Subject(s)
Medicine, Traditional , Medicine , Humans , Organizations , Medicine, Chinese TraditionalABSTRACT
Policy Points Hospital-at-Home (HaH) is a home-based alternative for acute care that has expanded significantly under COVID-19 regulatory flexibilities. The post-pandemic policy agenda for HaH will require consideration of multistakeholder perspectives, including patient, caregiver, provider, clinical operations, technology, equity, legal, quality, and payer. Key policy challenges include reaching a consensus on program standards, clarifying caregivers' issues, creating sustainable reimbursement mechanisms, and mitigating potential equity concerns. Key policy prescriptions include creating a national surveillance system for quality and safety, clarifying legal standards for care in the home, and deploying payment reforms through value-based models.
Subject(s)
COVID-19 , COVID-19/epidemiology , Caregivers , Hospitals , Humans , Reimbursement MechanismsSubject(s)
Biotechnology , Delivery of Health Care , Medicine , Quality of Health Care , Biotechnology/legislation & jurisprudence , Biotechnology/trends , Clinical Governance/legislation & jurisprudence , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/standards , Humans , Legislation, Medical/trends , Medicine/standards , Medicine/trends , Quality of Health Care/legislation & jurisprudence , Quality of Health Care/standards , Social ResponsibilityABSTRACT
The COVID-19 pandemic created significant challenges for academic health systems (AHSs) across their tripartite mission of providing clinical care, conducting research, and educating learners. Despite these challenges, AHSs played an invaluable role in responding to the pandemic. Clinicians worked tirelessly to care for patients, and institutions quickly reoriented their care delivery systems. Furthermore, AHSs played an important role in advancing science, launching studies and clinical trials to examine new vaccines and treatments for COVID-19. However, there is room for improvement; AHSs can use lessons learned from the COVID-19 pandemic to reshape their operations for the future. To prepare for the next pandemic, AHSs must modernize, adapt, and transform their clinical operations, research infrastructure, and educational programs to include public health and to build surveillance capacity for detecting, monitoring, and managing emerging outbreaks. In this Invited Commentary, the authors describe the opportunities AHSs have to build on their experiences during the COVID-19 pandemic and the ways they can take advantage of their unique strengths in each of their 3 mission areas. Within clinical care, AHSs can reach patients outside traditional clinical settings, build national and regional networks, advance data-driven insights, engage with the community, and support and protect the workforce. Within research, they can leverage data science and artificial intelligence, perform pandemic forecasting, leverage the social and behavioral sciences, conduct clinical trials, and build a research and development preparedness and operational plan. Within education, AHSs can promote remote learning, make interprofessional learning the norm, and build a system of continuing education.
Subject(s)
COVID-19 , Pandemics , Artificial Intelligence , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Pandemics/prevention & control , Public Health , WorkforceSubject(s)
Learning Health System/organization & administration , Biomedical Research , History, 20th Century , History, 21st Century , Humans , Learning Health System/history , Learning Health System/methods , Medical Informatics , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , United StatesSubject(s)
Health Personnel/psychology , Intersectoral Collaboration , Occupational Stress/epidemiology , Opioid Epidemic , Substance-Related Disorders/therapy , Humans , Licensure, Medical , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Occupational Stress/psychology , Occupational Stress/therapy , Opioid Epidemic/prevention & control , Organizational Culture , Substance-Related Disorders/epidemiology , United States/epidemiologyABSTRACT
The research and development (R&D) ecosystem has evolved over the past decade to include pandemic infectious diseases, building on experience from multiple recent outbreaks. Outcomes of this evolution have been particularly evident during the COVID-19 pandemic with accelerated development of vaccines and monoclonal antibodies, as well as novel clinical trial designs. These products were developed, trialled, manufactured, and authorised for use in several countries within a year of the pandemic's onset. Many gaps remain, however, that must be bridged to establish a truly efficient and effective end-to-end R&D preparedness and response ecosystem. Foremost among them is a global financing system. In addition, important changes are required for multiple aspects of enabling sciences and product development. For each of these elements we identify priorities for improved and faster functionality. There will be no better time than now to seriously address these needs, however difficult, as the ravages of COVID-19 continue to accelerate with devastating health, social, and economic consequences for the entire community of nations.
Subject(s)
Global Health , International Cooperation , Pandemics/prevention & control , Research/economics , Research/organization & administration , Humans , Models, OrganizationalABSTRACT
In 2016, in anticipation of the US presidential election and forthcoming new administration, the National Academy of Medicine launched a strategic initiative to marshal expert guidance on pressing health and health care priorities. Published as Vital Directions for Health and Health Care, the products of the initiative provide trusted, nonpartisan, evidence-based analysis of critical issues in health, health care, and biomedical science. The current collection of articles published in Health Affairs builds on the initial Vital Directions series by addressing a set of issues that have a particularly compelling need for attention from the next administration: health costs and financing, early childhood and maternal health, mental health and addiction, better health and health care for older adults, and infectious disease threats. The articles also reflect the current experience with both the coronavirus disease 2019 (COVID-19) pandemic and the health inequities that have been drawn out sharply by COVID-19, as well as the implications going forward for action.