Health System Resilience

How health care CEOs can take the lead on safer education this fall

David Brailer | August 12, 2020

The debate about reopening schools has deeply polarized Americans, which is quite an accomplishment in this age of cynicism, division and tribalism, in extremis. Some people believe that schools can safely open for in-person education this fall; others firmly disagree. Some people think schools need to reopen to provide food for children and income for struggling families, even if there is an adverse impact on safety. Regardless of which side of this debate you may be on, or how you feel about the national and state leaders who have been increasingly delegitimized by this issue, we are heading into what is more-or-less a real-life experiment. Some school districts will reopen for in-person education next month, while others will only operate virtually. 

Health care and education have been rivals for years in a race for which is the least transformed industry in America. Both have ignored and been surprisingly unchanged by the wave of technology that has profoundly disrupted other industries. The pandemic is forcing education, as it is health care, to finally address years of neglect over the role of virtual engagement and other technologies in the educational experience. We will now see how different educational approaches impact education achievement and later educational and work performance. The is the same rapid learning health care is experiencing with telemedicine. 

At the same time, there is a lot that the health care industry can and should do to help make the fall semester safer – regardless of how schools proceed. Here are five ways health care institutions can help schools operate during the pandemic.   

Risk reduction. We know that schools are not designed to support the kinds of social distancing, flow and ventilation that are needed to lower viral transmission. Various public health agencies have published guidelines for what needs to happen in schools, but it is exceedingly difficult to translate these into real life situations. This is made further difficult by variations in culture and acceptance for risk reductions among local population of students and faculty. An easy way for local hospitals to invest in their community is by sending teams into schools with advice on workable solutions for layout and people flow based on the norms of the community. 

Hygiene. We know that hygienic practices are essential to transmission reduction. However, what is second nature to most health care professionals is a new field to teachers, staff and students. Many well-off schools may hire consultants but most schools can use help in development of programs that are responsive to the local community on hand-washing, mask-wearing, distancing and influenza-like-illness screening. Local hospitals and physician groups can create in-service teaching for teachers and programs for students on these practices. These will benefit the community and slow COVID-19 spread whether students are online or in school in the fall.

Testing. Testing is essential to keeping schools open, protecting students and faculty and keeping virus from spreading. However, most schools are not equipped to test students or teachers with symptoms, and almost none have the capacity to do the testing needed for syndromic surveillance or screening.  This means that schools will relegate potential cases to community testing facilities and potentially losing them to follow up.  Local health care organizations can collaborate with schools, to develop tight testing protocols, and to help them manage positive cases in an integrated manner. 

Behavioral health. The fall, regardless of how schools operate, will be a challenging time for teachers, students and their families, on top of the ongoing economic and social disruptions that are exploding all around. Students engaged in virtual learning may be particularly affected by the lack of social experience, isolation and loneliness. Experts in the local health care system can pro-actively work to strengthen behavioral health support for students and faculty. 

Safety net. Community health programs and food and housing interventions that are spearheaded by many health care systems are needed now more than ever. Despite the financial strains on health care organizations today, it will become much worse if the tide of failing health turns into a torrent. These programs are the first line of defense for the community. Health care systems can use many existing programs and resources to ensure that children who are educated at home have safe environments, including physical safety, as well as access to proper food every day. 

Many exemplary health system-school collaborations exist. For example, University Hospitals of Cleveland announced their Healthy Restart Playbook for school reopening here. Likewise, Children’s Hospital of Colorado announced a similar program for school nurses here. These health systems and many others recognize the important and unique role they play in community health, and also recognize that making schools safe addresses a key concern of health systems employees. 

What health care researchers can learn as schools reopen

Whether we like it or not, this fall also presents a unique opportunity to learn how disparate education approaches impact virus transmission and overall community health. Health care researchers should take advantage of the unintentional experiment being conducted across many school districts and collect data about how forms of school engagement affect viral spread and contagion. 

At the same time, the impact of virtual learning on behavioral health, depression, social isolation and other drivers of health can be assessed on a large scale as well. These results should be shared rapidly and widely because we are likely to be in the grips of the pandemic far beyond the fall semester of 2020. Our ability to operate schools safely in 2021 will be shaped by these learnings. 

Why health care CEOs are critical to schools reopening

We have seen a never-ending series of leadership failures as we confront COVID-19 and the economic and social fallout from it. It seems like the abdication of leadership by federal and state officials, as well as groups who purport to advocate for child health and safety, have become so apparent that we just absorb it now, undaunted and unperplexed as we might have been 6 months ago. 

During times like this, it is imperative that local health care leaders fill the void and ensure that our society continues to be led in a diligent and compassionate manner. 

About the Author

David Brailer, MD, PhD, is the Chairman of Health Evolution

David Brailer is known around the world for his leadership and entrepreneurialism in health care. Over the past three decades, Dr. Brailer has built a variety of private and public-sector organizations. From 2007 to 2017, Dr. Brailer was managing partner at Health Evolution Partners, a fund that invested in companies with the potential to transform health care delivery. Prior to that, Dr. Brailer was appointed by President George W. Bush as the nation’s first National Coordinator for Health Information Technology. From 1996 through 2002, Dr. Brailer was founder and CEO of CareScience, a health care information management company. He earned his M.D. from West Virginia University and his Ph.D. in economics from The Wharton School. Dr. Brailer serves on the Board of Directors of Walgreens and as a board member or chairman of five private health care companies.
You can follow him at @hes-morenz