Expanding public-private partnerships, greater data interoperability, more robust supply chains, and streamlining regulations are among the suggestions.
A blue-ribbon panel of experts from all sectors of healthcare recommended a coordinated national response to the COVID-19 crisis, including making permanent certain measures adopted during the pandemic, including allowing providers to practice medicine where they are needed most, without burdensome concerns about state licensure.
The Healthcare Leadership Council (HLC) recently released the report, "National Dialogue For Healthcare Innovation: Framework for Private-Public Collaboration on Disaster Preparedness and Response."
"The COVID-19 pandemic and immediate response has exposed vulnerabilities in the nation's ability to handle a national-scale crisis," said Mark McClellan, MD, PhD, founding director of the Robert J. Margolis Center for Health Policy at Duke University. "A positive sign was the organizations and people in the healthcare space who typically are competitors showing willingness to work together for the good of all Americans."
The study originated before the pandemic began, and was focused on responding better to disasters and catastrophes in general. Once the pandemic struck, "we realized that we needed to expand the scope of what we were doing, and to bring in even more expert voices," said Mary R. Grealey, president of the HLC.
In response, HLC launched a partnership with the Duke-Margolis Center for Health Policy to assess lessons learned from COVID-19 in 2020, which led to the new initiative and report.
Starting in the summer, initiative leaders created three specific work streams on care delivery, data and evidence generation, and supply chain innovation, according to Calvin Schmidt, MBA, senior vice president and worldwide leader of government affairs and policy at Johnson & Johnson, who chaired this initiative for HLC.
"What we are trying to do is lay out a framework in which we will be less reliant on the extraordinary and the heroic in times of crisis, because we will be better prepared for the unthinkable in the future," Schmidt said during a press briefing.
"We should never again have a situation where states and healthcare providers are feverishly competing against each other for the critical supplies that they need," Schmidt said.
Health Inequities Faced During Crisis 'Must Never Reoccur'
Schmidt also said the report makes clear that the healthcare inequities exacerbated during the COVID-19 crisis must never occur again, and that healthcare systems must be equipped with metrics and a commitment to direct resources where they are needed the most.
Another goal of the report is to promote real-time data collection, reporting, and sharing. In addition, the report recommends leveraging interoperability of health information technology and public health data systems.
Judy Faulkner, founder and CEO of Epic and co-chair of the initiative's workgroup on data and evidence generation, expressed concern about hospitals that are on outdated versions of their electronic health record software. "It is the responsibility of that system, as well as the vendors, to make sure that they too can be able to interoperate," Faulkner said. She added that public health organizations need to be "much more modernized" to be able to interoperate with other healthcare organizations.
The report also recommends creation of an ongoing funding stream to support needed data systems in federal, state, tribal, territorial, and local public health systems, such as immunization systems, including supporting staff who maintain and update these systems, and who make decisions informed by these data systems.
Yet another objective is to strengthen capacity and transparency of the U.S. healthcare supply chain. "Fragile supply chains that depend on single sources outside the country, those were a challenge in many parts of the pandemic response," McClellan said.
As part of this recommendation, the report advocates strengthening stockpiles and preventing supply shocks by creating standards for what should be stored in stockpiles, both in quantity and how long particular supplies should be stockpiled before being replaced.
Supply shocks can be minimized by developing mechanisms for collecting supply chain information to identify vulnerabilities in a manner that protects confidential commercial information and trade secrets, the report said.
Strengthening Public-Private Collaborations
Many of the steps described in the report require public funding, McClellan said. Others will be privately funded, and "a lot of them are shared," he added. For example, telehealth requires some public investments such as improving infrastructure, but the report also describes many ways the private sector is taking steps, and with federal collaboration could take more, to support new care models, such as alternative payment mechanisms.
Other recommendations would create regulatory streamlining and reforms and uniform waivers to enable all levels of government to respond to emergencies with fewer regulatory impediments.
Antitrust laws that prohibit providers sharing information with other providers about the fact that they need 10 times as many diagnostic testing supplies, or 1,000 times as much protective equipment, must be waived during times of crisis, McClellan said.
"Information that wouldn't be [normally] shared needs to be shared with the federal government," he added.
Among the contributors and participants in the report are Aetna, the American College of Emergency Physicians, the American Medical Association, America's Health Insurance Plans, Anthem, Ascension, Baxter, BlueCross BlueShield of North Carolina, BlueCross BlueShield of Tennessee, Bristol Myers Squibb, Business Roundtable, the Centers for Disease Control and Prevention, Cleveland Clinic, Epic, Federation of American Hospitals, HCA Healthcare, Johnson & Johnson, Labcorp, Mayo Clinic, McKesson, Merck, Mount Sinai Health System, the National Governors Association, New York‒Presbyterian Hospital, NorthShore University HealthSystem, SSM Health, Surescripts, The Joint Commission, The Sequoia Project, the U.S. Department of Health and Human Services, and numerous others, totaling 106 organizations.
“The COVID-19 pandemic and immediate response has exposed vulnerabilities in the nation's ability to handle a national-scale crisis.”
Mark McClellan, MD, PhD, founding director of the Robert J. Margolis Center for Health Policy at Duke University
Scott Mace is a contributing writer for HealthLeaders.
Real-time data collection, reporting and sharing, as well as data interoperability, play roles in averting future catastrophe.
Fragile U.S. supply chains were a challenge, and stockpiles must be strengthened, both in quantity and through improved standards.
Public-private collaborations, regulatory streamlining, and antitrust law waivers are also recommended steps.