The Michigan Value Collaborative (MVC), an initiative based at the University of Michigan, published a new report on 20 April helping hospitals to plan and prioritize their operations as they gradually returned to provide non-emergency services that have been disrupted as a result of the ongoing COVID-19 pandemic.
The report was created by examining seven years’ worth of data on 17 common procedures that are being carried out in dozens of hospitals within the state and it’s made available as an open-source for the public.
Power of a data-driven guide
According to MVC’s Director, Assistant Professor of Surgery, Division of Hepato-Pancreato-Biliary Surgery at the Michigan Medicine Dr. Hari Nathan and his colleagues, the initiative has been collecting information from 87 hospitals and 40 physician groups in Michigan for many years. When the coronavirus began to spread and then spike in the US, many medical facilities are forced to cut down on clinic visits and non-urgent procedures as preventive measures to reduce the risks of infection and make room for the sudden surge of patients.
On top of which, they also have to divert a significant amount of resources on protective gears, ventilators, and intensive care unit (ICU) beds. As such, MVC utilized their wealth of data to generate customized reports for hospitals to look for patterns and deploy effort in most needed areas. Now, MVC is doing it once again but for hospitals to “get back to business”.
MVC believes these data and reports are vital because not all hospitals have the capabilities to recover immediately. For example, up to 91% of patients undergone recent coronary artery bypass graft surgery (CABGs) require ICU beds and an average of nine days inpatient stay. Only 12% of these patients will eventually be discharged back home with no additional health assistance while the majority will need to be placed either in rehabilitation or nursing centers or call for some sort of in-home help.
Thus, hospitals cannot resume all CABGs at once. They need to review each patient and liaise with relevant rehabilitation or nursing centers as well as home health aides to ensure patients will receive the kind of care they need after discharge. Apart from the allocation of resources, hospitals will also need to consider urgency for patients based on their clinical status.
Planning for the long-term
The pandemic has probably given the healthcare systems a valuable lesson on how to ration the way they render care in a way that had never been witnessed before. They have to re-learn the way they match medical support based on the complexity of patients or procedures. They may also need to relocate where certain procedures are done. At times, scarcities may also vary during the pandemic. For example, Michigan experienced a shortage of blood in March but this was eased by April.
With that, MVC hopes the guide will assist hospitals to decide what they should restart first, so they do not have to go through a post-pandemic toll. At the same time, they wish to highlight the disparity between hospitals in resources they use for the same procedures.
The guide was put together by a team of data scientists and medical experts. They promise to continue monitoring resource use in different healthcare facilities; observe the pattern of change and strategies used before, during and after COVID-19. Most importantly, since the pandemic will not go away anytime soon, it’s crucial to come up with a COVID-19 census.
This means healthcare systems will have to figure out how many resource-intensive operations can take place during a global health crisis and maintain a specific capacity to attend to those who were ill as a result. Ultimately, no care should be delayed, especially for the less urgent but medically needy cases.
The guide is available here.