Out of adversity comes opportunity: COVID-19 and the future of healthcare
Healthcare authorities were right at the forefront of the COVID crisis. It was a torrid time, but with it came lessons that have the potential to change care provision for the better – if momentum can be sustained. During at Global Government Forum webinar, public health experts discussed the future of healthcare focusing on digital transformation, international collaboration, and mental health
The coronavirus pandemic upended healthcare systems around the world, requiring hospitals and medical professionals to cope with the huge influx of patients, and governments and agencies to scramble to enable virtual appointments and other digital health services.
Now, many countries are facing up to a backlog of tests and treatments. But they also have a greater understanding of the role of digital technology in creating a more accessible healthcare system.
During a Global Government Forum webinar, government health officials from Canada, Estonia and Israel discussed rebuilding healthcare provision post-COVID and what can be done to futureproof the sector.
Here, we present the best bits of the conversation, with accompanying clips.
Natalie Verdon, director of digital solutions & border strategy at the Digital Transformation Branch of the Public Health Agency of Canada, began with an overview of the agency’s role in protecting travellers to Canada and minimising disease transmission during the pandemic, with a focus on the successes and failures of associated digital programmes.
There was what she described as a “mad scramble to synthesise tools that would meet the new digital needs of the remote government using pre-existing and available resources”.
What was quickly realised was that the government’s existing online infrastructure was unable to support the capacity needed to run the required public health programmes and the digital transformation needed to deliver it.
Data sharing was one of the hurdles. As Verdon explained, “there were gaps in existing data-sharing and retention policies, as many of them were written with the expectation that the data was immutable”.
Data feeds of border crossings were coming in from various agencies and from different levels of government, each governed by different policies and standards which meant they couldn’t be easily integrated, leading to “huge data delays”.
In addition, it became clear that people were confused about where they could access the forms required to enter Canada, in part because there was not one single source of traveller information.
While Verdon acknowledged these negatives, there were positive actions to have come out of the pandemic. These included a partnership between the Public Health Agency of Canada and the Canadian Border Services Agency, which meant they could more easily share and integrate data; and the public health agency’s work with five major labs whose testing data was received digitally and matched to traveller records, reducing wait times.
And there are more innovations to come. Verdon explained that Canada is “moving forward with plans to develop a next generation case management system through electronic traveller health information”, with several solutions currently being considered.
“We understand how much we require other government partners and departments to be able to move us forward,” she said.
Nele Labi, deputy secretary general, innovation policy at Estonia’s Ministry of Social Affairs – who is responsible for integrating social services, healthcare and employment programmes – shared how the country’s advanced digital government had responded to the crisis.
She began by emphasising the impact the pandemic had had on the population’s wellbeing. Showing the audience an infographic representing Estonia’s progress on national strategic goals, she highlighted that since the pandemic, life expectancy had gone down and avoidable and preventable deaths had risen, as had cases of suicide and mental health and behavioural conditions.
Moving on to talk about Estonia’s digital health system – which was fully digitalised prior to the pandemic and included a patient portal for digital prescriptions, for example – she said the COVID acted as a test period for the system.
One of the few things that was not digitalised before 2020 was doctors appointments – “we valued human contact there”, she said – but when COVID hit, virtual appointments had to be stood up fast.
Other learnings revolved around digital COVID certificates – Estonia introduced its own but, when the EU launched its certificate a month later, had to work to revise it – and around integrating datasets that it hadn’t considered merging before. For example, the government needed to understand nursing home patients’ contacts and which personnel worked in more than one healthcare institution. “Getting this cross-domain data was a challenge,” Labi admitted.
She concluded her opening comments by saying that facing multiple crises at once – the pandemic, the war in Ukraine, which saw an influx of refugees, and the energy crisis – all of which affected the healthcare and social sectors, meant that approaches had to be multifaceted.
“You can’t really prepare by integrating [only the] medical sector possibilities – we have to integrate along different domains,” she said, adding that this means difficult decisions are having to be made around prioritisation.
The government is “refiguring everything”, she said. “COVID shifted the funding of the medical sector and somehow we have to deal with the backlog. We can’t do everything at once, so everything is on the table again.”
Adam Cutler, deputy director for international affairs at Israel’s Ministry of Health, explained how the Israeli healthcare system promotes digital transformation and meant the country was well-placed to avoid a backlog in medical procedures during the pandemic; the need to rebuild public trust; and the importance of international cooperation.
The Ministry of Health acts as a regulator for Health Maintenance Organizations (HMOs), or ‘sick funds’, that provide universal care for the country’s residents. HMOs compete with each other for members, putting a focus on customer service and accessibility, which has driven up digital transformation in the sector. Each HMO has an app and an electronic medical record system that is compatible across the national health information exchange.
“That was particularly useful throughout the pandemic,” Cutler said, but “what we didn’t have was the interconnectivity to serve real-time data gathering on a national scale”.
This needed to be developed to create “real-time situational awareness for decision-makers. At the beginning of the crisis, we were gathering data through phone centres and calling up each health facility. Towards the end, it was mostly automated”.
Another major consideration was preventing a significant backlog in care. This involved early enablement of virtual doctors appointments (the infrastructure was already in place but regulations had to be adjusted to facilitate them), and an approach to planned surgeries that many other countries were unable to adopt.
In Israel, with the exception of the first lockdown, hospitals weren’t prevented from performing elective surgeries and procedures as long as they maintained spare capacity for any changes in the direction of the pandemic. As such, waiting times for health services are back to where they were prior to the pandemic.
Cutler said that to truly recover from the pandemic and build a system that is better prepared for future shocks, a focus on public trust was required.
“That’s not to say that we’ve betrayed public trust, I think we made the best decisions that we could with the information that we had as we went through the pandemic – all countries did. With hindsight, I’m sure there are some decisions we would change, but for the most part, decisions were made in good faith.
“That said, the restrictions took their toll on the economy, on people, on relationships, and on mental health. And all of that causes an erosion in trust. We need to rebuild that – to pay attention to growing anti-vax movements, and to be responsible stewards of the public’s trust going forward.”
As for now, Israel is working to build cooperation among countries to develop an early warning system for a pandemic or similar event with available tools. This includes situational awareness capabilities, real-time data collection and the agility to make and implement decisions quickly.
“It will include the ability to innovate quickly and roll out innovations in the field and to share information internationally, which is absolutely critical in foreseeing and giving yourself a little bit of time to prepare before a new pandemic arrives.”
In the Q&A section of the webinar, panellists answered questions about how health departments and authorities should keep digital transformation momentum going; how governments can ensure data gathering and analysis is done to best advantage; how you ensure quality of care and accessibility as remote health services continue; AI in healthcare and what that could mean for capacity; and a deeper dive into international collaboration, reducing backlogs and trust building.
Ending with a question on what the panellists hoped for the future of healthcare, Verdon said she’d like to see rapid response times, more information sharing nationally and internationally – with the appropriate policies and procedures in places to do so safely and securely – more transparency, and evidence that governments’ efforts to regain public trust were paying off.
Labi and Cutler said they’d like to see a shift from reactive to preventative healthcare, done in part through use of early detection tools which are already available and developing.
Cutler finished on a note about mental health, pointing out as Labi had earlier in the discussion that the pandemic had emphasised the need for better mental health management. His hope is that in future, “physical and mental health [are treated as] one package and addressed accordingly”.
To learn all this and more, you can watch the full The doctor will see you now – future of healthcare post-COVID – webinar on our dedicated events page. The webinar, hosted by Global Government Forum, was held on 13 June 2023.
About Mia Hunt
Mia is a journalist and editor with a background in covering commercial property, having been market reports and supplements editor at trade title Property Week and deputy editor of Shopping Centre magazine, now known as Retail Destination. She has also undertaken freelance work for several publications including the preview magazine of international trade show, MAPIC, and TES Global (formerly the Times Educational Supplement) and has produced a white paper on energy efficiency in business for E.ON. Between 2014 and 2016, she was a member of the Revo Customer Experience Committee and an ACE Awards judge. Mia graduated from Kingston University with a first-class degree in journalism and was part of the team that produced The River newspaper, which won Publication of the Year at the Guardian Student Media Awards in 2010.
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