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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me

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While the tragic scope of the COVID-19 pandemic rightly dominates the news cycle these days, there is an undercurrent of stories about new behaviors being adopted by individuals and organizations aike, and in particular what lasting impact these may have.

As we continue our #physicaldistancing efforts a la Cordan Sanitaire, we’re all virtual now. We are also  all getting used to our new workday “meetings” with our colleagues against the backdrop of their living rooms, kitchens, home offices, and the now occasional interloping child popping into the call. The increasing ease with conducting business this way has sent a shiver of fear down the spines of commercial landlords (who are at the center of the second largest business sector in the US), and sparked more positive thinking by employers and designers, who are investigating how much office space is actually needed, what it should be used for, and in fact what the very nature of “work” actually will be in the future. Work, and the commercial real estate market, may never look the same again.

Closer to home, Crossover has rapidly transitioned our entire care model to be responsive to the crisis via our Pandemic Primary Care approach. As I’ve noted previously, this shift has been an almost unbelievable acceleration of our already planned pivot to a national, digital-first medical group. The same shift is happening across the U.S., as providers of all types quickly adapt —and often jerry-rig—remote care solutions to address patient needs. Whatever the sophistication of the remedy, there will be a large percentage of providers and consumers who will be experimenting with the innovations (and implications) of remote care, and who will want to retain the virtual form of engagement once we emerge on the other side of the pandemic.

Interestingly, there’s another area that has been transformed by the critical needs and rapid spread of the Coronavirus—medical research. Understandably, pretty much all of the resources of the global research community have been targeted at the novel Coronavirus: what it is, how it might evolve, what drugs might work, how to effectively treat patients in the absence of a working drug, etc. According to a myriad of articles this past weekend (such as here and here), the standard playbook for research has been tossed out the window. No peer review, no lumbering path to publication, no closely held data—just test, share outcomes, and test again. Whether people can see it or not, I believe that the entire medical and scientific research community just walked through a large, one-way door. 

A few other examples of this shift include:

  • WHO launching a rapid AI-based trial process (The Solidarity Trial) for aggregating data from field trials. Thousands of doctors and their data have joined from almost every affected country. 
  • The pre-publication research archive MedRXiv has been inundated with novel Coronavirus research from around the world, including a huge contribution from Chinese researchers, who simply want to advance progress. 
  • Thousands of people are contributing to FoldIt, a remarkable protein-folding game that uses crowdsourcing to solve protein challenges. 
  • Lots of interesting stories about how the private sector is rapidly mobilizing to address the urgent needs as well as potential solutions required for a brave new health world. 

None of this—the scope, the analytics, the speed, the connectivity, the openness—would have been technically possible even a decade ago, nor would any of it have translated so quickly into potential long-term effects and benefits. And, without a doubt, the most effective petri dish has been in zones whose governments expect and enable a swift and coordinated partnership with the scientific communities. Germany in particular seems to have embraced and encouraged this approach and currently enjoys the lowest fatality rate in the EU

When things return to “normal,” there may be a retrenchment of sorts, but I don’t think so. Very similar to the previous arcane rules limiting virtual care, all the hidebound rules about how medical research is conducted, by who and for whom, by what contributors, and how transparently, was reimagined and rebuilt in a matter of weeks. This is how “new” eras are ushered in . . . gradually and then suddenly.  

I literally just wrote a post about my concerns around how cognitive capacity is being commandeered by the attention economy, and within days, we have several examples of the potential of a massive species-level problem being solved in an open-source, global collaboration, that fully harnesses the power of our interconnected, digital world. I could not describe this any better than this New York Times article did here: “While political leaders have locked their borders, scientists have been shattering theirs, creating a global collaboration unlike any in history.”

And with that, we pass through the one way door to never look back.

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