At FutureMed 2020, an online global event copresented by HIMSS and Clalit, HIMSS CEO Hal Wolf and Chief Clinical Officer Dr. Charles Alessi shared some of the lessons they’ve seen the global health community learn from the first several months of an unprecedented global pandemic.

Wolf described some lessons learned and challenges ahead for healthcare technology and innovation, while Alessi looked at the global response to the virus and pulled out some different lessons from around the world.

Blowing up the encounter-based paradigm

The COVID-19 pandemic forced healthcare organizations around the world to confront some of their own shortcomings, Wolf said, including information and interoperability gaps, as well as a general tendency to innovate slowly cautiously.

“In this pandemic, we pretty much had to blow up the classic encounter-based paradigm of health,” he said. “We had to create a situation where clinicians, physicians, nurse practitioners could in fact talk to people not inside the walls of the clinic, but to accelerate areas of telehealth and digital health communications, and we had to do so quickly. And that, frankly, is not the forte of the healthcare ecosystem. It doesn’t move quickly, and this time we had to.”

Professor Ran Balicer, founding director of the Clalit Research Institute and one of the event’s hosts, observed that the pandemic had the effect of nudging along big changes that had been waiting in the wings, as it were.

“In many organizations worldwide, and I’m sure you’ve experienced this with all of the different organizations you were working with, this was one of the most effective facilitators of changes that were long-standing and waiting to happen, and this event transformed a potential theoretical promise to something that everybody had to accept, implement and put into practice,” he said.

The challenge ahead, Wolf concluded, will be evaluating those changes, figuring out which ones to keep and how to keep them effectively, and what further changes we need to effect along roads we’ve already begun to travel.

“In the end, this is a massive change-management challenge,” Wolf said. “And at HIMSS we use the phrase ‘Be the Change,’ and we’re calling on our members to embrace this change so we can get the best out of a very difficult health situation.”

Lessons from around the world

In Alessi’s presentation, he surveyed at the responses in places like Taiwan, South Korea, Singapore, Japan, Germany and Sweden to look for common factors that led to effective management of the crisis.

The strongest takeaway was that there’s no substitute for preparedness – which was usually found in areas that had weathered similar crises in the recent past.

“There is something which is abundantly clear,” he said. “It’s that people that have had a recent coronavirus – in other words SARS, MERS, H1N1 – or events like earthquakes or volcanoes, where there was already a process to respond to emergencies, things went remarkably well compared to places where memory of how things actually work might not have been as good as we think they might have been.”

These places had procedures lined up that allowed them to “flip a switch” to make big changes, like standing up a contact-tracing operation or creating effective quarantine measures and public health messaging.

“We need to rediscover our short-term memory,” Alessi said, “because by having that short-term memory we’ll be in a far better place to manage the next waves of this pandemic.”

Later in the program, Dr. Ashish Jha, director of the Harvard Global Health Institute, laid bare the ways in which that lack of preparation and experience has hurt the response in the United States.

“The response in the U.S. is going so incredibly badly,” Jha said. “The first case of the virus in the U.S. was on January 20th, around the same time as South Korea. You could not think of two countries that have gone in more different directions. Where South Korea took the virus very seriously, built up an entire testing, tracing and isolation program, and has generally managed to keep the virus suppressed, the U.S. approach was really about denial. And in many ways it remains about denial.”

The United States suffered from several issues, Jha said, including an unusual amount of misinformation and the size and ideological and political diversity of the country.

“One of the things that’s a feature of the United States is it often doesn’t act like one country. It acts like 50 different countries,” Jha said. “So even when we had a national shut down, the bottom line is many states didn’t really end up closing.”

At the end of the day, the United States can learn many lessons from other countries, but will ultimately have to forge its own path. That path, Jha stressed, will have to start with taking the virus more seriously.

“Fundamentally for America we are at a very critical crossroads,” he said. “We have to decide as a country, are we going to take the virus seriously? Are we going to suppress the levels of the virus, or are we going to have to just learn to live with hundreds of thousands of new cases?”