Health care systems in Iowa and across the U.S. have undergone unprecedented challenges in the past year amid the global pandemic, adding to the disruptions that the medical profession has faced from changing societal, technological and financial issues.

The Business Record’s initial Power Breakfast of 2021 on Feb. 18 will feature four influential Iowa leaders who will discuss key issues that Iowa’s health care system faces through the ongoing global pandemic, and examine both new and continuing trends that will challenge the medical industry as we move forward.

The panelists are:

Dr. Tom Evans - president and CEO, Iowa Healthcare Collaborative.
Suresh Gunasekaran - CEO, University of Iowa Hospitals and Clinics.
Mary Sparks Thompson - CEO, Clive Behavioral Health.
Dr. David Williams - chief clinical officer, UnityPoint Health.

We envision a lively discussion as these health leaders consider your questions about what’s ahead for the health care industry post-pandemic, and what it may mean for the Central Iowa business community. Among the topics we plan to delve into with the panel are:

- How do we provide support for the health care workforce facing burnout?
- What are the best ways to ensure health care equity for everyone in Iowa?
- How can our health systems better attain goals of affordability and access?  
- What role should telemedicine and other technological systems play in health care?  
- What needs to be done to fix our broken mental health system?
- What will federal health care reform under the Biden administration mean for Iowa?

Ahead of the Feb 18 live virtual Power Breakfast event, we asked our panelists to answer an initial question to prime the discussion:  

From your perspective, what is the biggest lesson Iowa’s health care providers should take away from the coronavirus pandemic?

Dr. Tom Evans
President and CEO, Iowa Healthcare Collaborative

For the past decade, health care has been in a transition towards value-based reimbursement models. The challenge in Iowa is how to do this in a rural environment. Providers, employers and payers have been in a careful dance to create a system that works for everyone and is sustainable.  

The COVID pandemic was like a fire alarm in the dance. The emergent need to react to a societal challenge changed the rules for all parties. It has forced us to focus on a new set of priorities and has changed both the rules of how we do what we do (telemedicine, for example), but also the rules of how these parties work together. Health care and public health, for example, historically operated separately. Providers fixed people when they were sick. Public health was about creating a society that kept people from getting sick. The COVID pandemic forced public health and health care to align strategy and resources.

I believe we will be different after the pandemic. First, we have identified new ways to do some things that are as effective, more consumer-friendly, and more cost-effective. There will be an expectation that we innovate more to find safer, cheaper and more effective ways to deliver care.

Second, I believe that, as a society, our expectations of both health care and public health have changed. We were all shocked that the pandemic hit and were awakened to the real risk of viral infectious disease in our society. We reacted to the crisis together. However, there will be a new expectation that health care and public health are aligned in a strategy to protect us in the next crisis.  

The pandemic disrupted the rules of the dance and forced us to work together in new and more innovative ways. Our job now is to capture the lessons learned, hardwire beneficial changes, and look to the future.

Suresh Gunasekaran

CEO, University of Iowa Hospitals and Clinics

The pandemic has shed light on how critical it is that we collaborate with each other, as well as community, public health and government officials. The reason we are here today with the end of the pandemic in sight is because all of these entities worked together to tackle the challenges we’ve faced this past year. This includes the payers that worked with health care providers on expanding telehealth reimbursement and waiving administrative costs of the vaccine, and the public health agencies who helped disseminate critical messages to populations that have limited health care access and are more difficult to reach.

There is a symbiotic relationship between the public and their health care providers – it takes us all working together to protect the health of our communities. In order to keep the pandemic under control, we needed to extend our influence outside of our walls and encourage everyone in our communities to step up and follow the safety guidelines.

The importance of collaboration goes far beyond responding to the acute pandemic crisis – this lesson will continue to apply as the pandemic ends and we return to more routine business operations. If we are to tackle Iowa’s health care challenges, such as shrinking access to quality care in our rural communities, we must all work together to find unique and innovative solutions. We can’t solve these problems alone.

Mark Sparks Thompson
CEO, Clive Behavioral Health

Iowa’s health care providers have shown tremendous heroism, resilience and creativity as they responded to the coronavirus pandemic.

• In the face of overwhelming and unrelenting need for care over the past year, Iowa’s health care providers provided consistently outstanding care for patients struggling with severe illness, isolation and death.  

• At the same time, health care providers – like the community as a whole – continued to care for themselves and their loved ones through their own illnesses, challenges with at-home work and school, and isolation from normal support systems.  

• And health care providers rose to the challenge to work with government officials and community partners to develop innovative responses to the challenges of the pandemic.  MercyOne’s partnership with Corteva for COVID-19 testing is just one example of such a partnership.  

There are many, many lessons health care providers – and all of us – should take from the pandemic. One multifaceted issue is important to me as it relates to the system of care for mental health.  

That is, the mental health system in Iowa was not well prepared for the increased demand for services brought on by the pandemic. Lack of easily accessible mental health services is a well-established reality in Iowa. The pandemic exacerbated the pressure on an already inadequate system. Across the state, we have seen increased suicidality and substance abuse. Those with mental health challenges prior to the pandemic have experienced even more stressors and care interruptions. Many health care providers are experiencing first-time mental health crises and are burning out or leaving the workforce. For many Iowans, usual coping mechanisms are stretched to the limit. As a consequence, many of us are trying to access mental health care for the first time.

Dr. David Williams
Chief clinical officer, UnityPoint Health

Iowa’s health care providers have learned several valuable lessons during the pandemic. The one that tops my list is the importance of being nimble. Nimble is not a word generally used to describe health care. It is a mindset that was critical in response to a novel virus, with serious health implications, and no established medical evidence to lean on.

At UnityPoint Health, we assembled a small dedicated group of physician and clinical leaders to make decisions in this environment. They scoured the evolving literature, used the best evidence we had on hand, combined this emerging evidence with clinical outcomes data and predictive analytics, and our executive team empowered them to make rapid decisions. We didn’t have the luxury to wait for established clinical care protocols. We made decisions and changed on the fly when necessary.

Nimbleness also describes our operational response during the pandemic. Some examples:
• Through our system incident command structure, UnityPoint monitored the evolving situation in our nine regions.  
• We embraced technology and utilized telemedicine in all our facilities.
• We blazed new trails in COVID treatment and testing abilities.
• We established physician and nursing workforce plans to combat the growing issue of illness among our team members.
• We updated our brand campaign messaging to reflect the reality of COVID and focus on getting people the care they needed.
• We focused on workforce support as soon as COVID hit.

COVID-19 has been devastating to our state, to our communities and to so many of our families. Our nimble response and rapid decision-making are positive lessons learned during this horrible pandemic and we have implemented these lessons in our normal clinical and operational practices.