The coronavirus pandemic has forced a sudden acceleration of a prior trend toward the virtual provision of healthcare, also known as telemedicine. This acceleration was necessary in the short term so that provision of non-urgent health services could continue despite lockdowns and self- isolation. Federal and state policymakers have supported the shift toward telemedicine through temporary adjustments to health benefits, reimbursements, and licensure restrictions.
Yet if policymakers direct their attention too narrowly on expanding telemedicine they risk missing a larger—and as yet mostly unrealized—opportunity to improve healthcare in the United States: increasing the overall share of health services provided directly to the home. At-home healthcare includes not only telemedicine, but also medical house calls (home-based primary care) as well as models in which individuals within communities offer simple support services to one another (i.e., the “village” model of senior care, which could be extended to included peer- to-peer health service delivery). The advent of “exponential” technologies such as artificial intelligence (AI), blockchain, and the Internet of Things (IoT) is unlocking new possibilities for at- home healthcare across each of these models.
The next administration should act to reduce four types of barriers currently preventing at-home healthcare from reaching its full potential:
- Labor-market barriers (e.g., unnecessarily restrictive scope-of-practice rules and requirements for licensing and certification)
- Technical barriers (e.g., excessively slow and burdensome processes for regulatory approval, weak or absent standards for interoperability)
- Financial/regulatory barriers (e.g., methodologies for determining eligibility for reimbursements that favor incumbents over innovators)
- Data sharing / interoperability barriers (e.g., overly restrictive constraints related to data privacy and portability)
While the U.S. government grapples with the definition of the bioeconomy and what sectors it does and does not contain, another definitional issue needs to be addressed: What does sustainability mean in a bioeconomy?
Federal clearinghouses should incorporate open science practices into their standards and procedures used to identify evidence-based social programs eligible for federal funding.
To better address security and sustainability of open source software, the United States should establish a Digital Technology Fund through multi-stakeholder participation.
Building on existing data and privacy efforts, the White House and federal science agencies should collaborate to develop and implement clear standards for research data privacy across the data management and sharing life cycle.