Investment in the health care workforce

Health care workers have been hailed as heroes since the start of the pandemic, but “if we pray for them, we also should pay them,” says Raj Panjabi, a physician in Boston and the CEO of Last Mile Health, a nonprofit focused on strengthening public health systems through community health workers. He advocates for hazard pay and noted that until a few years ago, the World Health Organization didn’t even recognize the fact that community health workers should be paid.

Beyond paying health care workers, there’s the matter of protecting them, Panjabi stressed. The scarce nature of PPE (personal protective equipment) throughout the pandemic has been “atrocious,” he said, noting that at his well-resourced hospital in Boston, he had to reuse the same gown all day. “Imagine community health workers in India are going door-to-door without proper masks, or midwives who are trying to deliver babies and keep those essential services going in community clinics without a face shield.” He cited analysis colleagues had done that determined 450 million pieces of PPE were needed to cover about 900,000 community health workers across sub-Saharan Africa. “We’re nowhere near to closing that gap.”

Functional data tools

In the early days of the pandemic, as health care providers scrambled to get a handle on the supply of PPE, ICU beds, ventilators, and other important resources, they resorted to emailing spreadsheets and communicating, the old-fashioned way, by phone.

“People were just doing a bunch of workarounds,” said David Rhew, chief medical officer at Microsoft. “It doesn’t work efficiently that way, and it’s very, very hard to be able to draw any insights and predict what’s happening next and predict how much supply you will need.”

The health care universe, of course, doesn’t lack for data systems—but it does lack for ones that are interoperable and can seamlessly share information. It’s important for policymakers to make achieving this interoperability a priority, said Rhew.

Jessica Mega, chief medical & scientific officer at Verily, also spoke of the promise of data tools to better study and more comprehensively understand the health of patients, as her company is attempting to do with its Project Baseline.

A more accessible, patient-centered health system—and the political will to get there

Patients who use health systems regularly know well that “it’s a completely fractured health system, where the right hand doesn’t speak to the left hand. Their doctor may not know about their latest treatments,” said Alessandra Durstine, principal at Catalyst Consulting, and an advocate for patient centricity in the health care system.

With the pandemic, people more broadly have experienced this reality, and she hopes it will mobilize populations to demand better. “I’m hoping that one of the benefits of the pandemic, and of this need of the public as a whole to depend on the health system, will mean that we’ll go from having patient advocates to citizen advocates. Right now, we’re all one grocery store visit away from being a patient ourselves,” she said.

While technology, like telemedicine, is improving the system for patients, she noted that health care providers are not always compensated for adopting them. “We really have to continue to hold our policymakers’ feet to the fire,” she said.

She added, “It really does take a whole society approach to change health systems, and to make sure that everyone is protected and that their health is protected.”