How COVID-19 is changing research and healthcare

Collaboration in clinical settings Collaboration between different experts and institutions has become more important than ever, not just in research but also in clinical settings and in ensuring effective communication between health experts and the general public during what has become a distressing time for all. In a statement from May 2020, Dr. Hans Henri P. Kluge, the WHO regional director for Europe, emphasized the importance of “[c]ollaboration, coordination, and communication across the public health community.” He noted that: “Strong and integrated management of public health services, primary care services, and […] hospitals and long-term care facilities is critical to [navigating] this delicate phase.” Although healthcare systems everywhere have been under great strain due to the high number of COVID-19 patients requiring urgent hospital care, this has not negatively impacted healthcare professionals’ collaborative efforts, according to some recent studies. Medical News Today spoke with Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, about the ways in which interprofessional collaboration in a clinical setting has changed since the start of the COVID-19 pandemic. Interprofessional and interdisciplinary collaboration has been important to clinicians for decades, he told us, as health workers aim for stronger communication between specialists to ensure holistic care for their patients. “Several forces are at play [that] foster greater interprofessional cooperation. First, there is the hospitalist movement,” he explained. “Over the past decade, inpatient hospital care has transitioned from being mostly provided by physicians with practice outside the hospital who would see their few patients in the hospital daily to one where full-time, hospital-based physicians provide the primary care for inpatients.” “Since hospitalists will generally have no prior knowledge of these patients or follow them subsequent to their hospitalization, there needs to be close collaboration between inpatient and outpatient physicians during the course of the hospitalization to optimize care,” Dr. Cutler noted. During the pandemic, this spirit of open collaboration in the healthcare system has become all the more present, he went on to say. According to Dr. Cutler, that is because: “[COVID-19] is treated very differently when it is mild/moderate/outpatient than when it is severe/inpatient. […] [R]ecognizing early on when hospitalization may improve outcomes requires effective and timely communication between primary care, urgent care, ER, specialists, and inpatient physicians. Getting patients to the right level of care can be a matter of life and death. Decisions regarding monoclonal antibody infusions, steroids, remdesivir, intubation, and ECMO [extracorporeal membrane oxygenation] therapy involve multiple physician specialties.” Technological advances, such as having greater access to e-medical records, are also helping strengthen interprofessional collaboration in a clinical setting, added Dr. Cutler. “The electronic medical record is perhaps the greatest force improving physician collaboration during the pandemic,” he told MNT. “Physicians who may even be in different healthcare systems can see prior testing and treatment done elsewhere, which promotes improved interdisciplinary care.” “Electronic records also allow patients access to records generated by geographically diverse providers, which is a great boon to the quality of care,” he added. Addressing COVID-19’s social ‘side effects’ Inevitably, the public health crisis that led to numerous lockdowns and travel restrictions across the world has also had a severe impact on the mental health of people around the globe. This means that mental health care has also had to step up to the challenge. One key way of doing this has, once again, been pushing for more interdisciplinary and interprofessional collaboration. MNT spoke with Lea Milligan. He is the CEO of MQ Mental Health Research, which is a United Kingdom-based charity funding mental health research. Milligan told us more about the challenges and successes of collaboration across fields and specialisms during the pandemic. “On the eve of the pandemic, the mental health research community had performed the great task of agreeing [on] a set of ambitious 10-year goals for 2020–2030,” he told us. “They derive from recommendations in the ‘Framework for Mental Health Research’ published in [December] 2017, and [they] also build on previous research priority exercises.” Milligan explained that the agreed-upon goals for mental health research and care require cross-disciplinary collaboration from the get-go: “Research to support the targets under each goal should be undertaken in partnership with the life sciences industries, charities, the NHS [National Health Service], voluntary, social and independent healthcare sectors, together with patients/ service users, their families/carers and clinicians.” This need for collaborative mental health research and care has increased exponentially due to the COVID-19 pandemic, he went on to point out: “Coordination across the [mental health research] sector is essential for the tide to be turned and for mental health science to become the super discipline it has the potential to be. Substantial investment is needed in both human capacity and infrastructural capacity. The emergent umbrella discipline of mental health science needs [an] opportunity to convene, develop a common language, and explore opportunities for collaboration between different approaches.” The good news is that collaboration is already happening. According to Milligan, “Over the [past] year, in response to the pandemic, we have seen many groundbreaking projects with experts from psychiatry, data science, [and] neuroscience and people with lived experience coming together to tackle some of the biggest challenges faced within mental health care.” As an example, he mentioned DATAMIND. This is a U.K.-based “hub for mental health informatics research development,” which makes new tools and mental health-related data available to researchers from all disciplines who may benefit from using them. He also mentioned the Post-hospitalisation COVID-19 Study, which aims to look at the long-term effects of COVID-19 — including those on mental health. “This holistic approach has resulted in a far more in-depth understanding of the virus’s impact and has opened the door to further areas of research into the long-term cognitive effects [that] many [people] are reporting,” said Milligan.