Iodinated contrast material used in many imaging tests was in short supply for about six months after a temporary Covid-19 lockdown closed with lids a GE Healthcare factory in China that was the main supplier of the material. As a result, US doctors have been forced to postpone non-urgent follow-up appointments, putting thousands of patients at risk of missing critical early warning signs of disease progression. Although the shortage was initially expected to last until June, it did not officially end until the end of the year September. Now that it’s finally finished, it’s time to check out what went wrong.
The pandemic has exposed several cracks in our country’s already fragile health care system, from unsustainable levels of clinical burnout to serious gaps in equal access to care. The signs are clear: our health care system is not prepared for the stressors that the coming decades will undoubtedly bring.
Fortunately, there are several ways we can improve our adaptability and resilience to these stressors, and embracing medical technology should be the first step. In fact, devices already in use in and out of the clinic can improve our resilience to supply chain disruptions and the volatility of the 21st century.
Take telemedicine for example. During the pandemic, virtual appointments have eased the pressure on hospitals and patients – especially for immunosuppressed groups – and ensured continuity of care. Virtual meetings clearly also have a place in the post-pandemic world. Telehealth is used 38 times more than before the pandemic, ranging from 13 percent to 17 percent across all majors, and 92 percent of consumers report that they prefer a virtual care option when looking for a new provider.
As an extension of telemedicine and virtual care, remote patient monitoring (RPM) also has the potential to help meet patient needs while reducing pressure on the system. Technologies that record and transmit patient health data, such as pacemaker information or glucose levels, can create a registry of accurate, real-time health information that can help inform disease management and treatment decisions, while eliminating the need for providers to manually record data. Although this technology has a long way to go before it is considered standard of care – as of June 2022 only 25 percent of healthcare leaders report that their practice offers RPM – studies show that RPM combined with health coaching can make lasting improvement in the patient’s well-being.
It is also worth noting that fewer trips to the hospital by car or ambulance and fewer resources needed to perform scans and operations will have a positive impact on the carbon output of the healthcare industry overall, a multifaceted sustainability strategy in itself, as improving the planet’s health will improve our own.
Moving beyond invasive procedures whenever possible is another resilience strategy worth exploring. Because of the reduced staff needed to sedate and monitor patients, shortened hospital stays, and less overall time in the operating room, minimally invasive surgery (MIS) can help bridge the gap between understaffed hospitals—which has even been a problem before the pandemic – and growing patient need.
Another example is blood biopsies, which can be used instead of CT scans in cancer patients or traditional biopsies in organ transplant patients. In organ transplantation, these biopsies may have similar effect such as MIS by reducing the resources and labor involved in traditional biopsy, which requires multiple providers and anesthesia.
After years of incremental progress, it appears that liquid biopsies in cancer treatment are beginning to gain ground: Just this month, the European Society of Medical Oncology published new directions which support the use of liquid biopsies in guiding treatment decisions, which may help sparing patients of these expensive, uncomfortable chemotherapy regimens whenever possible.
Of course, this does not mean that the materials associated with these blood tests will never experience their own shortages. However, being able to use these biopsies and revert back to CT or traditional biopsies only when needed would help create a more adaptive model of care.
As supply chain disruptions continue to threaten public health, it’s time to think about how we should use technology to build a stronger, more resilient system. Strengthening adaptability to changing circumstances and stressors is imperative if we are to meet the health needs of the US population in the coming decades. We have several technologies, such as the examples I mention, already at our disposal. All that remains to be done is to integrate them into the standard of care – ideally before the next global health crisis.
Photo: freedigitalphotos user Salvatore Vuono