COVID-19 Briefing: Impact on the Healthcare System

Our national healthcare system is on the front-lines of the COVID-19 pandemic. In this hour-long virtual meeting, Dr. Pooja Kumar and Gretchen Berlin, leaders from McKinsey’s global health care practice, shared the latest facts and forecasts on the pandemic in the United States, steps providers can take to mitigate the crisis, and the likely longer-term economic impact on the health system. Dr. J. Stephen Jones, President and CEO of Inova Health System, gave a provider view of the crisis and how Inova is working to turn the tide.

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Discussion Summary

Dr. Pooja Kumar & Gretchen Berlin, McKinsey & Company

  • The virus is still spreading globally. We are approaching 2 million cases and 200,000 deaths, although those numbers may not be reliable since there are inconsistencies in how they are counted. For example, some countries require a patient to be confirmed positive with a COVID-19 test to count their death towards a COVID-19 death total, others may count patients who were not tested but displayed COVID-19 symptoms.
  • The curve of the D.C. area’s case count mirrors that of other regions in China, Italy, and South Korea that have been hit hard by the crisis, but our count, and the overall curve, is lower—a likely validation of the social distancing measures we’ve taken.
  • The D.C. metro area is in a strong position in terms of infection rate and hospital bed availability.
  • Providers need to think about this crisis in stages.
    • First, resolve immediate challenges. Set up a “nerve center” to address patient needs.
    • Second, think about resiliency. Set up a team to track spending and manage cash flow.
    • Third, return to clinical norms. Plan for returning to routine care.
    • Fourth, reimagine the “new normal.” How will care change post-COVID?
  • Providers should be considering nine key issues:
    • Establishing tracking mechanisms and a “nerve center”
    • Managing bed capacity
      • Preparing the workforce
    • Fortifying supply chain and addressing critical shortages or gaps
    • Adapting care delivery and their clinical model
    • Communicating to patients, employees, and their communities
    • Shoring up IT infrastructure
    • Ensuring financial resilience
    • Engaging with government and other health systems
  • Healthcare providers should expect to take a financial hit while we are in the worst of the pandemic, but there will be a bump afterwards due to pent up demand. But that bump will not completely make up for lost business because not everyone will reschedule their planned appointments.
  • McKinsey identified four key themes that providers should explore when planning for the “new normal”
    • Telehealth adoption
    • Nuanced workforce management
    • Safer and more efficient approaches to clinical patient care
    • Faster and more effective organizational decision-making

Dr. J. Stephen Jones, Inova Health System

  • Inova took several steps to prepare. They stocked up on PPE to the point of feeling like they were overstocking, but now they are glad they did. They set up additional negative-pressure rooms.
  • This preparation has become a significant financial challenge. The CARES Act is helpful but it isn’t close to enough to solving the financial issues.
  • It has been inspirational to see how their teams have responded to this threat. Staff have really stepped up and excelled. Some nurses and doctors are crossing fields and learning new clinical skills to take care of patients. Dr. Jones has “gotten out of the way” to let them excel and has been proud.
  • Outreach from the community has been great – things like donated meals, chalk drawings on sidewalks, etc. send a message to care providers that they are appreciated.
  • Early on, people were warned not to come to the emergency room unless absolutely necessary. People have listened, but maybe too well—a trend he is seeing is people with serious conditions letting those conditions get worse because they are afraid to come into the hospital. People should continue to go to the hospital when they have serious health conditions that require care!
  • To get back to normal and begin reopening businesses, we need widespread testing, widespread availability of personal protective equipment (PPE), and medications for treatment. An antibody test, which can potentially identify recovered individuals who are now immune, is being studied but is not anywhere close to being ready for implementation. A vaccine is also in development and they are working as fast as they can but will not be ready until 2021 or later.