Los Angeles county, like the rest of the US has hospital centric care. Even in bigger suburbs like Torrance with several large hospital systems, the pandemic brought severe disruptions to hospital-based healthcare delivery.

This year it was Covid-19 and soon it may be another virus or a catastrophe that brings more healthcare challenges in Torrance and other communities. This pandemic brought to the fore that the current health care system is not patient centric – inefficient for both patient and provider and financially unsound. In the past family physician used to treat the whole family and often drive to their home for doctoring the sick.

Today, we have Healthcare system of hospitals with ER where everyone goes for basic evaluation, testing, hospital care and surgeries. In order to prevent spread of the virus, current efforts enacted have altered the delivery of and access to healthcare across the U.S.

The impact of pandemic on healthcare:

1. Hospital care decreased by over 75%.
2. ER visits decreased by over 45% and more in some states.
3. Procedures and surgeries were reduced to urgent or emergent cases and elective procedures halted. OP surgery centers where elective surgeries are performed were non-operational
4. Gold standard treatment for acute myocardial infarction (heart attack) that has been in place for at least 2 decades of “door to balloon time less than 90 minutes” was traded for thrombolytic (clot busting) therapy.
5. Decreased traditional doctor encounters for face to face visits at outpatient clinics, as most people afraid to leave home.
6. Delayed wellness care/labs/therapy.

Also Read: Anxiety and Depression with the Coronavirus Pandemic

7. Disruption of supply of prescriptions/ medications and supplies that are essential for patients.
8. Mental and physical exhaustion by healthcare providers due to unavailability of services like home visit doctor and doctor via phone.
9. Long term management and maintenance of non-communicable disease like DM, cancer and other chronic disease was adversely affected and is expected to rise with its complications
10. Quality of in-home doctor visit for elderly care is declined
11. Rural hospitals and healthcare centers were worst affected
12. Decrease visits to outpatient clinics and diagnostic centers lead to delayed treatment and complications therefrom

Los Angeles county, like the rest of the US has hospital centric care. Even in bigger suburbs like Torrance with several large hospital systems, the pandemic brought severe disruptions to hospital-based healthcare delivery.

mHospital is a Vertically Integrated Technologically Aligned Ecosystem (VITAE) of healthcare delivery. The system is patient and provider centered and driven. The patient can choose the type of care/ service needed, how they wish to be taken care of – telehealth, outpatient or an in-home doctor visit. Patients receive care and resume daily routine without disruption. Urgent and continuity health care is rendered seamlessly round the clock. It provides referral to services, second opinions, and options for delivery of care. Healthcare delivery participants are FP, IM, NP and specialists. The system includes supportive services like PT, OT, Home Health nurse and pharmacies. This system empowers the patient and providers alike.

Also Read: Delay in Seeking Healthcare Leads to Dire Consequences

At inception of this system in 2017, there were several limitations including prevailing laws and legislation, payors and widespread public acceptance. If the patients were to stay put at their residences, get healthcare by doctors, nurses and other supporting services, hospitals would not have been overwhelmed during the pandemic.

Traditional hospitals in and outside Torrance have bureaucracy for healthcare professionals on staff and each hospital operates in a silo greatly restricting the providers, patients and healthcare delivery. This factor stacks up the healthcare challenges in Torrance. VITAE is an open source across physical and geographic barriers where patients and providers interact on a technology-based platform without resource limitation. Providers determine when, how much and in what modality they would like to work.

Therefore:

• Patients have access to more providers and vice versa
• Hospital beds are more accessible to sicker patients
• Elective surgeries/procedures are not delayed
• Established healthcare protocols based on large randomized clinical trials are continued, for example in heart attack as sited above (door to balloon time)
• Lower statistical likelihood of transmission of airborne disease – Covid-19
• Patients of all ages are most comfortable in their own environment
• Family members/loved ones are not completely isolated
• Wellness care uninterrupted with best online doctor services
• Improved and efficient ongoing treatment of patients with chronic illnesses like DM and cancer
• Decreased demand on essential preventive supplies like PPE, facemask etc
• Counseling services can be performed using technology – drug rehab, psych and AA
• Centralization of healthcare and data sharing via platforms

Once VITAE is more commonly accepted there will be legislative changes, further technological advancements, deeper reach of healthcare delivery in remote areas, decrease in resource utilization, readily available and a more equitable healthcare delivery. This, we believe, will prevent imploding of traditional hospitals and prepare the society for another unforeseen disaster.

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