COVID-19: The Great Disruptor

By Majid Tanas, PharmD, MHA, MS, VP Pharmacy, Legacy Health

Introduction

Some may argue that COVID-19 came out of nowhere; others may debate it was always on the horizon. One thing is certain – the sheer amount of disruption that has descended upon the United States healthcare system has resulted in far-reaching repercussions. Health systems across the nation cited significant financial loss at the onset of the pandemic, which highlights the antiquated system of healthcare. If nothing else, COVID-19 demonstrated that a hospital-based approach alone is vulnerable to market disruptors more than we initially realized.

Online Trend

Consumers of healthcare resources are no different than other services, with the exception that they are often consumers of necessity, rather than desire. It is no surprise that most consumerism has transitioned online. From Amazon to Instacart, many retailers have been striving towards online accessibility before the pandemic. COVID-19 has accelerated this change with the increased burden on traditional delivery care systems. Those who had existing online access could thrive in this new economy – while those who relied solely on a storefront struggled to maintain profitability. The number of retailers who began to develop an online presence in response to the pandemic was impressive as they sought to adapt to novel market disruptor trends.

Disruptor Trends

Prior to the pandemic, market disruptor trends were already evident. Services like Netflix disrupted storefront retailers like Blockbuster, purportedly over late fees. Other inventions taken for granted today, such as the iPods or smartphones, preempted the obsoletion of CDs and cassette tapes.

Unlike those scenarios, COVID-19 pushed healthcare to evaluate how to recover the financial loss. Too often, organizations look to the personnel budget cuts, rather than investigating the reason behind the lack of consumers.

The pandemic is a massive disruptor that is pushing health systems, traditionally anchored in hospitals, to shift in favor of virtual-based platforms.

Enter the rebirth of telemedicine and telepharmacy: as city dwellers migrate to the suburbs and beyond, employers must evaluate the benefit of the home office in lieu of office skyscrapers.  Organizations should assess how quickly they repurpose their workforce to respond to pressures in market trends. The pandemic is a massive disruptor that is pushing health systems, traditionally anchored in hospitals, to shift in favor of virtual-based platforms. 

Payor Trends

Insurers are also feeling the pressure of their bottom line. Recently, the Centers for Medicare and Medicaid Services (CMS) have begun to apply pressure to hospital systems via the Outpatient Prospective Payment System ruling. Alternatively, companies like AstraZeneca and Eli Lilly, have limited access to 340B medications to contract pharmacies, while other manufacturers are demanding adjudication claims to track the savings from 340B medications. The Health Resources and Services Administration (HRSA) is taking the lead to investigate the legality of these actions. Unfortunately, the majority of health systems do not have the luxury of waiting for the judicial system while keeping pace with executing their mission.

While it is a tough time to be in healthcare, it is prime time for us to consider how to adapt to these disruptors, or go the way of the VHS tape.

The Future

Pharmacy is arguably the most regulated profession in the medical field. The additional challenges of COVID-19 has created undue pressures on an already overwhelmed field of practice. This should be used to accelerate change and not wait for the change to happen.

The most imperative hurdle to overcome is the concept that our current jobs may not be solvent in the post-pandemic era. This is only the first in an onslaught of pressures on medicine and pharmacy practice. In the next decade, if the labor force for pharmacists and pharmacy technicians are downsized in favor of automation, how rapidly will the health systems evolve to accommodate for these changes?

This leads us to answer the final question: what is the future of medicine? Quite simply, less product-based services and more service quality. As pharmacies are moving away from the traditional image of “pill pushers,” we are challenged to emerge as a hub of care and service quality, at home, for our patients…our big “C” customers. COVID-19 is pushing us to change our daily habits at home – and should be doing the same for us in our place of work.