Since the start of the COVID-19 pandemic, changes in public health, immunizations, and telehealth that were expected to take years shifted seemingly overnight.
Now in a new phase of the pandemic, this is no time for healthcare professionals to back down from advocacy positions. In fact, the coming months may prove critical, three experts said during AHIMA’s Advocacy Summit on Monday.
During the session “Accelerating Digital Health Public Policy: How Has the COVID-19 Pandemic Changed Healthcare?”, panelists Mary Beth Kurilo, senior director of health informatics at the American Immunization Registry Association; Kyle Zebley, director of public policy at the American Telemedicine Association; and Sana Chemi, director of policy and advocacy at the Prevention Institute talked with AHIMA’s director of government affairs, Kate McFadyen, MA.
The panelists described the rapid changes that affected their industries with the onset of the COVID-19 outbreak.
Zebley noted that the pandemic created “a game-changer for the telehealth industry.” Telehealth had been seen as something on the horizon. But “in the early days, we realized policymakers had been reading our comment letters after all,” he said.
For Kurilo, as vaccinations became available, the flow of immunization information also entered the spotlight. Seeing federal requirements for immunization reporting being accepted was also important. “We can now have a near real-time view of immunizations out there, and in terms of opportunities, in the last six months, we have really seen polices shifting to meet this moment,” she said.
The nature of Chemi’s work didn’t change, but her organization saw an acknowledgement that existing “policy and systems weren’t meeting peoples’ health and wellness needs. In the past, those conversations have been perceived as theoretical, but the pandemic and the movement to do something about structural racism changed the context and refocused attention on solutions,” she said.
The pandemic also indicated a need for bigger policy shifts and big-picture thinking, the speakers said.
Prior to the pandemic, there were a number of regulations blocking access to virtual care, Zebley said. The spring 2020 waivers of existing laws created rapid change. “It kept our hospital system from collapsing and proved what we already know: Quality care can be provided through technology,” he said.
Kurilo has noticed increased attention to the need for standards, both regarding electronic health records (EHRs) and for information exchange across state lines.
Chemi said that there is recognition that “many policies and systems weren’t meeting peoples’ needs in the first place, particularly BIPOC [black, Indigenous and people of color] people,” she said. “What does it look like to reimagine and rebuild as we are talking about recovery from COVID-19?”
As those recovery discussions happen, the panelists said, remember that the positive changes of the pandemic aren’t necessarily permanent. In many cases, further advocacy is needed. In the case of telehealth, the blanket waivers are temporary and can expire. “I don’t think the public appreciates that unless Congress acts, access to care they have due to current flexibility can go away,” Zebley said. “It requires a law to make sure this stays in place. We’re not going to go over a telehealth cliff—we need to educate people to demand that Congress act.”
Kurilo agreed that “we want to be embedding changes, not snapping back. We want to leap forward.” Strong capture at the state and local level of care can be leveraged at the federal level to give us a picture of what is happening and ultimately help with tracking a longitudinal record of care, she said.
“Snapping back will happen in some respects if we don’t advocate, educate, and use this moment now to explain that people should not take the changes for granted,” Chemi said. “They need to be made permanent. There’s been a shift in understanding; now we have to act.”
The panelists also emphasized that the pandemic has brought the importance of accurate, timely health information to the fore across all areas. For immunization registries, Kurilo said, data is the lifeblood. “Immunization information systems need complete, accurate, and timely data, and getting it back out for clinical decision support and consumer use is also critical …We also look at the patient identification issue for this reason,” she said.
The story of racial disparities and COVID-19 begins with the data, Chemi added. “In the early days of the pandemic, we were all in the same boat, but the experiences in communities were very different,” she said. “Communities of color were getting sick more than other communities. We needed that data to be shared, then the story and solutions started to shift.”
Information is critical for the success of telehealth as well, Zebley said. “Telehealth is healthcare—we know how important data is for that. As we look forward to how telehealth can be part of a solution, you have to ensure the right data gets to the right provider at the right time.”
Anne Zender (firstname.lastname@example.org) is senior director of strategic communications at AHIMA.