Impact Of COVID On Healthcare


Written by Ian Diener, MD, MBA, FAAFP
Presented by Coding & Billing Solutions, LLC

The stress of the COVID crisis will cause many paradigms shifts in the provision of health care. These paradigm shifts will impact primarily the methodology of the doctor-patient encounter, the role of inpatient medical facilities, and preventative health care.

The first paradigm shift will impact the traditional doctor-patient relationship. Many of the technologies utilized during this crisis will become the norm in medical care.  Telemedicine, telemonitoring, and “cell phone” medical interactions will be used in most of the minor medical care.  A technology review and update of your facility should be performed.  To prepare for this shift, offices will also need to put into place billing procedures allowing for prompt reimbursement of these services.  I predict an increase in overall patient encounters with providers.  When a new patient enters the practice an introduction packet should be supplied consisting of precise instructions for care access, a consent for telemedicine and telephone services and a financial agreement for payment.  Medical Insurance companies and credit card companies could develop joint payment protocols to pay for medical services. 

The next paradigm shift will be the role of the in-patient hospital during an emergent health crisis.  Numerous hospitals have closed in America leaving us with practically no place to house sick individuals during a medical crisis.  Few hospitals have had sufficient personnel and supplies for a disaster of this magnitude.  This lack of medical preparation was primarily the result of economic constraints due to lower reimbursements and more stringent control of insurance reimbursements.  Admissions were denied and downgraded with regularity.  Appeals were rarely successful. The new normal will be expandable hospital facilities with a plan for increased availability of beds when the need arises.  A contingency force of medical workers such as nurses nursing assistants, and lab technicians should be developed.  The workforce could be hospital initiated or a corps like the National Guard, activated only when necessary but with a regularly scheduled training and mustering each month.   A dedicated emergency fund subsidized by the government will need to be created to provide the resources. Financial incentives would be awarded to members of this corps as well as continued education to maintain their skills.

The third paradigm shift will be a change in our attitude towards preventative health care.  Flu shots should be mandatory for individuals participating in public activities.  Other vaccinations should be up to date.  The conditions which led to increased vulnerability during the pandemic should be addressed in the general patient population.  Obesity, smoking, poor care for chronic conditions such as diabetes, hypertension, and heart disease should be evaluated by routine medical visits and followed electronically by the provider to ensure a good outcome and compliance.  Every patient should be assigned a risk index for susceptibility to various illnesses.  This index would be based on diagnoses, attainment of therapeutic goals, voluntary adverse behavior such as alcohol, drugs, tobacco, and participation in dangerous activities, and the overall patient compliance with medical treatment.  This process will also help providers determine the risk of their patient population for insurance purposes.

All medical providers should undergo an assessment of their preparedness for a crisis and develop a set of recommendations for improvements and suggestions for attainment of best practices.

Dr. Diener Expertise:

  • 20+ years Family Medicine Physician (Internal and Pediatrics)
  • Physician education/consulting with Intellis, Berkeley Research, and IOD Incorporated
  • Adjuncts medical staff LVHN -Family Medicine
  • Intellis, CMO and consultant
  • Physician Advisor LHVN
  • Speaker National HIM meetings
  • Advisor and consultant Medalagroup
  • ICD10CM physician education
  • Education for Clinical Documentation Specialists
  • Development of Wellness and Integrative Medicine Options


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