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Social Determinants of Health: COVID-19 and Beyond

Often, it takes a crisis or other significant disruption to draw attention to societal shortcomings and needs – and the COVID-19 pandemic has been no exception.

From inadequate plans for remote work to confusion surrounding medical coding and supply chain disruption, a number of issues have cropped up in the wake of this unprecedented scenario.

One such underserved area of healthcare is the social determinants of health – in other words, how social factors affect an individual’s ability to achieve health and wellness.

The COVID-19 pandemic has brought equity of care in America into the spotlight and highlighted on a national level what the quality-of-care spectrum looks like.

Exploring health disparities across communities is not a new concept, but these social determinants, such as socioeconomic status, health behaviors and access to care, have become more visible as outcomes related to the novel coronavirus are connecting the dots on just how much your community directly affects your health outcomes.

So, why has it taken a pandemic for there to be a real conversation about the effects of social determinants of health on care and outcomes?

The answer, said Navicent Health SVP and Chief System of Care Integration Officer Dr. Reg Gilbreath, is simple – funding. Where focus is, funding goes.

While this may sound like it has a negative connotation on the surface, it’s possible that this new light being shed on social determinants of health could drive real change.

Let’s explore how.

Setting the Scene: The Impact of COVID-19

Put simply, the COVID-19 pandemic has in a short time, already reshaped the United States’ healthcare system.

And excitingly, the majority of the country’s response has been impressively quick. As Dr. Gilbreath noted:

“It’s completely changed what we do from day to day. It’s just tossed out all the old stuff, and now every project I get is something to do with COVID. So that’s phenomenal – (how we’ve) been able to change fairly quickly to managing the condition.”

Gilbreath highlighted, however, a general uncertainty about how quickly the country will return to some state of normalcy, the potential for secondary and tertiary waves of infections and beyond. He also shared his own insight about returning to more normal medical operation and performance of elective procedures.

“I think we prioritize. Obviously, the survival and medical outcomes probably take weight if you have limited resources. But, at some point, even if the pandemic continues in either low grade or moderate grade, we’re going to need to go back to cardiovascular prevention and things of that nature,” he said. “Now, that theme really resonates, because people who are at high risk for COVID actually have these chronic medical conditions which we need to be treating better, anyway. So, there is common ground that you can discover in treating COVID complications and also getting back to normal medical care prior to a pandemic.”

This overlap between the treatment of COVID-19 and conditions that exacerbate the disease could be at the forefront of beneficial change in U.S. healthcare on the other side of this pandemic.

Advancing Healthcare Practices in Response to COVID-19 and Funding Boosts

On a national level, the COVID-19 pandemic has initiated unprecedented funding and care focus on conditions and populations that, prior to the outbreak, were sorely in need of that attention.

Essentially, individuals experiencing certain social determinants of health and underlying risk factors, such as inadequate access to food and shelter, preexisting conditions and more, are at greater risk for contracting COVID-19.

This link has brought funding aimed at preventing these populations from inordinately suffering from the virus, accelerating a process that Gilbreath said was likely already in motion.

Focusing on federal grants, Gilbreath hopes Navicent is  awarded a FCC telemedicine grant to enhance their applications and management through the implementation of the COVID-19 Outcomes Impact Center to help expedite the process and impact the Coronavirus disease.

“We need to bring it up pretty quickly, get granted and bring it up to impact COVID disease” he said. “Even if COVID becomes less of an issue in the next three months, we’re still going to keep that same center to manage the same conditions going forward.”

Similarly, Gilbreath said a forced focus on telemedicine and other necessary forms of care in the face of the pandemic will likely have lasting ripple effects throughout the country’s healthcare system as providers become more comfortable with these strategies and make them a permanent part of their care offering and as a adequate reimbursement for these types of patient interactions is made available

“I think this movement is going to push patients to ambulatory surgery, virtual health, and all the things that we’ve been talking about for several years now,” Gilbreath said. “We need to move to, if you will, more appropriate levels of care that are more customer-centric, rapid turnaround times, home recovery, and expanding home health services. All of that, we all agreed, was inevitable.”

And the initiator, Gilbreath said, was funding.

“What changed was the financing. The financiers said, ‘We’ll pay for it,’ and we decided, because of that reimbursement, we can probably continue to invest in these care modalities,” he said. “But even if COVID becomes less of an issue in the next three months, we’re still going to keep that same center to manage the [chronic conditions and underserved populations] going forward.”

Looking Ahead at the Post-Pandemic Future

As the nationwide effort to fight COVID-19 rages on, thorough looks at data surrounding social determinants of health, telemedicine, preexisting conditions that could put certain patients at risk of the disease and other similar viruses in the future, and more will almost certainly drive beneficial change in the way the U.S. healthcare system treats its patients.

To learn how Navicent and Quantros have worked together to bridge health equity through quality reporting of patient data, click here.

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