The collapse of the health system and its effects on medical care
Since its spreading through Spain, the COVID-19 has not only confined citizens due to an unprecedented state of emergency in the country, but has also pushed many health centres to the limits of their resources.
The pandemic causes a large number of people to be affected, a percentage of whom require hospital treatment and even the most severe cases require intensive care. A situation that has completely overcome the established forecasts and that is leading hospitals to transform as much area as possible into zones where COVID-19 patients can be treated.
A scenario that is not only experienced in Spain, but worldwide. The problem does not lie in the lethality of the virus itself, but in its rapid transmission, which is overwhelming health facilities, equipment and staff.
The chart obtained from the article ‘Coronavirus: The Hammer and the Dance’, regarding the availability of beds in the United States to assist people in intensive care vs. people who would need such care, illustrates this situation:
Besides this circumstance, we must add all the support staff required to maintain health activity at all levels, as well as the need to safeguard the safety of every patient who requires attention due to many other causes than the virus.
These three issues have led to a change in the medical paradigm, breaking all short and medium-term health plans. The fact is that relieving the pressure on medical centres is an urgent priority, which has meant postponing and cancelling all consultations and processes that are not vital.
▶ Most of the Primary Care Health Centres have been closed, so that staff can provide support in the hospitals, or they can only be reached by emergency or telephone assistance.
▶ For hospitals, since the beginning of the expansion of this new type of SARS-CoV-2 coronavirus, surgeries have been postponed for pathologies or problems that do not present serious conditions, as well as specialist visits or non-urgent tests.
Thereby, it is possible to avoid potential contagion through care at the centre, to have extra beds (which were reserved for other needs) for patients who need isolation and treatment and, furthermore, to release that staff, both to support and to save them in case the health workers require replacement due to contagion or prevention.
Implications of this medical parenthesis
The most visible consequences are undoubtedly the postponements of non-urgent surgeries which directly affect waiting lists.
Until now, one of the main health objectives was to reduce waiting lists, and therefore improve patient care.
According to the latest data provided by the Ministry of Health , this objective was not achieved in the past few months, with 87,000 more patients on the waiting list and increasing the average waiting time from 93 to 115 days.
These statistics, analysed by Autonomous Community, would improve in some regions such as Madrid, where the waiting time would be 46 days, La Rioja (47) and the Basque Country (49). While the worst data were then observed in Andalucia, with an average of 164 days, Castilla-La Mancha (149) or Catalonia (146).
Overall, in Spain, based on these latest statistics, 671,494 patients were waiting for an intervention, that is, out of every 1,000 inhabitants, 14.85 were on the hospital waiting list.
This delay extends to all specialties, even the most delicate and important ones such as Neurosurgery (153 days of waiting), Angiology and Vascular Surgery (99 days) or Pediatric Surgery (132 days).
Not very positive data that existed not only in Spain, but in all of Europe, as shown in the following graph extracted from the Euro Health Consumer Index (EHCI):
1.00 means that more than 90% of patients wait less than 90 days to receive treatments, while a score of 3.00 means that more than 50% of patients wait more than 90 days. In this sample of 35 European countries, all exceed the 1.00 score.
This is not very encouraging data, which undoubtedly, after all the cancellations and date changes carried out during the days when the COVID-19 overloads the hospitals, will be even higher, both in number of waiting days and patients.
A situation for which, in Spain, some political parties have proposed measures such as promoting a national law to set maximum response times. However, at the moment, it is not planned to be carried out.
How can we return to medical standards?
Although there are no fixed dates for the stabilization of the pandemic, it is certain that at some point a balance will be reached between those affected and healthcare capacities, and therefore society will be able to return to a certain degree of normality, as well as the medical system.
Without these specific measures, it will be a challenge for hospitals to return to normality.
A challenge that involves improving the productivity of surgical processes. A performance that should not be demanded from health professionals, after all the effort that they are currently undertaking, but rather it should fall on the optimization of these procedures so that they are as efficient as possible for both professionals and patients.
It is exactly in this regard that technology is once again the great ally.
Spain, Europe, the world in general, is suffering from a situation without precedent in modern history. A crisis that highlights the importance of health care, the magnitude of its deficiencies and the efforts of all medical personnel to overcome them. This situation should make us rethink how to regenerate and evolve the medical system with tools that can assume a fundamental role, such as digitalization and process automation.
At this point it is essential to have a system like ORVital from the MYSPHERA platform, a bluetooth solution, based on Real Time location Technology (RTLS) that allows both the visualization of surgical processes and their optimization.
How can such a complex and demanding management be carried out?
• By maintaining absolute control of all processes and their status (delays, cancellations, etc)
• Automating tasks that allow coordination between all health personnel (nurses, doctors, guards and cleaning staff)
• Knowledge of the status of each patient and direct communication among the different participants in the process (health professionals and family members) ç
ORVital is a system that has optimized the surgical performance of several European reference hospitals by more than 10% and that ultimately aims at the satisfaction of both health staff and patients and their families.