social determinants of health?
  • What’s the best way to re-engineer healthcare delivery, including a re-examination of the who, what, when where, how and how much of healthcare?
  • How does healthcare prepare for new and emerging crises, including subsequent pandemics?
  • How can organizations respond to retail’s massive push into healthcare? Are partnerships and alliances the answer?

Confronting individual and population health

COVID-19 forced healthcare providers to postpone elective procedures, resulting in backlogs and revenue shortfalls. One in five adults delayed receiving medical care or were unable to get care in a crisis. The result: Increased risk of complications and death for those who experienced heart attack, stroke, cancer, or respiratory disease.

Hospitals and health systems continue to suffer financially. Hospitals nationwide will lose an estimated $54 billion in net income over 2021, even when accounting for funding from the federal Coronavirus Aid, Relief and Economic Security (CARES) Act. Hospitals are likely to sustain negative operating margins through the end of this year.

COVID-19 also put a spotlight on healthcare disparities and the so-called social determinants of health: housing, food, transportation, air quality and neighborhood safety.

Minority and low-income communities experienced a disproportionate share of COVID infections, hospitalizations, deaths. The pain was exacerbated by high rates of high blood pressure, diabetes, and obesity within minority and low-income communities.

In response to these challenges, boards will tackle issues like the following in 2022: 

·      How do we revamp care delivery to focus on caring for populations at the lowest or most reasonable cost?

·      Is there a way to segment vulnerable and minority populations to ensure consistent, evidence-based allocation of resources?

·      How can the organization build out primary care with a focus on prevention?

·      What’s the best way to embed concepts like convenience, culture, literacy, and language into healthcare, creating a bridge between acute, hospital-based care and more routine care?

·       How could partnerships with community groups confront the social determinants of health:  safe housing, transportation and neighborhoods; education, jobs and income; food, nutrition and exercise and more?

·       Should we make an enterprise-wide commitment to combat racism, discrimination and bias as we move forward on diversity, equity and inclusion?

Confronting shortfalls in staff, ppe, equipment and devices  

The pandemic illuminated the consequences of shortages in healthcare staff and supply chain.

Growing numbers of healthcare professionals — physicians, nurses and therapists — continue to display symptoms of burnout, anxiety, depression, post-traumatic stress disorder and suicidal ideation.

 

Fifty-five percent of frontline healthcare professional experience burnout, with those caring for Covid patients most likely to experience anxiety, depression and mental distress. Other stressors include extended isolation, childcare and violence against minorities.

 

Healthcare workers took breaks and leaves of absence or moved into part-time work. Many questioned their commitment to a healthcare career while others quit their jobs.

Healthcare worker shortages were compounded by shortages of personal protective equipment (PPE), and medical equipment and devices. Hospitals relied on global supply chains and frozen by the massive disruptions of COVID-19. The result: soaring prices, shortages of PPE, medical supplies and devices and organizational struggles to protect staff, patients and communities.

Healthcare boards will make decisions related to burnout, mental distress and building a more resilient workforce and supply chain by posing questions like the following:    

  • How do we build channels and networks where healthcare professionals can raise safety issues, build trust with co-workers, and recommend positive change?
  • What’s the best strategy for reducing the stigma and fear connected with seeking mental health treatment as a healthcare professional?  How can we offer healthcare professionals mental health resources and referrals?
  • How can we promote more expansive approaches to scheduling, including restrictions on emails and calls, limits on work in high stress environments and streamlining of electronic health records and health information systems?
  • What kind of financial and psychological support can we offer healthcare professionals in the form of benefits like paid family leave, childcare, or eldercare?
  • How could this organization build reliable domestic supply chain sources via creative partnerships?
  • Is there a better way of taking control of supply inventory by focusing on cost, standardization, and collaboration with competitors?
  • Could we join forces with government to safeguard the supply chains needed for emerging crises like natural or man-made disasters and pandemics?
  • How can we operationalize data driven decision making via data gathering and integration, and more precise calculation of supply chain needs?
  • Should we invest in tech solutions that seamlessly connect healthcare organizations with suppliers and distributors?

As board members interact with C-Suite executives, they can’t afford to backburner frontline workers who increasingly leave jobs and demand workplace change. Boards members can nudge CEOs to invest in frontline workers via improved compensation and benefits, flexible work arrangements, mental health support, and enhancements to safety and security.

Taking on innovations in care delivery via technology

Fifteen percent of U.S. adults used telehealth for the first time during the pandemic, while a third of adults have already used telehealth. Three-quarters say they are very or somewhat likely to tap telehealth in the next normal.

The pandemic forced healthcare to go remote and rely on telehealth for one-on-one and group consultations with patients and families.

Telehealth morphed into the new technology normal as clinicians and insurers recognized the value of keeping consumers safe, secure, and connected from home. 

But the proliferation of telehealth also revealed the broader opportunity of telemedicine — specifically how to avoid moving medically fragile or elderly patients to big city hospitals for brief consults.

Some providers already rely on telehealth to treat patients in severe emergencies--from car accidents and violent mass casualty events to natural disasters like hurricanes and public health emergencies like COVID-19. They know how to blend telehealth with electronic tools that accelerate diagnosis and treatment and offer relief to overburdened healthcare staff.

Health tech transformation also hinges on wearable health monitoring devices, including smart healthcare watches and wearable fitness trackers, ECG monitors, blood pressure monitors and biosensors.

The ability to monitor patients remotely — known as remote patient monitoring — allows clinicians to check on patients from any location and fulfill the promise of healthcare anytime and anywhere.

Boards will tackle disruptive technologies like telehealth and sensors by asking questions like the following:

  • How should we analyze and evaluate digital projects based on long-term value, added risk and short-term returns?
  • How can this organization implement technology with a project and risk management process that aligns with enterprise risk management?
  • Should we navigate the disruptive risks of technology by integrating disruption and innovation into board agendas?
  • What’s the best way to provide oversight of new and emerging technologies via analysis of trends, risks, benefits and clinical and business results?
  • How can this board monitor the recruitment, hiring and re-skilling of technology talent with a focus on teaching the analysis, adoption and integration of new technologies?
  • How can board members monitor the metrics of innovation, including the percentage of revenue from new products and services, resources allocated to new products and services and innovation ROI?
  • What’s the best way to remove barriers to widespread tech adoption and use, including the permanent loosening of telehealth regulations?
  • How should board members advocate for legislation and regulation that promotes health equity, supports primary care, improves health outcomes, coordinates care and protects patient privacy?

Expecting the best but preparing for the worst

The COVID-19 pandemic exposed shortcomings in the financial, operational, and clinical performance of hospitals and health systems. Many hospitals in COVID hotspots were unable to provide an adequate number of hospital beds. Some providers were filled to capacity, but still suffered revenue losses.

During the fourth COVID-19 wave of fall 2021, hospitals transported patients hundreds of miles from their homes because local hospitals were full. Some patients waited for care in hallways, storage rooms, emergency departments, or waiting ambulances.

Other hospitals resorted to care rationing or application of “crisis standards of care” as COVID case numbers soared in states like Montana, Alaska, Wisconsin and Kentucky. Health systems in Alaska announced that they could no longer provide care to every patient due to a steep rise in COVID-19 hospitalizations there.

Healthcare board members can prevent a repeat of COVID-19-driven shortages and denials of care. While they can expect the best from an emerging new normal, they must prepare for the worst by addressing these issues:  

  • How can board members build systems that assess community vulnerabilities and outline responses to future outbreaks? How do we retrain staff in infection control, reporting of cases, and use of PPE?
  • What’s the best way to plan for long-term support of healthcare workers — from needs assessment and implementation, to monitoring and evaluation of results and lessons learned?  
  • Do we build out a more agile, resilient culture via strategies like appointment of a chief wellness officer, temporary suspension of nonessential tasks, or ongoing research on stress drivers and levels?
  • How do we uncover the potential of remote, hybrid and on-site work in the workplace of the future, including the role of clinicians in in remote care delivery and tapping extenders for routine tasks like order entry and documentation?
  • What education, training, and coaching would prepare healthcare professionals to work in ICUs, emergency departments and other high-stress settings?
  • Can we safeguard he emotional well-being of healthcare professionals by positioning therapists in high-stress locations and creating wellness teams that deliver in-the-moment support?

Confronting retail’s move into healthcare  

The pandemic fed into the retailization of healthcare, as people avoided physician practices and hospitals in favor of local pharmacies, urgent care centers and retail clinics. More than a third of adults say that they got care at a retail clinic during the pandemic, while more than half say they will do so in the future.

Retail’s pivot into healthcare first made news in 2018 when CVS purchased Aetna for $69 billion. CVS manages prescriptions for 75 million Americans with more than 70 percent of Americans living within three miles of a CVS pharmacy. Meanwhile, Walmart cemented a relationship with health insurer Clover Health, expanding its healthcare services to include primary and urgent care, lab, x-ray, diagnostics, counseling, dental, vision and hearing.

Retail giants like Walgreen, Target, Best Buy and Dollar General made inroads into healthcare, generating competition for more traditional hospitals, health systems and physician practices.

At the same time, urgent care clinics and standalone retail clinics offer consumers affordability and convenience via walk-in appointments, neighborhood locations and expanded hours.

Healthcare boards recognize the rise of retail clout and will pose questions like the following:  

  • How should this board lead the transition from a physician-centric to a consumer-centric model of care where service is more accessible, convenient and friendly?
  • Should this organization divert acute care services from acute care settings to easy-to-access locations where people live and work? Would doing so enhance health outcomes and chronic care management?
  • What’s the best way to balance the demand for retail and primary care with the need for high-level medical services in specialties like oncology, neurology or gynecology?   
  • How could board members help facilitate partnerships and alliances between retail, primary care, insurers, and hospitals and health systems?
  • What’s the best way to monitor the needs and expectations of healthcare consumers?  Would they use CVS, Walmart or Target for basic healthcare but access a hospital, health system or medical center for treatment of an illness or injury?

Healthcare boards will continue to confront pandemic driven issues like those outlined in this article. But healthcare is a complicated and growing industry. Board members will take the lead in every vital area of health and medicine — from care delivery innovation and patient engagement and experience, to infrastructure development, data and analytics, and care payment and funding.

Jena Abernathy is a Senior Client Partner and Sector Leader for Healthcare Board Services for Korn Ferry International, a global organizational consulting firm. She is a partner in the Korn Ferry Global CEO & Board practice and specializes in C-suite and board-level searches.


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