As a result of the pandemic, healthcare organizations face continued uncertainty. Recovery from coronavirus will be a marathon not a sprint. The only true exit depends on an effective vaccine. Until then health providers and systems will need to adapt and find new ways to balance COVID-19-related work with providing regular healthcare services.
Building on our previous COVID-19 insights, KPMG International offers our Recovery and resilience in healthcare thought leadership that features perspectives on global trends, practical advice and tools to help support organizations in their journey to a strong recovery.
Governments around the world will likely follow similar paths as the pandemic evolves, potentially seeing eight pandemic management phases – from international travel restrictions, through vast closures and to the gradual easing of restrictions. These phases correlate and influence the rate of rise and decline of the pandemic.
Since the onset of COVID-19, a number of trends have been observed by KPMG healthcare specialists in 46 countries and territories. Using the framework below, these trends have been mapped to the pandemic’s health conditions, healthcare recovery phases and wider economic circumstances.
As many jurisdictions have made their way through COVID-19 peak mitigation or lockdown measures, the following trends have been observed that, if combined, can form the pillars of a flexible risk-based confinement exit strategy.
In numerous countries and territories, there has been continued implementation of reliable and scalable strategies for both viral testing for current infections and antibody testing for the past presence of the virus (e.g. potential immunity) being used to inform decision making around return to work or school policies.
Global example: In Canada, the province of Ontario turned the tide against an initial testing backlog and has gone on to significantly expand testing of symptomatic and asymptomatic individuals.1
Globally, many jurisdictions are undertaking robust contact tracing activities to understand who COVID-19 positive people have interacted with (proximity and duration) to identify individuals who may be at risk and are required to self-isolate. Several jurisdictions have adopted technology-enabled approaches.
Global examples: In Singapore, the TraceTogether smartphone application enables health professionals to quickly track people who have been exposed to confirmed coronavirus cases.
A smartphone-based “health code” has also been implemented in China that identifies peoples’ COVID-19 status through a color-coded system. Those with red or yellow codes should be in quarantine and those with green codes can move about freely.
In some jurisdictions to support confinement exit approaches have been taken that consider risks for specific demographics, communities and workplaces that are adapted by the level of restrictions to reflect the vulnerability of particular populations. Identifying and effectively communicating with the most vulnerable people has helped provide additional protection for those most at risk of harm.
Global example: In the UK, the Shielding program,2, 3 was set up to support 2.2 million clinically vulnerable people. Through this program, seven government departments used National Health Service data to enable local authorities and a range of charities and NGOs, to provide vulnerable groups with food and basic supplies throughout a 20-week isolation period.
As jurisdictions pass their first virus peak, they enter a period of recovery and potential relapse. It is currently unclear how long this phase will last and what the level of severity future waves of the virus will have. As health providers adjust to the new reality, they need solutions to address near-to-midterm challenges.
Based on global perspectives, common themes for successful and sustainable recovery for health systems and providers are emerging. To return, organizations to sustainable operations with high levels of preparedness for future potential waves of coronavirus, KPMG International analysis suggests that there are five areas with ten key actions for healthcare leaders to focus their resources on.
1. Continue to accelerate digitally-enabled care transformation
2. To ensure any solutions created during the pandemic become sustainable, build them into revised care models, pathways and workflows
Spotlight: The Australian Government has invested $669 million to expand Medicare-subsidized telehealth services for all citizens.4
3. Revise existing workforce plans, by taking an ‘atomized’ view, focusing on tasks and competencies, not roles and job titles to get a clear view of what skills are needed
4. Improve support and arrangements for remote and flexible working (where possible) to prevent staff attrition and burnout
Spotlight: To support its more than 75,000 members, the Canadian Medical Association released a resource for maintaining physician wellness during the pandemic5 and launched a Wellness Support Line in June 2020.6
5. Address procedure backlogs, by formalizing pathways that separate COVID-related care from “business as usual” healthcare, including the use of “hot and cold” designated facilities
6. Increase virtual care, care at home or in residential settings through remote consultations
Spotlight: Santiz, a Dutch hospital group has created one aligned strategy for “hospitals at home” and “hospitals in long-term care settings” for less complex cases, convalescence and palliative care.
7. Monitor and manage system-wide capacity and performance, by establishing command or control centers that are embedded into operations management systems
8. Increase collaboration and continuity planning across organizations and systems to centralize cooperative procurement
Spotlight: In Saudi Arabia, the Ministry of Health is undertaking a major review of their stockpiles by assessing demand and supply for Personal Protective Equipment (PPE), medical equipment and pharmaceuticals. The objective of the review is to identify high-demand items that are at risk of supply shortage, in addition to planning for warehousing and logistics arrangements. The review includes future demand planning, to ensure that the supply chain is in a robust position to support the re-commencement of elective surgery and the clearance of the resulting accumulated backlog.
9. Adapt payer reimbursement schemes for compensation of cancelled care and extra pandemic-related costs
10. Identify liquidity and financing options to mitigate loss of revenue and undertake stress testing and forecasting activities.
Spotlight: In the Netherlands, mental healthcare provider, Parnassia Group has implemented robotic process automation to increase financial stability, insights and flexibility, furthermore it reduces pressure on its workforce and the cost baseline, which has proved very valuable in these COVID-19 times.
To support healthcare organizations KPMG International offers the following self-assessment maturity matrix tool.
[Click on image to download a PDF of the maturity matrix (PDF 176 KB)]
To further support healthcare leaders, the high-level roadmap below sets out the next steps for organizations or systems looking to ‘lock in’ beneficial changes, adapt to new ways of working with reconfigured business and operating models, and secure supply chains and financial recovery. It should be noted that some areas of work will need to be undertaken concurrently, while other tasks will need a consecutive approach.
[Click on image to download a PDF of the recovery roadmap (PDF 144 KB)]
If you have any questions about our maturity matrix, your self-assessment or the roadmap tool, please contact us to discuss further.
1 Ontario Government. (2020, May 29). News release: Ontario opens up COVID-19 testing across the province. Retrieved from: https://news.ontario.ca/opo/en/2020/05/ontario-opens-up-covid-19-testing-across-the-province.html
2 UK Government. (2020, March 21). Press release: Major new measures to protect people at highest risk from coronavirus. Retrieved from: https://www.gov.uk/government/news/major-new-measures-to-protect-people-at-highest-risk-from-coronavirus
3 UK Government. (2020, June 22). Press release: Plans to ease guidance for over 2 million shielding. Retrieved from: https://www.gov.uk/government/news/plans-to-ease-guidance-for-over-2-million-shielding
4 Australian Government, Department of Health. (2020, May 30). Government response to the COVID-19 outbreak. Retrieved from: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/government-response-to-the-covid-19-outbreak
5 Canadian Medical Association. (2020, June 4). Maintaining wellness during a pandemic. Retrieved from: https://www.cma.ca/maintaining-wellness-during-pandemic
6 Canadian Medical Association. (2020, June 15). New Wellness Support Line launches to help Canadian physicians and medical learners. Retrieved from: https://www.cma.ca/news/new-wellness-support-line-launches-help-canadian-physicians-and-medical-learners
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