The top healthcare stories of 2021
Here were the stand-out topics from Connections by athenahealth in 2021:
Vaccination efforts encountered starts and stalls
Despite vaccinations becoming available for front-line workers at the end of 2020 – and more widely available in early 2021 – they were met with more hesitation than expected. The result was one of the country’s most dynamic public health efforts ever, which spanned from grassroots communication efforts to strategic call and email campaigns. Tools like athenahealth’s Consumer Scheduling relieved some of the scheduling burden from healthcare workers and put the power in the hands of patients. Cloud-based EHRs empowered clinicians to swiftly stand up testing and vaccination in novel facilities such as parking lots and sports arenas, and to quickly deploy resources to localized pandemic flare-ups – particularly impactful now with new variants like delta and omicron.
The pandemic spotlights the need to bolster and enrich immunization information systems, which have lagged behind health information exchanges and EHRs in enabling access to vital population data on the impacts of vaccination.
A new White House administration continued to push progress
President Joe Biden and the 117th Congress continue “unprecedented advancements” in healthcare regulations that increase access to health information systems for patients, clinicians, payers, and more. The 21st Century Cures Act was signed into law by President Barack Obama in 2016 but not fully implemented until 2021. The regulations provide a technological framework for increasing that access and expand the boundaries of what medical information has to be shared with whom and when. This gives patients unprecedented insights to their own medical information (i.e., as more portable records on their smartphones instead of through portals). The growing importance and innovation surrounding digital vaccination passports could open the door even further for more verifiable, interoperable clinical information across the healthcare continuum.
The pandemic turned up the spotlight on the social determinants of health
Virtual care gave clinicians the most unfettered access into their patients’ homes that they’ve ever had. From food access to hygiene challenges and mobility woes, the healthcare community learned even more about why patients often can’t make progress toward their health goals until their social needs are met.
Across the U.S., systemic barriers like lack of insurance, limited finances, and poor health literacy bar those who need preventative care the most from getting it. athenahealth research surrounding high-risk patients – classified as those with two or more chronic conditions, such as diabetes or heart disease – finds that the pandemic can increase that susceptibility without the right social supports in place.
In the coming months and years, expect more of a focus not on symptoms but on systems. Value-based care models, care managers who can access community-based resources to meet patients’ social needs, and personalized outreach and support are all methods to target those who need help the most.
By choice and by necessity, telehealth showed that it’s likely here to stay
Beginning with the pandemic declaration in March 2020, virtual health helped mitigate declines in appointment volume. The mainstreaming of telehealth has continued through 2021, thanks in no small part to payment parity rules from CMS (Centers for Medicare & Medicaid Services) that were adopted by most private payers. CMS also expanded the list of healthcare professionals who can provide virtual care and grown the scope of practice of some healthcare occupations such as medical assistant. The move not only eases the burden on clinicians struggling with the ongoing needs of the pandemic and burnout (see below), but helps expand patient access to medical services.
In November 2021, CMS announced the extension of Medicare reimbursement to clinicians for several telehealth services through 2023 – instead of merely through the declared public health emergency – an indication of more permanency for new modalities of healthcare delivery.
COVID pushed healthcare burnout to its tipping point
Due to many factors like administrative work and regulatory measures, clinician burnout was already a significant issue prior to the pandemic. But added stressors like financial woes resulting from reduced patient volume and the threat of mergers and acquisitions pushed many medical professionals to the brink.
Despite an ongoing provider and nurse shortage in the U.S. – making these professionals highly in demand – two years on the frontlines have pushed swaths of healthcare workers to consider leaving medicine altogether. They’re not alone: Healthcare administrative workers are also dealing with severe staffing and retention challenges, as seen in a 2021 athenahealth survey. By and large, their feedback surrounding such issues as the direction that healthcare is moving and attitudes toward technology trend more positively than clinicians’. But as COVID-19 rages on, lucrative hiring bonuses lure workers to and fro, and retirements ripple throughout the healthcare continuum, it’s uncertain how clinician and healthcare staff sentiment will change in 2022.
The demand for mental health services remained strong
In 2021, COVID-19 continued to contribute to increases in the demand for mental health services. Patients presenting with anxiety, depression, sleep problems, and substance use disorders often cited the pandemic as a primary cause of their distress.
But who is diagnosed and at what rate often varies according to ethnicity, gender, and age, athenahealth research finds. Data show that white Americans were significantly more likely to be diagnosed with either anxiety or depression than Black, Hispanic/Latino, or Asian patients.
What holds promise, however, are different modalities like virtual care that can help expand access to services while also helping address staffing challenges. Across the athenahealth network, mental health averages the largest percentage of appointments held via telehealth across all specialties – 33 percent according to research published mid-year. At organizations like Esperanza Health Centers in Chicago, Director of Behavioral Health Services Jessica Boland says the increased pandemic-related demand for services prompted hiring several new clinicians. She had more “bargaining power” to do so because those clinicians were offered flexible schedules and didn’t have to commute five days a week because they could hold virtual appointments. Clinicians’ productivity scores have also increased since Esperanza began offering virtual behavioral health services.
Any measure that enhances productivity and access while reducing stressors that can lead to burnout helps address many of healthcare’s most common challenges from 2021.
Read more about top healthcare predictions for 2022 here