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新冠疫情下美国医疗保健系统如何创新抵抗病毒?

  • 责任编辑:siyu.zhang
  • 来源:互联网
  • 时间:2021-02-23 09:41:01

  美国新冠疫情还未平息,那么美国新冠病例的增加量是否也减少?一起和天道小编看看美国医疗保健系统的情况吧。

  大流行的弹弓:从国家危机推进到有弹性的卫生保健系统

  Melinda B. Buntin和Kristine Martin Anderson, 2021年2月22日

  新冠疫情已经过去一年了,美国仍在与这场危机作斗争。随着中国进入第二和第三轮新冠病例,我们知道它不会很快恢复“一切如常”。但是,在我们的医疗保健系统中,“一切如常”真的有效吗?

  我们俩把我们的一生都奉献给了医疗保健事业,并一直在思考它的未来。我们看到,大流行暴露了美国基础设施的严重裂缝,比如供应链挑战导致卫生保健工作者没有必要的防护装备,获得医疗服务的机会悲惨地不平等,太多美国人死于可治疗疾病,公共卫生能力因资金不足而受到限制。

  我们也敬畏地观察到关爱团队——努力应对劳动力短缺和其他长期存在的问题——不断以强大的创新、果断和协作迎接挑战。

  在这场健康危机中,我们有机会问:美国怎样才能摆脱危机,变得更强大?

  最近,我们从政府、学术界、私营部门和联邦合同部门的共同视角,考虑了这个体系的强大之处、薄弱之处以及未来的发展方向。让我们惊讶的是,我们带着一种乐观和紧迫感离开了。

  医疗保健现在正在创新

  为了保证病人、工作人员和社区的安全,一线卫生保健工作者面临着人手不足、空间短缺和供应问题等紧迫而巨大的挑战。

  通过快速、集中决策组织内,我们看到麻醉医师人不再协助与插管选择性外科手术介入帮助,心脏病专家志愿者为“超级居民”Covid-19病房医务助理从专业实践重新分配到初级护理支持慢性疾病,和当地员工找出自己在医院安全卫生保健是什么样子。

  护理团队对设施进行了改造,以适应弹出式重症监护病房,创建了临时冷却系统,以支持更多的呼吸机等。这些努力为工作过度的工作人员节省了时间,有助于减少接触,最大限度地使用个人防护设备,并促进患者治疗和安全。

  “我怎么帮你?”已经成为全国卫生系统的口头禅。即使在大流行消退之后,这种应变能力、应变能力和实时解决问题的能力对医院和其他护理设施发挥其工作人员的全部潜力和才能,推动卫生保健的未来至关重要。

  比我们想象的要快

  长期以来,远程医疗和向电子医疗记录的缓慢转变等技术的采用一直是阻碍医护人员和患者进行创新的障碍。Covid-19加速了技术的采用。与企业和学校一样,医疗保健在2020年3月也以前所未有的速度变得遥不可及。以往与远程医疗没有联系的领域,如术后随访、物理治疗和康复,都转向了远程交付,这得益于智能手机和高容量网络等技术。

  可以利用这一势头加速卫生系统其他领域的创新。电子健康记录互操作性这一顽固领域需要继续取得进展,并加快对护理提供者的认证和入职过程。系统必须利用实时数据分析和人工智能工具等技术创新。消费者除了可以方便地获得预约、实验室结果、账单和价格信息以及护理选择之外,还应该能够更好地访问远程医疗,以帮助做出更明智的医疗决策并获得更好的护理结果。

  它可以非常敏捷

  随着护理团队团结起来应对Covid-19,我们看到官僚主义减少,等级结构被压扁,筒井被打破,人才得以释放。

  这种需求催生了新的做法,比如医院和政府机构协调大规模应急计划,引导患者进入最合适的数字或物理护理渠道。它还放松了监管,促进了新的做法。例如,24个州放松或暂停法律,允许实时扩大ICU和急性护理病床,以便在紧急情况下可用。

  各州对医生、护士和其他临床医生的严格许可继续阻碍了获得护理。在医学界面临卫生保健工作者短缺的情况下,它阻碍了卫生从业人员充分实践他们的培训,并使向州外患者提供的远程医疗保健的报销变得极其复杂。使Covid-19远程医疗和远程医疗解决方案永久化,可以扩大护理团队和卫生保健专业人员的执业范围。

  过去一年,跨部门、跨机构的问题解决取得显著成效。跨卫生系统的紧急负载平衡意味着更多的人可以获得救生服务。创新的工作流程造就了有史以来速度最快的疫苗。卫生系统需要将这种灵活性和协作应用于长期的社区卫生需求,例如在低收入社区获得预防性保健的机会不平等,以及创造急需的药物。

  医疗保健的未来从现在开始

  随着我国从Covid-19疫情中恢复过来,并将重点放在其他复杂的卫生问题上——降低药物发现成本、为下一次公共卫生危机做好准备、重振我们的卫生保健队伍等等——它不能简单地倒退到“正常”状态。他说:“这场全国性的危机暴露了分歧,但也造成了协作的中断,从而改变并加强了美国的医疗保健系统。

  快速采用telemedicine-first姿态,确保患者获得医疗证明需要灵活的床和人员能力以满足病人需求上升和证明的能力进行实时动态监测、公共和私人的资源和创造性的完美结合各级产生突破性的创新可能没有发生大流行。

  当面临危机时,我们的国家公开反思危机的原因和后果,并团结起来促进变革。这次大流行也应如此。一旦案件平息,国家开始复苏,拜登政府和国会应该成立一个国家委员会来捕获、制度化、投资和加速这些创新的持续采用。这个委员会应该有三个主要原则:

  首先,它应该有权力在没有政治干预或游说的情况下做出艰难的决定,就像基地调整和关闭委员会的运作一样,确保自主做出必要的选择,有效和有效地支持美国军队。

  第二,应该给予它足够的资源来制定一份弥合差距和建设能力的国家路线图,就像9/11委员会通过制定一份彻底和可执行的报告而完成的那样。

  第三,也是最重要的一点,它必须超越这场危机,确定未来的国家投资如何在这些创新的基础上加强我们的医疗保健系统,并产生附加效应。

  我们相信,美国全球定位系统的发展提供了一个有趣的模式。这项定位、导航和定时技术的革命,最初是为支持军事任务而开发的,后来扩大到创建新的商业和服务,改变了所有美国人的生活,现在在我们日常使用的技术中无处不在。

  在一场前所未有的危机的催化下,在一个共同的愿景和一个既定的委员会的共同努力下,美国可以实现一个远比一切照旧更好的医疗保健的新未来。

  Melinda B. Buntin是范德比尔特大学医学院健康经济学教授和健康政策系主任。克里斯汀·马丁·安德森(Kristine Martin Anderson)是博思艾伦汉密尔顿公司(Booz Allen Hamilton)的执行副总裁,领导公司的民事业务,支持美国联邦民事机构。

  关于作者

  梅林达•b•恩

  @MelindaBBuntinKristine

  马丁•安德森

  linkedin.com/in/kristine-anderson-9957663/

  附上原文,以供参考,拒绝转载,侵权必删:

  The pandemic slingshot: propelling from national crisis to a resilient health care system

  By Melinda B. Buntin and Kristine Martin Anderson Feb. 22, 2021

  Ayear into the Covid-19 pandemic and the U.S. is still battling this crisis. As the country enters its second and third waves of cases, we know it won’t be back to “business as usual” soon. But was “business as usual” in our health care system really working?

  The two of us have devoted our lives to health care and to thinking about its future. We’ve watched the pandemic expose critical fissures in the country’s infrastructure, like supply chain challenges that left health care workers without essential protective gear, tragically unequal access to care, too many Americans dying from treatable diseases, and public health capacity constricted by underfunding.

  We’ve also observed with awe as care teams — grappling with workforce shortages and other long-standing problems — have continuously risen to the challenge with formidable innovation, decisiveness, and collaboration.

  During this health crisis, we have the opportunity to ask: How can the U.S. emerge from it stronger?

  With our collective perspectives from government, academia, the private sector, and federal contracting, we recently considered where the system is strong, where it is weak, and where it can go from here. To our surprise, we came away with a sense of optimism — and urgency.

  Health care is innovating right now

  To keep patients, staff, and communities safe, frontline health care workers have battled urgent and enormous challenges like understaffing, space shortages, and supply issues.

  Through swift, centralized decision-making within organizations, we’ve seen anesthesiologists who were no longer assisting with elective surgeries step in to help with intubations, cardiologists volunteering as “super residents” on Covid-19 wards, medical assistants reallocated from specialty practices to primary care to support chronic disease, and local staff figuring out for themselves what safe health care looks like in their hospitals.

  Care teams modified facilities to accommodate pop-up intensive care units, created ad hoc cooling systems to support more ventilators, and more. These efforts saved time for overworked staff and helped reduce exposure, maximize available personal protective equipment, and facilitate patient treatment and safety.

  “How can I help?” has become the mantra in health systems nationwide. Even after the pandemic subsides, this resourcefulness, resilience, and real-time problem-solving will be essential for hospitals and other care facilities to harness the full potential and talent of their staff to drive the future of health care.

  It’s faster than we thought

  Slow adoption of technology, such as telemedicine and the glacial shift to electronic health records, has been a long-cited obstacle to getting innovation into the hands of care providers and patients. Covid-19 has kicked technology adoption into overdrive. Along with businesses and schools, health care became remote at an unprecedented rate in March 2020. Areas not previously associated with telemedicine, like post-surgery follow-ups, physical therapy, and rehab, pivoted to remote delivery made possible by technology like smartphones and high-capacity networks.

  This momentum can be harnessed to accelerate innovation in other areas of the health system. Progress needs to continue in the stubborn area of electronic health record interoperability and in speeding the process of credentialing and onboarding care providers. Systems must take advantage of technological innovations like real-time data analytics and AI-powered tools. Consumers should also have improved access to telehealth in addition to easily accessible follow-ups on appointments, lab results, billing and pricing information, and care options to help make more informed health care decisions and attain better care outcomes.

  And it can be quite agile

  As care teams rallied to respond to Covid-19, we saw bureaucracy decrease, hierarchical structures flatten, siloes shatter and talent unleashed.

  Necessity fueled new practices like hospitals and government agencies coordinating large-scale emergency response plans and directing patients to the most appropriate digital or physical care channels. It also loosened regulations and facilitated new practices. For example, 24 states relaxed or suspended laws to allow the real-time expansion of ICU and acute care beds to make them available in emergencies.

  Restrictive state-by-state licensing for doctors, nurses, and other clinicians continues to hinder access to care. It prevents health practitioners from practicing to the full extent of their training at a time when the medical community faces a shortage of health care workers and makes reimbursement for telehealth care provided to patients out of state incredibly complicated. Making Covid-19 telehealth and telemedicine solutions permanent can expand the reach of care teams and health care professionals’ scopes of practice.

  The cross-departmental and cross-organizational problem-solving of the past year achieved remarkable results. Emergency load balancing across health systems meant more people could have access to lifesaving care. Innovative workflows contributed to the fastest vaccines that have ever been created. Health systems need to apply such agility and collaboration to long-standing community health needs, such as unequal access to preventive care in low-income communities and the creation of much-needed drugs.

  The future of health care starts now

  As the country rebounds from Covid-19 and focuses on other complex health issues — lowering drug-discovery costs, preparing for the next public health crisis, revitalizing our health care workforce, and more — it cannot afford to simply drift back to “normal.” This national crisis exposed fissures, but it also produced collaborative disruptions that transformed and strengthened U.S. health care systems.

  From quickly adopting a telemedicine-first posture to ensure that patients had access to care to demonstrating the need for flexible bed and staffing capacities to meet the rising patient demand and to proving the ability to conduct real-time dynamic surveillance, the combined resources and ingenuity of public and private entities at all levels generated groundbreaking innovations that might not have occurred without the pandemic.

  When faced with crises, our nation has openly reflected on the causes and consequences and come together to foster change. This pandemic should be no different. Once cases subside and the nation begins to recover, the Biden administration and Congress should empanel a national commission to capture, institutionalize, invest in, and accelerate continued adoption of these innovations. This commission should have three chief tenets:

  First, it should have the power to make tough calls without political interference or lobbying, similar to how the Base Realignment and Closure Commission has operated, ensuring autonomy in making the necessary choices to efficiently and effectively support U.S. troops.

  Second, it should be given sufficient resources to formulate a national road map for closing gaps and building capacity, much like the 9/11 Commission accomplished through development of a thorough and actionable report.

  Third, and most importantly, it must look beyond this crisis and define how future national investments can build on these innovations to strengthen our health care system and produce additive effects.

  We believe that the development of the U.S. Global Positioning System offers an intriguing model. This revolution in positioning, navigation, and timing technologies, initially developed to support a military mission, was scaled to create new businesses and services that have transformed the lives of all Americans and is now ubiquitous in technologies we use daily.

  Catalyzed by a crisis like no other and working together under a common vision and an established commission, the U.S. can realize a new future for health care that’s far better than business as usual.

  Melinda B. Buntin is a professor of health economics and the chair of the department of health policy at Vanderbilt University School of Medicine. Kristine Martin Anderson is an executive vice president at Booz Allen Hamilton and leads the firm’s civil business supporting our nation’s federal civilian agencies.

  About the Authors

  Melinda B. Buntin

  @MelindaBBuntinKristine

  Martin Anderson

  linkedin.com/in/kristine-anderson-9957663/

  Source of articles:https://www.statnews.com/

  Author:

  Melinda B. Buntin

  Kristine Martin Anderson

  以上就是新冠疫情下美国新冠病例的情况介绍了,希望对各位学子了解美国医疗保健系统有所帮助。


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