By this point, it is something of a cliché to describe 2020 as “unprecedented,” particularly in healthcare. Not only was the system overloaded with COVID-19 patients, providers also had no roadmap for providing standard care without exposing patients to the disease. And we are all still working to process the sheer magnitude of the loss of life and livelihood that has defined 2020 for so many Americans, even as we grapple with the issues of healthcare access and equity laid bare by the global pandemic.

Amid the chaos, healthcare organizations found innovative ways to care for patients while keeping them safe from the pandemic. Through virtual care, mobile apps, patient engagement, and sheer perseverance, providers and practices remained committed to protecting the health of their patients and their communities.

Throughout 2020, athenahealth covered these trends and more, focusing on the lessons learned that will define the next stage of evolution in the healthcare ecosystem.

Here are our top stories from 2020.

1. Dr. Patrice Harris shares her vision for a thriving healthcare ecosystem

COVID-19 highlighted many cracks in the current healthcare system, calling attention to the inequities and imbalances that have existed for years. At Healthcare’s Next Act, athenahealth’s two-day conference on the future of healthcare, Dr. Patrice Harris, former president of the American Medical Association, laid out her vision for a broader definition of healthcare: an interconnected ecosystem linking multiple stakeholders throughout the community and focusing on health rather than treatment.

2. The less we get together, the healthier we will be

Data from the athenahealth network show that social distancing measures and increased focus on hygiene resulted in a dramatic decrease in cold/flu symptoms (like sore throat) when compared to the same time in 2019. However, it is no surprise that there has been a significant year-over-year increase in COVID-19 symptoms like abnormal breathing and loss of taste or smell. Whether this represents an increase in COVID infections or reflects that patients are just more likely to seek care for these symptoms remains to be seen. In either case, it is clear that COVID concerns are impacting patient behavior, including increased demand for flu vaccinations, especially for children.

3. 5 apps to make patients’ lives easier

2020 stressed just how important it is to be able to reach and connect with patients outside of the exam room, and just how crucial the right technology can be to achieving that goal. Technology companies are working hard to offer mobile and web apps that make it easier for patients to engage in their care wherever they are. From online scheduling to remote monitoring, to filling out pre-op paperwork from home, these tools are saving patients time and effort, and helping keep them healthy.

4. Information Blocking Rule 101: Just the beginning of connecting the dots to enable true interoperability

The 21^st Century Cures Act came into effect in 2020, designed to increase patient access and choice in healthcare. With some provisions taking effect as early as November 2020, the law means that if a healthcare provider requests patient data from any other healthcare entity, they have to provide it. The intended result is that patients can more readily choose the best, most cost-effective care as they will be able to obtain and transfer their medical records at no cost. And healthcare organizations can choose the best technology tools to support care without being held hostage by technical barriers. It may not be flashy, but this regulatory change has the potential to increase cost transparency and improve outcomes throughout the healthcare ecosystem.

5. The athenahealth COVID-19 dashboard: High-risk patients

Older people and those with certain underlying conditions like diabetes, cancer, or chronic lung disease, are at higher risk of severe illness from COVID-19, according to the Centers for Disease Control (CDC). These high-risk conditions are not evenly distributed throughout the country. To identify where patients at greatest risk are concentrated, athenahealth is pulling data from our national network to create this near-real-time dashboard. When combined with information regarding available health resources, this data can have significant implications for the distribution of tests and personal protective equipment and the allocation of healthcare investment.

6. Thriving on the frontlines: Stories of resilience and resolve

This five-part video series documents stories of athenahealth customers who found (and are still finding) ways to engage patients and support caregivers to provide high-quality care in a pandemic world. With a focus on building resilient relationships, organizations like Steward Medical Group and Cahaba Medical Care share their innovative and very human stories of staying connected to patients during a global crisis.

7. Expert Forum: COVID-19 puts new spotlight on value-based care transition

In addition to concerns about access to care, the global pandemic highlighted significant financial vulnerabilities within the system. As visit volumes plummeted, many practices struggled to cover operational and administrative costs. Value-based care models provided a buffer to some organizations, with a focus on patient outcomes rather than volume. Executives from three healthcare organizations, with varying levels of risk in their patient panels, discuss how virtual check-ins, targeted patient outreach, and chronic care management tools can protect healthcare organizations against future systemic shocks and lead to better patient outcomes.

8. Pandemic Pivot: Providers turn to telehealth to keep practices running

By now, more patients than ever have experienced a virtual visit. When COVID-19 pushed practices to avoid non-urgent in-person visits, almost as one they turned to telehealth tools to preserve continuity of care — many for the first time. Encouraged by the Centers for Medicare and Medicaid Services with more lenient telehealth regulations and reimbursement parity, 26 percent of primary care visits were virtual between March and July of 2020. Data from the athenahealth network show that, mirroring the COVID-19 outbreak, practices in the West and Northeast were the biggest telehealth adopters. Additional analysis indicates that primary care and mental health work particularly well through virtual care. The data offer lessons that can provide a blueprint for how telehealth can and should be used in the future.

9. Female primary care physicians spend more time with patients for less pay

It has long been known that there is a gender pay gap in medicine, with female physicians earning 8 to 29 percent less than male physicians. Whatever other factors may be at work, this study, published in the New England Journal of Medicine, uses timestamp data from athenahealth’s network to prove that it is not because female primary care physicians work fewer hours. On the contrary, female PCPs are conducting longer visits, documenting more diagnoses, and spending more time with patients overall. Although they do bring in less revenue than their male counterparts in a fee-for-service world, that may be very different under value-based care models focused on outcomes rather than visit volume.

10. COVID-19 spurs innovation across the healthcare ecosystem

Along with the undeniably terrible impact of COVID-19, the pandemic has driven healthcare organizations and partners to rethink the way they care for patients and run their practices. Paul Brient, athenahealth’s senior vice president and chief product officer, shares how this crisis has inspired practices to take a more holistic approach to patient care, focusing on risk-based outreach and between-visit health tracking. This thinking has given rise to innovative new care models that put the patient at the center. And technology partners are working to enable this focus by reducing clinical and administrative work with options like robotic process automation and automated clinical decision support. Out of the crucible of catastrophe may come the connected thriving healthcare ecosystem we all deserve.