From the Dean: The future of healthcare

The pandemic obviously has had a profound impact on the healthcare enterprise and patients in general. One of the more interesting effects has been in the realm of virtual care delivery – the use of telemedicine and devices to assist in care. Telehealth – the use of audiovisual technology to deliver healthcare to remote sites like the patient’s home – has demonstrated both the potential and the limitations of such an approach. In the midst of the pandemic, there was expanded use of telemedicine, and it made routine healthcare delivery possible where it might not have been otherwise. Yet as the limitations imposed by the pandemic have lessened, it’s been a fairly uniform observation that patients generally prefer an in-person visit to a virtual one. We hear similar feedback from students – that remote learning was better than nothing, but they really value the in-person educational experience.

A recent experience suggests that perhaps a better way to think about virtual care is not as an alternative to in-person care but as a supplement. What was the experience? A friend was playing tennis and tripped. She was not injured but as she was getting up, her smart watch buzzed her and said that it appeared that she had fallen, and was she alright or did she need assistance (which the watch offered to call if needed)? I assume that the smart watch has some sort of accelerometer that helped it conclude that she had fallen. Isn’t that amazing technology?

All of this got me thinking about how we might use technology to augment the way we already provide care. An example in a rural state like North Dakota might be to use drones to deliver medications or devices to patients in remote locations. Another is the 14-day monitor that we cardiologists use routinely to record every single heartbeat of a patient during that two-week period to uncover irregularities of the heart rhythm. The device (which is about the diameter of a quarter) is placed on the chest with adhesive bands and is removed by the patient and mailed back for analysis.

Prior to the pandemic, the School started an initiative in virtual care, which didn’t pan out for a number of reasons. These more recent experiences and observations suggest that perhaps we should revisit this initiative. I’d welcome any thoughts and suggestions that you may have. I fear that we could miss a real opportunity if we don’t look at this entire field again.

Congratulations to Dr. Jonathan Geiger, Chester Fritz Distinguished Professor and Professor of Biomedical Sciences, for being recognized by the Canadian Institutes of Health Research (CIHR) as one of their outstanding peer-reviewers of submitted grant applications. For those who are not familiar, peer review is the process by which acknowledged experts review and comment on the merits of proposed research protocols. It is only on the positive recommendation of such reviewers that grant requests are funded by the CIHR (which is analogous to the National Institutes of Health here in the U.S., which utilizes a similar process). Congratulations to Dr. Geiger for being recognized by the CIHR as one of the top 139 reviewers out of the 1107 involved during a recent review period.

Here’s a brief update on UND’s evolving response to the pandemic as caseloads fall and more people get vaccinated. Earlier this week, UND updated its guidance on masks and gatherings; you can read it here. Please note that the effective date for the change is June 1 – until then, faculty, staff, and students are expected to continue to observe current UND policy. As indicated, the SMHS will be developing specific additional masking requirements that may be needed because of our work with vulnerable patients and individuals in the healthcare delivery environment. You can expect to see possible additional expectations beyond UND guidelines prior to June 1, 2021, in this column.

Finally, I’d like to extend my thanks and best wishes to Laura Block, former Associate Dean for Administration and Finance, who left UND and the SMHS recently after three years in the position. Laura was most helpful and supportive during the recent legislative session, which as you know ended with a positive budget position for the School. All the best to Laura in the future!

Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences