6 Clinical Care Predictions for 2021

As has been the case in 2020, the COVID-19 pandemic will dominate the clinical care field in 2021, three experts say.

A trio of clinical care experts have shared their 2021 clinical care predictions with HealthLeaders.

As is likely expected by most healthcare observers, the coronavirus pandemic looms large in the predictions for the coming year. But the grim COVID-19 outcomes of 2020 should ease in 2021, the experts say.

1. Coronavirus vaccine and the course of the pandemic

With two COVID-19 vaccines already granted emergency use authorization in the United States and more vaccines on the horizon, the vaccination of Americans will have a major impact on clinical care in 2021, says Shafeeq Ahmed, MD, MBA, interim president of Howard County General Hospital—A Member of Johns Hopkins Medicine.

"Vaccination is going to help us in healthcare. We are going to have fewer healthcare workers out sick because of COVID-19. That is going to be important from a staffing perspective," he says.

Despite the rollout of vaccines, Ahmed predicts coronavirus will affect patient care significantly into the summer of 2021.

"In 2021, we are still going to be social distancing, wearing masks, and taking other precautions. From an outpatient perspective, there is still going to be prepping and managing of patients with the precautions that we currently are taking. On the inpatient side, we are still going to be dealing with coronavirus patients, which challenges us on many levels including not being able to have visitors. After the summer, we will still have COVID-19 patients, but we are not going to have overwhelming surges."

Patrick Godbey, MD, president of the College of American Pathologists, and laboratory director at Southeast Georgia Regional Medical Center in Brunswick, Georgia, is more optimistic about the course of the pandemic.

"I expect the number of cases to go down in the spring. As the weather gets warmer, people will be able to spend more time outside and spend less time indoors close together. The major holiday season will be over. And more people will have been vaccinated. So, for a combination of reasons, by March or April our coronavirus infections should see a significant decrease," Godbey says.

2. Return of the patient

Both Ahmed and Godbey predict deferred care linked to the pandemic will decrease significantly in 2021.

"What has been shown is that patients are still interested in coming in for routine care as opposed to delaying care for a long time. They will want to get back to seeing their doctors. So, we should see an uptick in growth in care that is not related to COVID-19. With the vaccine out, people are not going to be as afraid to seek care. They are going to feel more comfortable with healthcare organizations and they are going to come back," Ahmed says.

"We have had patients who have broken their hips and have waited much longer than they should to receive medical care because they were afraid of COVID-19. Or care has been delayed at healthcare organizations because of the need to take care of COVID-19 patients. I predict that we will be able to deliver care and patients will seek care in a more expedient fashion as we get a better handle on COVID-19," Godbey says.

3. Coronavirus testing

Demand for coronavirus testing will remain high in 2021, but the healthcare system should come closer to meeting the need in the first half of the year, Godbey predicts.

"What we would like to have happen is to have more polymerase chain reaction tests available, so that we can have everybody who needs to be tested receive tests. We are not there yet. We need to be able to provide accurate testing to every patient who needs it. The demand will continue, and we need to address that need. We have been told that in the first quarter of 2021, we will see an increase in the availability of reagents. If that is the case, we will come closer to meeting the need," he says.

4. Telehealth sustainability

After explosive growth in the early phase of the pandemic, telemedicine will continue to play a major role in clinical care next year, Ahmed predicts.

"Healthcare organizations will continue to use telemedicine as an option for care to manage patients. Telemedicine is just another version of social distancing, so it is going to be with us for the foreseeable future. People are recognizing that there is a value to not having patients come in for office visits. Patients can get their health condition management from the comfort of their own homes. It is going to be very tough for patients to want to give that up," he says.

Brian Johnson, MD, the chief medical officer at West Penn Hospital in Pittsburgh, Pennsylvania, is bullish on telemedicine in 2021.

"Telehealth has certainly ramped up. It is here to stay—the question is to what degree. If we go back to March and April of this year, telehealth was being used a lot. Then it tailed off, but it has gone back up again. Telehealth will find a sweet spot in 2021," he says.

Telemedicine will help drive the consolidation of physician practices next year, Johnson says. "We will be able to use telehealth to consolidate outpatient practices and reduce overhead, particularly in primary care. We can have less overhead but bring better care to patients by adding telehealth services to the book of services that practitioners provide."

5. Behavioral health bubble

Demand for behavioral health services will explode in 2021, Johnson predicts. "Given the stressors around the coronavirus—not just the disease process itself but also the relationship challenges, economic challenges, and healthcare challenges for the general public and healthcare workers—I foresee much more of a need for behavioral health services."

6. Addressing health equity

After decades of lurking in the healthcare background, health equity will emerge as a high-priority issue in 2021, Johnson says. "COVID-19 has brought health equity to the forefront."

Large healthcare organizations will lead the charge on addressing health equity next year, he says. "With engagement from large healthcare institutions, we can make progress on health equity. We are not going to make headway through government. We are not going to make headway through little pockets of small physician practices or small healthcare organizations. It is going to require large healthcare entities such as mine at Allegheny Health Network."

The larger healthcare entities need to make a commitment to address health equity, Johnson says. "That is where we are going to have an impact—2021 is the year when we are going to begin to see health equity rise to the forefront. We may not be able to create an impact where we see changes in mortality or changes in health outcomes, but we will make the first step to ensuring that more people have appropriate access to the care and health education that they have not had in the past."