Guiding Principles for the “New Normal” in Health Care

By Evan Benjamin, MD, MS, FACP; Bozwell Bueno; Meghan Long, MHA; and Saranya Loehrer, MD, MPH

Over the past several months we have had the privilege of supporting health care organizations across the United States as they respond to unprecedented challenges brought forth by the COVID-19 pandemic. From policy and payment changes at the federal and state level to innumerable changes at the level of health care delivery and operations, seemingly every aspect of health care has been upended by the pandemic. Some of these changes were based on evidence, others a result of ingenuity, and many simply borne out of necessity.

As health care organizations begin to emerge from their initial preparedness and response efforts, many are revisiting decades old policies and practices and asking themselves how they can do better. We sought the perspectives through a survey as well as through crowdsourcing of ideas through social media of public health and health care organization leaders, policymakers, payers, patients, and providers at the frontlines of the pandemic. These leaders came from a cross section of the health care industry that has been leading efforts to improve the value of health care for some time. What follows is a distillation of what we heard into a set of guiding principles to support health care’s current moment of reflection and recalibration.

1. Meet the magnitude of the moment

2. Ensure that equity is central to redesign

3. Protect the health care workforce

To ensure the ongoing health and safety of the health care workforce, organizations should consider which aspects of their operations may be suited for remote work and make adjustments accordingly. Finally, organizations should evaluate internal policies such as ensuring a local living wage, paid sick leave, and other practices that provide a modicum of security to those who may otherwise come to work exposed or at risk.

4. Establish a robust system for learning and evaluation of high value care

5. Promote safety, transparency, and a just culture

6. Modernize payment to align with present and future demands

7. Seek new partnerships and collaborations

We must leverage the lessons learned throughout this crisis to transform the relationship between health care and society. Whether this level of cross-sector introspection, ingenuity, and collaboration can be sustained to the point of true transformation remains to be seen. What the past few months have shown us, however, is that the unthinkable is possible, the immutable movable. As Dr. Don Berwick so powerfully and succinctly stated, “fate will not create the new normal; choices will.”

Evan Benjamin, MD, MS, FACP, is the Chief Medical Officer at Ariadne Labs, an Associate Professor of Medicine at Harvard Medical School, and an Associate Professor of Health Policy and Management at the Harvard T.H . Chan School of Public Health.

Bozwell Bueno is a Project Manager at the Institute for Healthcare Improvement.

Meghan Long, MHA, is a Project Manager at Ariadne Labs.

Saranya Loehrer, MD, MPH, is Head of Innovation at the Institute for Healthcare Improvement.

Illustration by kameshkova / iStock

Our mission is to create scalable health care solutions that deliver better care at the most critical moments in people's lives, everywhere.

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