Three medical transformations during the pandemic

President's Blog,

It has now been just over one year since the arrival of COVID-19 changed the way that medical care is delivered. Reflecting back at the time of crossing this milestone, I remain impressed not only by the response, but at the speed of the response.

Compared to many other industries, the pace of change within medicine can appear slow. There are certainly exceptions to this, but it is obvious that over the past year the pace of change has been significantly accelerated.

Within my own field of anesthesiology, there are three transformations that immediately come to mind when thinking about practice-change over the last twelve months.

1 – Preoperative testing – Patients coming for elective or non-emergency surgeries are universally tested for COVID-19 prior to their procedure being performed.  Much of the logic behind this testing policy is related to the potential for an aerosol-generating procedure being performed and the existence of asymptomatic COVID-positive patients.  The development of this policy required the development of a testing site, operationalizing timing that allowed for a specimen to be received as close to the date of the procedure as possible while still allowing time for the result to be ready on the day the procedure was scheduled, and the communication with patients regarding why they were being tested and the result of the test. Typically, this would have taken several months to execute, but was developed and functional within weeks.

2 – Physical patient pathways – The way patients enter the medical facility, flow through it and then leave has been completely redeveloped. Before patient’s arrive, they are screened for symptoms. Once they do arrive, the screening is repeated and a clean mask is given to them. The spaces within the facility have been redesigned to allow for as much distancing as possible. In the perioperative areas, patients use the same room before and after their procedures whenever possible and visitor policies are adapted according to local COVID prevalence. In summary, the way we use the same space today is dramatically different from how the space was used one year ago.

3 – Telemedicine – Within our local anesthesia practice, telemedicine has played the most significant role within our preoperative clinical services. It is now more common than not for a patient to be evaluated prior to their procedure without a physical appointment in our clinic, but rather via telephone or video communication. The system has improved efficiency and, anecdotally, many patients have seemed to prefer it.

There certainly have been few, if any, silver linings related to the COVID-19 pandemic. But the experience of the past year of practicing through this pandemic has reminded me that, when motivated, the medical industry can be as creative, nimble and adaptable as any other.

In solidarity.
Kenton Allen, MD, MBA
NHMS President

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