Navigating the Future of Preventive Care

July 2, 2020 HMS

There are still many unknowns surrounding COVID-19. How did it start? How exactly does it spread? When will it end?

There is also more confusion than usual around how to navigate the healthcare system; specifically, whether it is safe to visit a healthcare facility. Understandably, this has led to trepidation about resuming routine and preventive care visits.

Preventive care is one of our most important defenses against chronic disease. An interview study published by the Centers for Disease Control and Prevention (CDC) notes that clinical preventive care, in conjunction with lifestyle changes, can reduce the incidence of chronic disease and associated death by a considerable margin.

Despite these known benefits, Americans are poor utilizers of preventive care — a trend that a highly infectious pandemic virus hasn’t helped. In fact, COVID-19 has dissuaded people from accessing healthcare in even the most critical of circumstances, as heart attacks, strokes and other serious medical issues all but disappeared from the emergency room at the height of the pandemic. Equally concerning is emerging data showing a sharp decrease in cancer screenings and diagnoses and dangerously low childhood immunization rates.

Pandemic or no pandemic, one thing we know with certainty is that preventive care is critical to health. Resuming preventive care services — and getting Americans comfortable enough to access these services — is yet another challenge that has emerged from the COVID-19 crisis.

Getting Back to the Doctor: Which Visits Are Essential?

Arguably, and certainly under normal circumstances, all preventive care should be considered essential. However, there are certain services for which a dip in demand could indicate serious long-term consequences for public health. Among them:

  • Cancer screenings. Routine cancer screenings were largely put on hold during the height of the pandemic in the U.S., with an Epic Health Research Network (EHRN) analysis showing an 86% to 94% drop in preventive cancer screenings during the pandemic period. In an accompanying article, EHRN notes that, should this trend continue, “many cancer cases could go undiagnosed or be diagnosed at a later stage with a poorer prognosis.”
  • Childhood immunizations. Delaying or neglecting early-childhood immunizations poses serious risks to both individual and public health. Amid the pandemic, childhood vaccinations dropped substantially nationwide — by 63% in New York City and more than 40% in California. The World Health Organization warns that even this brief interruption could lead to a resurgence of vaccine-preventable diseases, such as measles and polio.
  • Flu vaccinations. Given the very real possibility of flu season coinciding with a second wave of the coronavirus, a decrease in annual flu vaccinations could contribute to an overwhelmed healthcare system. As Dr. William Schaffner, a professor of preventive medicine and infectious disease at Vanderbilt University Medical Center told Reuters, “We’re in for a double-barreled assault this fall and winter with flu and COVID. Flu is the one you can do something about.”
  • Annual checkups. According to the CDC, chronic diseases, including heart disease, cancer and diabetes, are leading causes of death and disability the U.S. And with certain underlying illnesses contributing to the severity of COVID-19, letting these conditions go undiagnosed or unmonitored could increase a person’s risk of serious illness or a poor outcome of the virus. Regular health screenings are key to improving health outcomes while lowering costs of chronic disease care.

Preventive Care: Going Virtual?

The COVID-19 pandemic emphasized the value of telehealth and remote patient monitoring tools in protecting vulnerable individuals and mitigating the spread of the virus. This has led to a rapid increase in telehealth adoption that is likely to continue in the pandemic’s aftermath.

At-home screening and monitoring tools could prove to be a game-changer for preventive care as well. Commercially available cancer screening tests, such as for colon cancer, can help determine whether an in-person diagnostic test is warranted, which could enable earlier detection and, thus, more effective intervention. A recent study published by the American Society of Clinical Oncology found that at-home genetic-testing kits for breast and ovarian cancer risk are equally as effective — if not more so — than conventional, office-based protocols. Researchers are also studying the viability of self-collected pap smears to aid in the early detection and prevention of cervical cancer.

Personal health technologies that track blood pressure, oxygen saturation and other vital signs may also play an important role in early disease detection, prevention and management in a more virtual care environment. But although these technologies present promise for the future, at present, they are largely meant to enhance, not replace, in-person care.

Keeping Informed

If Americans were lax about preventive care prior to COVID-19, they may not be rushing enthusiastically to the doctor’s office in today’s environment. But as clinics begin re-opening their doors and resuming routine care visits, being informed can help to alleviate some of this unease.

For consumers, that means taking a know-before-you-go approach — ensuring providers have resumed normal operations, understanding COVID-19 related precautions and protocols, and inquiring about virtual or at-home services that may be available. For healthcare organizations and providers, it means being clear and proactive in their communications — educating consumers on the importance of preventive care and the measures that are being taken to keep them safe and healthy.

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