A Recap of Emergency Medicine’s Challenges and Bright Spots
This year has left a permanent imprint on emergency departments — instituting changes born of necessity and revealing moving stories of resilience. The lessons learned from this pandemic year are many, and the changes are far-reaching.
Emergency medicine has always been the most adaptive of the health care specialties, so it’s not surprising that the crises encountered over the last 10 months had our colleagues again tapping into their creativity and rapidly embracing new services. As we say goodbye to 2020 and look forward to a fresh start, we can find value in reviewing ways in which our industry has changed, the challenges we coped with, and the bright innovations that helped us get through it.
ED Volumes Down Overall
One of the first challenges that faced many hospitals early in the pandemic was a reduction in volume. The Centers for Disease Control and Prevention reported a 42% decline in ED visits from January 2019 to May 30, 2020.
While some hospitals were overwhelmed with COVID-19 patients, others were eerily quiet. Many fearful patients either attempted to cope at home or chose virtual care. Some of these decisions led to heartbreaking delays in care for strokes, heart attacks, and other serious illnesses. One study at a California hospital revealed a disturbing uptick in cardiac arrests that correlated with decreased ED visits.
Rural Health Care Shortages
As hospitals adjusted to lower volumes, some of them began experiencing a second wave of COVID-19 cases, particularly in rural areas. Rural critical access and community hospitals, which already struggled with ED physician shortages before the pandemic, now face the daily task of stretching scarce resources even further.
Data analytics has the potential to address the problem of rural physician shortages by offering smart data insights that help streamline operations — using existing staff in the smartest way possible to maximize impact. In the face of stress and unpredictability, organizations use analytics solutions like ours to leverage important data insights to aid in decision-making and strategic planning.
We can’t talk about physician shortages without talking about staff resilience. “Hero” has been a common word used to describe the frontline staff and physicians who have tackled COVID face-to-face every day. Emergency physicians may be used to the adrenaline rush of emergency practice, but COVID-19 has been a different type of stress, one that has tested that resiliency. They are rising to that challenge.
Many major organizations, including the National Academy of Medicine, the AMA, and the AHA, have realized the importance of supporting staff’s health and mental well-being during this time. Many physicians and other providers have risen to the occasion and traveled to hotspots in support of their colleagues, despite risk to themselves and their families. In some of the worst circumstances, the best qualities of our valued health care professionals have been shining through.
Increases in Virtual Care
The telemedicine industry came out as another hero this year, during a rapid shift to virtual care. As the need for telehealth became apparent, on March 17, CMS broadened the scope of telemedicine services and loosened restrictions. This rapidly developed into a stream of new services, bringing access to care to those on home restrictions and living in rural areas, as well as those who feared COVID exposure at clinics and emergency departments.
Telemedicine suddenly became much more than a sideline service. In an interview on the American Journal of Managed Care (AJMC) website, Registered Nurse Sara Douglas, Ph.D., said:
Telemedicine has grown from about 10% of all patient visits, before the coronavirus disease 2019 pandemic, to almost 90% at present, and it isn’t going away anytime soon.
The telehealth industry is booming, including in specialty areas such as mental health, chronic care management, and weight management.
Finding the New Normal
In the throes of such financial pressure, the drive to remain independent is strong. Health care organizations everywhere have been working to make sense of 2020, draw insights, and frame next year’s operations as they come to grips with the “new normal,” because our industry isn’t returning to the operations it once knew.
And while data-driven decision-making is not a new concept, it’s a grounding factor in a chaotic time. We stand with emergency medicine as it refashions itself, using data to diversify service lines and lean into the adaptive spirit that is at the core of this specialty.