From Clinic to Cloud: How a Pandemic Redefined Our Health
Increase in Telehealth Usage
Reduction in Clinic Wait Times
Patient Satisfaction with Virtual Care
Remember when seeing a doctor almost always meant taking time off work, sitting in a waiting room, and hoping your infection wouldn't spread to others? For decades, this was the unquestioned rhythm of healthcare. Then, almost overnight, a global pandemic forced a revolution. The COVID-19 pandemic didn't just create a health crisis; it became a dramatic catalyst for change, shaking the very foundations of how we deliver and experience healthcare 1 7 .
What has emerged is a "New Normal"—a transformed landscape where digital technology, innovative care models, and a renewed focus on accessibility are reshaping our relationship with health 3 . This shift goes far beyond simple virtual doctor's appointments. It represents a fundamental paradigm shift toward a system that can meet patients where they are, both physically and digitally 1 .
Adoption of telehealth services pre, during, and post pandemic peak
Before the pandemic, the "old normal" in primary care was already showing its cracks. Patients often faced month-long waits for appointments, had to take time off work, and incurred expenses traveling to clinics 1 . These barriers disproportionately affected Black people and other historically disadvantaged groups, deepening entrenched health inequities 1 .
The concept of the doctor's office as the sole location for care has been upended. Drawing on an idea famously used by Starbucks, healthcare is now embracing the concept of a "third place"—not home, not work, but a welcoming, connective environment 1 . The pandemic accelerated the reframing of this third place from a physical location to a virtual one that begins the moment a person thinks about their health 1 .
The most visible symbol of this change is telemedicine. Almost overnight, care migrated to wherever there was a telephone or computer: from homes, workplaces, and with family members conferenced in from multiple locations 1 .
However, this shift also revealed a digital divide. For older adults, low-income individuals, and some racial and ethnic groups with limited access to technology, telemedicine risked becoming another structural barrier to equitable care 1 . This highlighted a critical lesson: the goal is not just to create virtual versions of office visits, but to fundamentally rethink what it means to support patients wherever they are.
How does a temporary adaptation become a permanent part of healthcare? This question was explored by a team of researchers who conducted a qualitative study with clinical leaders across the United States to understand how new practices become normalized 4 8 .
The researchers used semi-structured interviews with 17 clinical leaders in quality improvement and implementation science. These leaders were recruited from diverse healthcare contexts, primarily urban academic medical centers 4 .
The interview transcripts were analyzed using a modified version of the Normalization Process Theory (NPT), a framework that helps understand how new practices become embedded in social contexts 4 .
The practice is fully woven into existing clinical workflows and no longer feels like an "add-on."
The change has been adopted across the entire relevant unit or healthcare system, not just by a few early adopters.
Clinicians and staff have developed strong buy-in and feel a sense of ownership over the new process.
The practice continues reliably without needing active monitoring, reminders, or evaluation to be sustained.
| Signal | What It Looks Like in Practice |
|---|---|
| Seamless Integration | A nurse documents a telemedicine visit in the same electronic health record workflow as an in-person appointment. |
| Organizational Scale | Every primary care provider in a health system offers and comfortably uses virtual visit options. |
| Staff Ownership | A medical assistant suggests an improvement to the virtual intake process because they feel responsible for its success. |
| Sustained Without Oversight | Virtual visits continue to be scheduled and completed without any reminder emails from management. |
The research also pinpointed key strategies that leaders use to successfully normalize changes. These include starting with a patient, incremental approach that builds momentum, proactively gaining staff buy-in, and continuously measuring progress toward normalization goals 4 .
The healthcare "new normal" encompasses far more than video calls with doctors. It represents a broader reimagining of how, when, and where care can be delivered.
Innovative models are emerging that truly "meet patients where they are" 1 . For example, some health systems have "right-sized" prenatal care by dramatically reducing low-risk in-person appointments and using virtual check-ins when examinations aren't necessary, thereby decreasing burden and cost for patients 1 .
Clinics mailing STI testing kits directly to patients' homes for privacy and convenience 1 .
Extending access to vaccines through drive-thru sites, mobile health clinics, and school-based health centers 1 .
Using data from wearable sensors to inform health recommendations based on real-time metrics 1 .
| Care Model | Core Innovation | Benefit to Patient |
|---|---|---|
| Right-sized Prenatal Care | Replacing some in-person visits with virtual check-ins for low-risk pregnancies. | Reduces travel time, cost, and potential COVID-19 exposure. |
| Home-based STI Testing | Mailing test kits directly to a patient's home. | Increases privacy, convenience, and access to crucial screening. |
| Digital Prescriptions | Using apps to obtain and manage prescriptions. | Streamlines access and reduces barriers for ongoing medication needs. |
| Drive-thru Vaccinations | Administering vaccines in a drive-thru setting. | Offers speed, convenience, and a sense of safety. |
Successfully navigating the new normal requires a specific set of tools and strategies. Based on insights from implementation science, here are some of the key "reagents" needed to make lasting change work 4 .
| Tool/Strategy | Function in the Change Process |
|---|---|
| Incremental Rollout | To build momentum and allow for adjustments by starting small rather than launching a change everywhere at once. |
| Champions & Early Adopters | To model the new behavior, persuade peers, and provide social proof that the change is feasible and beneficial. |
| Tailored Communications | To address the specific concerns and values of different staff members, making the change relevant to them. |
| Integrated Workflow Design | To ensure the new practice fits smoothly into existing routines rather than feeling like a disruptive, separate task. |
| Ongoing Measurement & Feedback | To track progress, identify problems early, and provide data that demonstrates the impact of the change. |
Underpinning all these tools is one critical factor: payment reform. The article in Annals of Family Medicine argues that if we simply reimburse telemedicine encounters with the same old transactional fee-for-service models, we will see little improvement in health outcomes or inequities 1 . Instead, the healthcare system needs payment models that encourage innovation beyond the traditional office visit. Capitated payments—where providers are paid a set amount per patient rather than per service—are one example of a model that could promote more patient-centered, on-demand primary care 1 .
The COVID-19 pandemic forced a dramatic and rapid evolution in healthcare. While the transition has been challenging, it has also created an unprecedented opportunity to build a system that is more flexible, accessible, and centered on patient needs.
Building healthcare infrastructure that can adapt to future challenges
Placing patient needs and preferences at the forefront of healthcare design
Ensuring all populations have access to quality healthcare services
The "new normal" is not a fixed destination but a continuous journey of adaptation and improvement 3 . The chaos of the global pandemic has revealed a path toward the bold action our healthcare system has needed for decades 1 . By embracing innovative strategies, equitable payment models, and a commitment to supporting patients wherever they are, we can move beyond simply surviving the crisis. We can seize this critical moment to achieve a system that truly transforms health and healthcare for everyone in this new era.