Healthcare is experiencing yet another crisis – one of many that have unfolded over the past two years. It’s not omicron or any variant of the coronavirus: this crisis is a shortage of workforce. While it has been compounded by the deferral of care as many Americans delayed appointments because of uncertainty and limited access due to the pandemic, this crisis is truly about workers: physicians, providers, technicians, nurses, housekeeping staff, and others essential for patient care. Like many of the other crises that healthcare has seen lately, this one seems like it may last for a while.
The healthcare workforce shortage lays bare a fundamental issue in our healthcare system: we use people as the ultimate workaround to navigate all of the challenges of making appointments, coordinating care, paying for care, and communicating. This reliance on human resources – and the current shortage of that resource – predisposes the system to errors and increases costs because the underlying system is so complicated. However, there are solutions that we can implement to solve this crisis:
- We should automate everything we can: appointment scheduling, appointment cancellations, requests for medical records, and updating insurance information are all readily automated by technology. They require investment and change management but they should be achievable. Medication renewal should also at least be partially automated: it seems straightforward that patients should be able to click on their current medication list and automatically request a refill that would go straight to a physician or appropriate provider. Patients should have access to their records without having to go through cumbersome unresponsive medical records processes: records should be easily available through their portal.
- Our payment processes need revision. Patients should be able to see and understand what is covered and what is not in real-time, and plans need to be less complicated.
- Third, to paraphrase Warner Slack, the patient is the most underutilized part of our system. Patients are both engaged and interested in managing their own health and we probably need to trust a little more of that management to them. This begins with basic health literacy that should be taught in elementary school and should include a “Drugstore curriculum” of what is available over the counter and how OTC treatments should be used. Trying to navigate the multitudinous products, many of which have similar ingredients in different combinations, is overly challenging and complex but can be taught, and better educational materials could be available right near those sections to help people navigate their choices. We should allow patients to update their medications before their visit, highlight their pharmacy and even transmit questions they may have ahead of time, instead of asking our medical assistants to do so after the patient arrives.
We will have to train more people and make it more appealing to come into healthcare; it’s an amazing job with Incredible rewards and satisfaction. But that won’t happen overnight, and in the meantime, we are going to have to work with what we have and streamline as fast as we possibly can. Much good will come from that if we can find the room in this crisis to change with an eye to the future.