Designing healthcare for a post-pandemic world

The third Midwest Healthcare Conference was held August 17, 2023, at the I Hotel and Illinois Conference Center in Champaign. Sponsored by Gies College of Business and the Carle Illinois College of Medicine, the theme of the conference was: Learning from COVID-19 and Managing Healthcare Beyond COVID with a special focus on social healthcare delivery to underserved communities.

“The COVID-19 pandemic has changed the way we think of healthcare delivery,” said Ujjal Mukherjee, associate professor of business administration and co-director of the conference. “COVID had a disproportionately higher impact on rural and underserved communities,  Therefore, the experience of the COVID-19-related disruption in healthcare delivery has renewed the focus on healthcare delivery to underserved communities. We believe we are in an opportune moment to learn from the pandemic and shape the future forms of healthcare systems grounded in our collective pandemic experience.”

The subthemes of the workshop were, (i) Reimagining public health by strengthening primary healthcare and community-based health systems while addressing social determinants of health that contribute to health inequities. For example, implementing community health worker programs to increase access to healthcare services for underserved populations. (ii) Leveraging digital technologies and data to improve health outcomes and health equity. For instance, using telemedicine to reach rural and underserved communities, thereby increasing access to healthcare services, and employing big data analytics to identify and address healthcare disparities. (iii) Crowdsourcing healthcare by engaging communities to promote health literacy and health equity. Moreover, crowdsourcing healthcare data could lead to fast-track algorithmic innovation. (iv) Examining healthcare supply chains in a post-covid world to improve their resilience and responsiveness. For instance, analyzing the vaccination process to identify bottlenecks in the supply chain, and developing strategies to secure essential medical supplies to be better prepared for future crises.

The workshop consisted of several academic and industry presentations with significant learning and impactful insights. Mukherjee opened the conference with a summary of the progress in healthcare research after the past year, such as advancement of research on the SHIELD testing program at K-12 schools, renewed funding for research with SHIELD testing data from K-12 schools, Jump Arches funding to work with OSF healthcare to conduct field experiments on implementing rural kiosks for rural and underserved healthcare delivery, and several collaborations with industry partners. Mark Cohen, dean of Carle Illinois College of Medicine, and Mark Peecher, executive associate dean of faculty and research at Gies, emphasized the need for a multi-disciplinary and collaborative approach toward healthcare delivery. The keynote address was delivered by Sameer Vohra, Director of the Illinois Department of Public Health, and Arti Barnes, Chief Medical Officer of the Illinois Department of Public Health. The keynote address stressed the role of public health spending and investment in ensuring public safety and preparedness for any future pandemics.

Several other important insights and focus emerged from the presentations and discussions during the conference, as follows:

• Professor Anita Tucker of Boston University and Minje Park of Columbia University presented their findings on the behavioral impact of COVID-19 on stockpiling of pharmaceutical drugs and its impact on subsequent shortages and price increases. Predicting and incorporating such behavior in policy decisions such as healthcare resource allocation and rationing is important for managing the secondary impact of pandemics on healthcare delivery.
• Professor Sebastian Souyris of Rensselaer Polytechnic Institute presented a collection of research work on policies for mitigating pandemic impact on public health. The primary insights are related to the important role that regular testing at educational institutions plays in ensuring the safe reopening and functioning of the institutions. The findings of this research focus on the behavioral patterns observed in response to public policy measures such as Test-to-Stay (TTS) programs promoted by the CDC. The key finding is that the opt-out-based TTS implementation policy, as compared to the opt-in implementation policy, led to a significantly greater school-level testing rate, and consequently, significantly lower test positivity. This difference is because of status quo bias among the population. In general, the effectiveness of policy measures depends largely on how individuals and populations behave in response to such policy options, an important learning that should be better investigated, understood, and incorporated into future healthcare policies.
• Along similar lines, Professor Ian Larkins from UCLA emphasized the important role of vaccine mandates in ensuring the safety of employees and patients of healthcare delivery institutions during public health disasters such as COVID-19.
• Professor Selva Nadarajah from the University of Illinois-Chicago spoke about the importance of sustainability in healthcare organizations and ensuring reduced carbon emissions from healthcare services for environmental reasons.
• Professor Pengyi Shi of Purdue University presented their study with a large hospital system in Indiana on addressing the nurse shortage. She demonstrated that dynamic sharing of nursing capacity across different hospitals can significantly improve the capacity, utilization, and efficiency of healthcare services.
• Along similar lines, Professor Sandeep Rath of UNC-Chapel Hill presented the role of optimizing healthcare resource utilization in surgical care to reduce waste and improve the costs of healthcare.
• Gies Professor Mili Mehrotra and her PhD student Xueze Song presented their study on managing clinical studies efficiently to maximize the success of innovations in the pharmaceutical industry.
• Professor Iva Rashkova from Washington University focused on the role of improved budget allocations for public policies related to food safety and healthcare delivery.
• One key challenge faced by the population was significantly increased levels of adverse behavioral health instances and issues. To address this issue, a study by University of Minnesota Professor Kingshuk Sinha and his PhD student Yi Tang demonstrated an innovative technology application (mobile Chatbot) to help identify and treat healthcare issues among the population.
• Professor Bhupinder Singh Juneja of the University of Minnesota focused on the allocation of vaccines and improving the enablers of the last-mile logistics of vaccine delivery to ensure improved and equitable vaccination coverage at a population level. The talk focused on the effect of the enablers of the last mile of vaccine supply chains along three dimensions: logistical connectivity, delivery infrastructure, and informational connectivity.
• Andy Allison of the Illinois Department of Healthcare and Family Services focused on the role of data analytics and AI in improving healthcare delivery through public programs such as Medicaid services.
• Along similar lines, Roopa Foulger of OSF Healthcare emphasized the role of personalized and compassionate care to a diverse population to improve outcomes from healthcare delivery. Her talk focused on how data-driven insights can enable healthcare professionals to adapt their practices to meet individual needs, ensuring equitable and effective healthcare delivery for all.
• James Parker of the Office of Medicaid Innovation at the University of Illinois spoke about the important role of efficient and effective ways to incorporate community health workers into health care delivery and the importance of alternative and innovative payment methodology for primary care to practice redesign, particularly for the underserved communities.
• Similarly, Rajesh Rangaswamy of Accenture emphasized the vulnerabilities of the current healthcare practices and systems that have been adequately highlighted by the COVID-19 pandemic. His talk focused on examples and strategies for building resilience in healthcare delivery systems of the future in a post-pandemic world.
• The workshop ended in a panel discussion coordinated by Gies Professor Sridhar Seshadri that included Sinha, Gies Professor Ron Watkins, Lee Kuhn of Claro Healthcare, Professor Rodney Parker of Indiana University, and Professor Ian Brooks of UIUC. The discussions focused on the role of allocation and implementation of low-cost ICU capacities to address the challenges of future pandemics and general healthcare delivery in a post-pandemic world. ICU capacity played a major role in ensuring reduced risks of mortality from healthcare disasters like COVID-19. However, the current ICU capacity is not sufficient and not accessible to a wide section of the population, particularly by individuals belonging to underserved communities and races. Therefore, future healthcare should focus on affordable solutions such that they become accessible to most of the population. The combination of technological solutions such as telehealth and affordability will be an important focus of the future.
• The concluding remarks of the healthcare workshop were delivered by Professor Amy Wagoner of Carle Illinois College of Medicine and Professor Carlos Torelli of Gies College of Business. Both focused on building research programs around the primary topics that emerged from the workshop.

In summary, several important directions that emerged are related to the use of innovative and affordable technological solutions to improve healthcare capacity and accessibility, incorporation of behavioral considerations in healthcare policy-making and delivery, optimization of resource allocation that takes into account socio-economic and demographic diversity of populations, and innovative social healthcare delivery that considers both the costs and accessibility of healthcare to a wide section of the population. Another important focus is on distributed data availability, analysis, and AI in healthcare delivery of the future. A coordinated and collaborative approach is important for meeting the challenges of healthcare delivery of the future to a diverse and distributed population. To carry forward, aggregate, and disseminate the insights generated from the workshop, the organizing committee of the workshop is trying to publish a book volume based on the proceedings of the workshop.