Health Care Companies’ Critical Role in Responding to COVID-19

Richard Migliori MD, EVP, and Chief Medical Officer of UnitedHealth Group describes the health care company's multi-pronged response to the COVID-19 pandemic.

By Richard Migliori M.D. - First published on The Doctor Weighs In on June 8, 2020 

Health care companies, including UnitedHealth Group, have a critical role and responsibility to help strengthen the national response to COVID-19. And, we must ensure that we apply the hard-learned lessons to future efforts. If we do that, we can do the accomplish the following:

• identify potential outbreaks
• protect the most vulnerable
• address gaps in capacity and resourcing early on

All of these efforts can help create safer and more efficient work protocols for our frontline health care providers.

UnitedHealth Group's approach 

That’s the approach we’ve taken at UnitedHealth Group, the world’s leading health service and health benefits company with more than 100,000 frontline health care providers. We continue to lean into that responsibility and leverage all our resources, expertise and reach to strengthen the national response to the coronavirus.

With so many frontline clinicians, we also have a special obligation to ensure their health and safety while they put themselves in harm’s way while caring for patients. In that regard, we launched a $5 million philanthropic partnership to source protective equipment and supplies for health care workers. And, we fielded a virtual support system to support their mental well-being and resilience.

We also redeployed and trained thousands of health care workers to meet unmet needs, such as

• remote care
• 911 phone call triaging
• COVID-19 testing 
• use of technology to connect nursing-home patients with their families.

We particularly focused this effort on front line workers who are or live with people at high risk of COVID-19 complications 

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Ensuring workplace safety: The ProtectWell protocol

In partnership with Microsoft, UnitedHealth Group is also laying the groundwork for the continued reopening of the health care system and the larger economy with the ProtectWell protocol.

Grounded in CDC guidance, workers screen themselves daily for risk signs of COVID-19 infection. An app guides them to care and/or testing if needed.

We have begun rolling it out within our company and have offered it to employers across the country free of charge to help ensure the workplace is as safe as possible.

Accelerating provider payments

The company also accelerated nearly $2 billion in provider payments to help them stay on the front lines throughout the crisis. And, we made it easier to treat patients and encouraged patients to seek care by implementing the following:

• waiving COVID-19 cost-sharing and prior authorizations
• encouraging the use of telehealth
• processing early prescription refills
• granting provisional provider credentials to expand our network of providers.

Addressing the testing bottleneck

As UnitedHealth Group’s chief medical officer, I’m also excited about our efforts to improve the clinical response to COVID-19. As the disease emerged and spread, the shortage of personal protective equipment became quite acute. We quickly identified testing as a major bottleneck in containing the spread of infection and protecting health care workers.

Our doctors in Everett, Washington, working with the Bill &Melinda Gates Foundation, seeded the ground for expanded testing. They showed the FDA that less invasive, self-collected tests worked as well as more invasive nasopharyngeal ones collected by a health care provider.

We built on that work and helped the FDA further expand testing by demonstrating that tests could be accurately conducted with shorter, less-invasive swabs and they can be carried in cheap, widely available saline.

Now we’re applying those streamlined methods at scale to help the state governments in California and Indiana to roll out expanded testing throughout their states. We are especially focusing on communities that don’t have easy access to health care providers.

The ventilator shortage

One other bottleneck that we recognized early was a shortage of ventilators. In response, we worked with the University of Minnesota to develop its concept of a ventilator that is lighter, cheaper, and easier to deploy than traditional ventilators. The result was an FDA-authorized product that could be mass-produced in 30 days with Boston Scientific and Medtronic.

UnitedHealth Group proudly fielded 3,000 light ventilators to address concerns that surging COVID-19 infections would overwhelm hospitals’ ventilator capacity.

The brilliance of these ventilators is that they are powered by a robotic arm that compresses an oxygen bag. Its simple design means more people can be helped. This is because a health care worker doesn’t have to be there to manually compress the bag for a patient to breathe.

The light ventilators, which went from concept to FDA authorizations and mass production in just 30 days. This exemplifies the collaborative approach that must become the new norm across the health care system.

Physicians at the University of Minnesota came up with the initial idea. Then, UnitedHealth Group, Boston Scientific, and Medtronic contributed their technical, regulatory, and production expertise. All of this ensured that the light ventilators were safe and could be deployed at a scale large enough to address surge-capacity concerns. 

Jumpstarting COVID therapy clinical trials

We also helped jumpstart the Mayo Clinic’s clinical trial of convalescent plasma to treat COVID-19.

Many experts suggest that it may take more than a year to develop a vaccine. In the meantime, coronavirus patients need better treatments right now. The use of convalescent plasma is one of the most promising approaches. This is because we’ve seen it work before to successfully treat other diseases similar to COVID-19.

Testing has expanded to more than 2,400 sites across the country. Preliminary results have demonstrated the safety and efficacy of the approach.

While research continues, the trials need more plasma donated from people who have recovered from COVID-19 to test whether it helps others who are fighting the infection.

WATCH PAT SALBER'S INTERVIEW WITH DR. MIGLIORI TO LEARN MORE ABOUT WHAT UHG IS DOING IN RESPONSE TO THE COVID-19 PANDEMIC. LINKS ARE AT THE END OF THIS ARTICLE.

I urge anyone who might have had COVID-19 to go to https://www.uscovidplasma.org to see if they might be able to help.

Further underscoring our engagement, UnitedHealth Group’s president, Sir Andrew Witty, recently took a leave of absence to co-lead the World Health Organization’s global effort to accelerate the development of a COVID-19 vaccine.

Going forward

I have every confidence that we will beat COVID-19. As long as we make habits out of how we worked and what we learned during this crisis. The experience will change not only our country but it also alters other aspects of healthcare, including:

• how we deliver and receive care,
• protect our frontline health care workers,
• help the most vulnerable.

I’m incredibly proud of the work my 325,000 colleagues have done to ensure that millions of Americans get the care they need during this pandemic. I am certain we will continue innovating and collaborating our way to a stronger health care system. One that delivers better care for everyone.

Be sure to watch every minute of Dr. Pat Salber's three-part interview series with Dr. Migliori here:

First part: https://youtu.be/bcGDs5xZKLA

Second part: https://youtu.be/1GtX_WaZSZs 

Third part: https://youtu.be/9hX0NkMwtDg

Enjoy!

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Financial disclosure: TDWI did not receive compensation for publishing this story.