These are unprecedented times, and as professionals dedicated to creating and using evidence to improve health and health care for all, the coronavirus pandemic is likely driving a different kind of angst for each of us. Early on, AcademyHealth members were among the first to run the projections, monitor the responses, and raise the alarms for the public. That we are now entering a phase of increased and aggressive response is of some comfort, but much remains unknown and unknowable.
Adapting
Our world is adapting to this new – hopefully short term – normal in interesting and exciting ways that might actually help us accelerate needed healthcare transformation. Take the flexibilities put in place by CMS to expand the use of telehealth in the care of seniors, for example. And the expanded approvals and partnerships with companies to ramp up screening. I wonder what changes you are seeing in policy and practice that you think should be permanent? Tweet me your answer at @DrSimpsonHSR.
Like so many other organizations, AcademyHealth has also been adapting how it works and as previously noted, we moved to virtual work yesterday, Monday, March 15. Although response times may be mildly affected as we adjust to working this way, all are still available via email and phone, and regular activities in support of our members and programs continues. Given that we now have employees in eight states, we were already power users of video meetings!
We have also made some difficult decisions, cancelling or postponing spring gatherings (check out our landing page here for details). However, at this time we intend to proceed with ARM as planned. You can read more details in our previous blog post here. We are researching options to accommodate those with travel restrictions, and have extended the early registration deadlines and cancellation policies to allow more time for your decision-making. We will continue to monitor the situation and evaluate its impact on our community, and will provide updates via our blog, Member Update and, when necessary, direct emails.
Learning
I know it might be hard to focus these days, but I encourage each of us to think about how we can learn from what is playing out each day in our communities, healthcare settings, and the broader world. Health services research is at its best when it informs policy and practice in timely and relevant ways. Our Impact Award recognizes some of the best examples, and last year, at a workshop we helped the National Academy of Medicine organize, David Blumenthal also summarized some of these.
So I ask you, what are we learning right now? What else do we need to learn? And just as important - how do we share what we are learning more effectively? I have been struck by the number of journals and media that have moved all COVID19 related findings and coverage to open access. I wish more were doing it. Days, not weeks or months, matter right now. I have also been impressed by the role that open access, preprint initiatives such as MedRxIV are playing in sharing and dialogue on COVID19 research. It makes me wonder if we will use what we learn from this pandemic to accelerate the shift to open access – in times like these it clearly demonstrates that timely evidence can save lives.
Yet, I recognize that the need for timely data and evidence must also be balanced with the critical need for it to be accurate. A commentary by Ioannidis in STAT raised some important questions about the quality of the data used to date by policymakers and the fact that estimates of the number of coronavirus infections in the US could be off by “a factor or 3 or 300.”
We have all seen the explosion of misinformation that always occurs at times of anxiety, which the psychologists in our membership will know is consistent with Allport and Postman’s “basic law of rumor”, where rumor strength (R) will vary with the importance of the subject to the individual concerned (i) times the ambiguity of the evidence on the topic (a). What could be more important or ambiguous than this pandemic?
Caring
Finally, I find myself reflecting on how each day has reminded me of the importance of maintaining our connection to each other and the world, even if we do so with appropriate social distance.
I am ever amazed at the brilliance, capacity and flexibility of the AcademyHealth team and the members and community we serve. I’ve watched with pride as our members provided important context to national and international audiences, using their training, expertise and platforms to spread facts and actionable information, and encouraging preparedness and response instead of panic. Meanwhile, the staff at AcademyHealth have risen to the challenges of the last month with grace and cooperation. They continue to do great work in difficult times, and are a tremendous asset to us all.
I am hopeful that the public and our policy leaders will emerge from this crisis with a deeper understanding of the role and value of public and population health, reliable data, evidence and research. As we assess the impact on the economy, our nation, and the world, all of us will have a role to play in understanding what has happened, and how we can improve systems and policies for the future.
I am encouraged by the many individuals and organizations that are taking action to flatten the curve, volunteer time and money to help others with less privilege and greater vulnerability, and generally coming together – virtually as needed – to lift up their communities. We must care for ourselves and each other.
The above are some of the things that give me hope and comfort. I invite you to share yours in the comments of the blog as you feel comfortable. There are many people doing good in our world, we will see them if we look for them.