Shawn Rowland Of Jase Medical: In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System -

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An Interview With Jake Frankel

Let your voice be heard. Our state representatives do value your input and the fact you took the time to reach out and voice your opinion.

The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Shawn Rowland, M.D..

As a board-certified family medicine physician, Shawn Rowland, M.D., experienced firsthand how timely access to medical care and treatment is lacking in our country, and decided to change that by founding JASE Medical in 2021. This one-of-a-kind online service offers U.S. and Canadian residents the opportunity to consult with a board-certified doctor online and obtain emergency antibiotics for emergency use. As a CEO of JASE Medical Dr. Rowland is supported by a group of experts in both infectious disease and primary care including experts from Harvard, Columbia, Stanford, and the Mayo Clinic, and together they are leading the way in medical preparedness for every family in America, making sure they have access to life-saving medications to care for themselves and their loved ones during the unexpected.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?

Prior to the pandemic, I was working in a mid-sized community hospital and every week we would receive a briefing on which medications were in short supply. At the time, I was surprised that in our sophisticated and advanced health care system we would be dealing with shortages of some really important antibiotics and other medications. That led me to do some research and what I found was very concerning. The general public isn’t aware that the US has virtually zero production capacity when it comes to all of our most common and important medications. Things like antibiotics and medications that people take on a daily basis like blood pressure, thyroid, and diabetes medications. Pre covid most of us in the US felt like we could get whatever we needed when we needed it. But now we know all too well, when the unexpected happens it’s too late to prepare. It doesn’t take much to disrupt and even stall access to life essentials.

Whether it’s supply chain issues or just an inability to get timely care when in a disaster scenario or even when just traveling, I set out to solve the problem of immediate emergency access to treatment. You’re smart to have food and water stored away in case of an emergency. But, if you get an infection, having the right medicine and knowing how to use it becomes more important than all of your canned food and tanks of water.

This lack of supplies was something I dealt with on a weekly basis while working in hospitals a few years ago. Fast forward to today and it just feels like a matter of time before the other shoe drops.

My desire to protect not only my own family but my neighbors and community is what led to JASE Medical.

Can you share the most interesting story that happened to you since you began your career?

Just before starting medical school I had a year to remember. In one years time I either witnessed or was the first on a scene of 4 rollover accidents. All of these occurred while I was just driving on the freeway, except for one that was in a very rural area on a dirt road. At three of the rollovers I actually pulled the driver out of the overturned automobile. It certainly drove the lesson home for me to always be prepared. Whether you are the one in the accident or the one helping as a bystander, you never know when your life might be literally turned upside down.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

“Funny” and “mistake” don’t typically go together in the medical field but I do remember one time as a medical student I made the mistake of doing a poor job delivering some unexpected news to a patient. This occurred in the emergency department one night. A moderately overweight young woman came into the ER for abdominal pain. Part of the routine testing for such a case is a pregnancy test. Her test came back positive. As a fourth year med student I went into her room to let her know that her pregnancy test was positive. The young woman was adamant that there was no way she could be pregnant and grew rather upset. She figured that after not having a period for nearly 9 months she must have been going through menopause and therefore couldn’t be pregnant. She was in her 20’s. After that experience I made sure to get more information from my patients about expectations and beliefs before delivering potential life-altering news.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Our access to information and media is so expansive nowadays. There’s always a counterpoint to every opinion. Conflict seems ever present. Truth can be hard to find. All of this can cause us to hesitate and doubt. A quote by Maxime Legacé is a great reminder that can be applied in all aspects of life, “You’re never wrong if you love and help people.”

Are you working on any exciting new projects now? How do you think that will help people?

We have a number of initiatives that we are working on at Jase Medical. Our mission is to empower individuals to be better prepared medically. That is a big task and we are constantly working on ways to improve our service and comply with that mission. One of those initiatives is providing patients the ability to request a year’s supply of their chronic condition medication. People who depend on their blood pressure medication every day will be able to obtain a long-term supply and not have to worry about possible disruptions to the availability of their medication.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider works WITH their patient. They take the time to listen to their patient. They ask the right questions. And finally, they take the time to both teach and be taught by their patients so that together, patient and provider can make decisions as a team.

Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?

The COVID-19 pandemic certainly put not just our healthcare system to the test, it also has had effects on virtually every aspect of our lives as a global society. In the U.S. it reaffirmed known issues like healthcare disparities amongst minority and underserved populations. It also brought to light other issues like the distance between technology and regulations. Something that helps address both disparities in healthcare and lagging regulations is telehealth. The telehealth industry has come a long way in the last few years. One of its main benefits is improved access to care for underserved populations but many regulations both federal and state are not able to account for the advances in technology and need to be brought current.

Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.

A healthcare system can only be as good as the human beings that make up that system. I think even though the pandemic highlighted our healthcare system’s vulnerabilities it also showed how incredible and selfless the individuals of our healthcare system are. From the environmental services person cleaning an exam room to the nurse, pharmacist, or doctor putting in 80+ hour weeks, seeing individuals make sacrifices and coming to the aid of their fellowman was very heartwarming. There were certainly many examples of heroes amongst healthcare professionals, but they also manifested themselves in many other important roles in our society including industries like transportation to grocery store workers.

Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

As the pandemic and its effects continue to unfold, we are now faced with the reality that the world has changed. Healthcare systems around the world have been put to the test and nowhere was this more evident than right here in the United States.

The United States healthcare system is the most advanced in the world and the best funded. Per capita the United States spends more than any other country on healthcare (Japan is also at the top with both countries spending more than $10,000 per person per year), yet many Americans still do not have access to quality health care services or medicine.

As demand increases there is more strain placed on the industry. High prices and a lack of access plague the system across the country as both patients and doctors struggle with scarcity, lack of innovation, and needs for better methods of delivery.

To Improve the United States healthcare system we need to do these 5 things:

Improve Access.

Access to healthcare continues to be a challenge. As of 2019 there was an estimated shortage of 13,758 Primary Care providers. By 2034 that shortage is projected to be between 17,800 and 34,000, some projections reach as high as 48,000. These predictions are based on several factors, ranging from providers retiring to transitioning to pediatric or surgery and other specialties and even provider burnout.

Improving access to healthcare is vital to our health as a nation. There are many ways that better access can be achieved including, increasing medical school enrollment, more residency training spots, better funding for state and local community health centers, as well as a relatively new technology that has the power to vastly improve access for patients and allows providers to be in more than one place at once. This new technology is what has been called telehealth.

Telehealth is a game changer in providing better healthcare access

During the pandemic, the government eased restrictions for doctors and mid-level providers to provide telehealth services. This limited infection to spread, along with offering patients the ability to seek non emergent and chronic care from the comfort of their homes.

Telehealth services include:

Services and communications between providers and patients such as:

E-mail or text messages with follow-up instructions or confirmations.
Images for evaluation.
Lab results or vital statistics.

“Real time” communication between patient and care provider

Video calls to share progress or check on healing.
Audio only calls to confirm instructions.
Text messaging to answer patient questions.

Remote patient monitoring, either real time, synchronous (from patient to provider) asynchronous (patient has information stored on device or log)

Blood pressure monitors.
Pacemakers.
Glucose meters.
Oximeters.

Telemedicine waivers are being rescinded.

As the emergent nature of the pandemic declines, Many states have rescinded or modified these waivers over the past year.

However, a recently passed bill titled “H.R. 4040: Advancing Telehealth Beyond Covid Act of 2022” could extend many of the telehealth services that the Covid 19 public health emergency included. The House-passed legislation would further extend the following flexibilities through December 31, 2024. A few highlights of this bill include:

Increased range of locations from which a patient may receive telehealth services by removing geographic restrictions and expanding originating sites.
Expanded telehealth services offered by qualified physicians and practitioners, including physician assistants, nurse practitioners, clinical nurse specialists, nurse-midwives, clinical social workers, clinical psychologists, registered dieticians, and nutrition professionals.
Audio-only telehealth services to ensure seniors and rural patients who may not have internet connectivity can receive the care they need.
Occupational therapists, physical therapists, speech-language pathologists, and audiologists to continue to furnish telehealth services.
The bill also delays implementation of certain in-person evaluation requirements for mental health telehealth services until January 1, 2025, or the first day after the end of the emergency period, whichever is later.
This bill was sent to the senate where, if passed, it will be signed into law by the president.

Both primary care physicians and mid-level providers cite the advantages of telehealth as:

Convenience for routine visits. As the workforce returns to work the convenience of not having to leave work to go to the doctor’s office is more attractive than ever.
Patients are more inclined to receive follow up care for their chronic diseases.
Less exposure to infectious diseases when able to hold their routine office visit from the comfort of their home or workplace.
Decline in urgent care visits, especially evenings and weekends- Care is literally at the patients’ fingertips. This is especially desirable for parents with young children, disabled and those who don’t have access to transportation.
In rural settings, telemedicine provides access to not only primary care but specialists that they may not be able to access unless they drove several hours to the specialist’s office. Cardiology and other specialist services have been greatly enhanced with the use of telehealth.

2. Eliminate Bias.

Telemedicine does indeed have its shortfalls and cannot replace the in-person visit in all cases. It is not intended to replace the office visit, but rather to be an adjunct to it. This method of healthcare delivery can overcome the barriers of transportation, weather, mobility issues and exposure to Covid and other seasonal illnesses. During the height of the pandemic telehealth proved to be cost effective, safe and had health outcomes that were equal to in person visits, this was particularly evident when comparing in person visits to telehealth visits dealing with a variety of chronic conditions such as diabetes, high blood pressure, COPD and weight loss. At risk and most vulnerable patients were able to meet with their doctors and care providers via secure video appointments to have their chronic conditions managed and medications refilled. The ease of obtaining telemedicine visits substantially improves accessibility to providers by breaking down the barriers that time, transportation, weather, and mobility issues can present to a patient. Patients also reported a high degree of satisfaction using telemedicine.

However, more needs to be done system-wide to improve the inherent biases that exist in our society and within our local communities. Bias and discrimination occur at both a personal level between patient and doctor but also at a system level. From public health decisions for population groups to the funds that are allocated towards research within certain at-risk populations, the more awareness that is brought to the issue of bias and discrimination the more we can do as a society to curb it and ultimately, eliminate bias.

3. Preventive Medicine Saves Money.

It is estimated that more than 90 percent of type 2 diabetes, 80 percent of CAD, 70 percent of stroke, and 70 percent of colon cancer are potentially preventable by a combination of nonsmoking, avoidance of overweight, moderate physical activity, healthy diet, and moderate alcohol consumption. Primary care providers are at the forefront of education, testing and appropriate referrals to prevent further progression of these diseases. However, the fee-for-service model of healthcare can prevent providers from the ability to provide this type of preventative care.

The value-based care model is replacing the traditional fee-for service model.

Comparison between the traditional fee-for -service and value-based care models.

The traditional fee-for-service (FFS) model pays healthcare providers based on individual care services provided, without regard to the effectiveness of the care that was delivered. This model has been in use for a very long time; however, it is unsustainable given the current economic environment and does not reward preventative care. Under the FFS model, physicians and other providers are paid more if they provide more services. Little attention paid to the longer-term clinical outcomes for the patient. This system does nothing to encourage low-cost, high-value services, such as preventive care or patient education.

Value-Based Care Model rewards healthcare providers who focus on the quality of provided care. Reimbursement of services is based on those providers’ effectiveness in preventing illness and promoting health. Value based models aren’t new. CMS has had 7 value-based programs in place for quite a while. — End-Stage Renal Disease Quality Incentive Program, Hospital Value-Based Purchasing, Hospital Readmission Reduction Program, Value Modifier (VM) Program, Hospital Acquired Conditions (HAC) Reduction Program, Skilled Nursing Facility Value-Based Purchasing, and Home Health Value Based Purchasing. These programs have proven to improve patient outcomes through prevention and education and save money.

H.R.4587 — Value in Health Care Act of 2021, a bipartisan bill introduced July 2021, enables accountable care organizations (ACOs) to receive payments for savings stemming from care coordination and management. It was referred to the subcommittee on health and has not gone any further. Fourteen leading health groups, including American Academy of Family Physicians signed a letter supporting this bill.

4. Improve Supply Chain.

The ongoing drug shortages seem to have no end in sight. India and China, both leading drug manufacturers for the US market, are still experiencing lockdowns and raw material shortages used to make both over the counter and prescription drugs. India, the world’s third largest drug producer by volume, imports 70% of its requirement of raw materials or intermediates from China. Raw materials from China are used in making major antibiotics, paracetamol, diabetes and cardiovascular drugs. China has imposed a phased lockdown to curb Covid outbreak, causing cargo delays at its two main ports. This in turn has caused a delay in raw materials used to make drugs entering India.

Ideally, the answer would be for the US to build manufacturing plants and produce most of our drugs in the states. This, however, can take years to happen. According to PHRMA, an advocate for biopharmaceutical research and development, building a new biopharmaceutical manufacturing facility can take 5 to 10 years, on average, before it is operational and can cost as much as $2 billion.

While we wait for a solution to the supply chain shortage, there are a few steps you can take in the meantime.

Become medically prepared. This means taking stock of what you and your family uses in the way of over-the-counter medicine (pain relievers, allergy meds, etc.), supplements, and prescription drugs.
Once you have taken inventory, stock up several months’ worth of these medications and supplements. Rotate and use these according to expiration date.
If you or your family are taking prescription drugs, ask your care provider for a 6-month supply (or more). Many insurance companies will not cover this, however, given the current situation on the world stage, if you are able to obtain an extended prescription it would be wise to fill it in case of further shortages.
According to U.S. Pharmacopeia’s (USP) Medicine Supply Vulnerability Insights Series antibiotics are 42% more likely to be in shortage compared to all other drugs. A Jase Case, available online through a group of board-certified doctors and licensed pharmacists is insurance against this shortage. This case carries the most common antibiotics to treat a wide range of infections and can prove to be lifesaving. From pneumonia to urinary tract infections, cellulitis, travelers’ diarrhea, ear and tooth infections and more, the Jase Case has you covered.

5. Contact your local state representative.

Let your voice be heard. Our state representatives do value your input and the fact you took the time to reach out and voice your opinion.

Find your state representative by entering your zip code at the House of Representatives website.

Snail mail (most effective), email or call and let your representative know you support H.R. 4040: Advancing Telehealth Beyond Covid Act of 2022 and H.R.4587 — Value in Health Care Act of 2021(let them know you are aware no further action had been taken since last year on this bill).

Both bills will help consumers save money and provide access to quality care through telehealth systems.

Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?

Yes, this was touched on a bit under ‘Improving Access’. A big part of improving access is addressing the physician shortage. This can be done on multiple fronts. Including, using technology as a ‘force multiplier’ such as telemedicine. This allows a physician to be in multiple places at once. Other fronts include increased class sizes at medical schools and just as important, increasing the number of residency spots at residency programs across the country.

How do you think we can address the issue of physician diversity?

While improvements have been made over the years with physician diversity there is much that remains to be done. If we want to encourage a more diverse group of individuals to become physicians, we should start at an early age. This means putting more resources into our young peoples’ education. More focus and funding for STEM programs especially in areas of the country that are traditionally underserved and lacking in support.

How do you think we can address the issue of physician burnout?

The strain put on physicians in today’s healthcare system is unsustainable. A lot of this strain comes from the sheer volume of patients to be seen and the amount of time allocated to each patient. Adding to this is the unnecessary non-clinical work associated with each patient encounter. It’s estimated that for every hour of face to face time with a patient, a physician must complete 2 hours of electronic health record documentation. And this ratio has steadily been increasing. I don’t know a single physician who came to the profession because they liked to type and fill out forms.

What concrete steps would have to be done to actually manifest all of the changes you mentioned? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Change starts at the beginning. In this case, get involved first by educating yourself to the issues and then following that up with letting your voice be heard regarding many of the proposed legislation that is already being considered. Contact your state and federal representatives! Leaders, for their part, should seek out direction from their local constituents and be careful to not focus too much on whoever is the loudest special interest group or lobby.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I’ll add to the first quote mentioned at the beginning of this interview, “You’re never wrong if you love and help people.” with another quote that I really like, “Lift where you stand”. Each one of us, on some level, wishes something was different about our lives. None of us is in the perfect situation. Whatever circumstances you find yourself in, lift others around you, do your best wherever you find yourself. In my experience this kind of attitude is a guarantee for increased happiness and satisfaction in your life.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work. (SOURCE)

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