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STEEP – Social, Technologies, Environment, Economic and Political – what factors influence the healthcare resources in your setting based on these categories?
Lack of communication due to WFH and social distancing strategy – Social
Use of technology in healthcare services, reducing need for human resources – Technology
Large spending of government to support the country, lower budget for other projects – Economic/PoliticalSome examples…
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In the context of COVID-19, the following factors influence the healthcare resources based on STEEP
Social – Social determinants of health, such as education and adequate housing, affect healthcare utilization. For example, marginalized people, despite lockdown orders, will need to find way to earn money for the day to be able to eat and pay rent. This is at the expense of being infected with COVID-19. Social amelioration programs may be insufficient and do not adequately meet their daily needs. Educational attainment may also play a factor in COVID-19 vaccine hesitancy.
Technology – COVID-19 pandemic led to the rise of telehealth or remote medical consultation. Several applications were also instituted, such as contact tracing apps and health declaration form which, in theory, will facilitate collection of health data and easier detection of a potential COVID-19 case. These technologies helped in reducing the human resources needed, especially on hospital setting where severe and critical cases of COVID-19 are of utmost priority.
In terms of shopping, e-commerce had huge boost in sales in lieu of mobility restrictions. It helped in reducing the need to physically go to essential services; thus, decreased the chances of transmitting COVID-19.
Environment – Environmental factors focus more on the prevention of COVID-19. Maintaining ventilation is key in preventing COVID-19 transmission especially in closed and crowded areas. Many businesses and institutions have adapted to this health standard requirement by introducing outdoor dining services or tents for diagnostic testing. Most establishments have alcohol/sanitizers in place to practice hand hygiene, and foot bath to wash of shoe dirt. Indoor dining now requires maximum percent capacity and acrylic dividers to limit respiratory droplets from scattering. All these preventive measures potentially avert the healthcare resources that will be utilized if these measures are removed.
Economic – As we all know, the worldwide economy has been greatly affected by closures of thousands of businesses as restrictions in mobility and gathering were imposed. This consequently led to loss of jobs, hindered market growth, and posted economic losses.
When vaccines began flooding the market, many countries have allotted billion currencies in order to secure supplies from pharmaceutical companies. The Philippines, due to its good debt standing, it was able to secure multilateral funding from various financing institutions. It was also crucial to study the vaccine economics (ie, supply and demand). Relying from one manufacturer may be easier, but it can face delays in production and subsequently lead to delayed implementation of vaccination. The Philippines entered agreements with at least 7 different manufacturers to reach its target herd immunity of 70%.
Political – In the Philippines, there are lots of controversies surrounding the pandemic response by the government. The response was slow and there were conflicting executive orders which led to confusion among citizens. Some implemented policies were fruits of corruption. Instead of channeling the resources to the important and pressing health issues, they were redirected to rehabilitation of the city capital’s beach, implementation of face shields, among others.
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I am now working for a private sector for a while, so there might be some differences from public sector. But I think it would be good to share my view about effects to healthcare resources in my setting.
Social – During COVID-19 pandemic, The outbreak affected resources in term of number of beds and ward. We have to spare a few floor of our hospital to be ready for COVID-19 infected patients. Moreover, we have to spare shared resources such as medical devices, elevator, entrance, and parking for COVID19 infected patients. The outbreak also significantly affected on human resources. For instance, some staffs had to quarantine themself in COVID19 ward after accidentally contact with patients. We also had to hire more healthcare providers to be able to deliver proper services during the peak period that cost a lot to hospital. Furthermore, some business collaboration was more difficult to be completed because of the lock down.
Technologies – My hospital decided to change every physical meetings to online meeting. Therefore there are some struggles at the beginning. Surprisingly, after a few sessions, our staffs got familiar with online meeting and found it more convenience to join and share their resources than traditional physical meeting. We had to implemented new information system to maintain quality of services while reducing risk of getting infection. Thus, IT team had more workload to deliver many systems.
Environment – Environment itself, such as climate and weather, didn’t affect much to my hospital.
Economic – During the outbreak, people had less purchasing power to access to private hospital that resulted in decreasing our revenue. This affected on other projects that should be done to improve quality of services. It also affected on individuals, such as decreasing in OT and other extras wage.
Political – Policy about Covid-19 frequently changed during the outbreak. Our staff had to spend much time trying to work along the policies. Policy about vaccine also affect us in management of all resources, including human resources, financial, medical device, and places, to be always ready to deliver vaccination services.
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Many people continually relies on government subsidy when it comes to healthcare, especially that COVID-19 care is expensive here in our country and our national health insurance program does not cover all the costs associated with COVID-19. Concurrently, the economic sector of every country fell significantly. This led into shortages of funds due to closing of enterprises and businesses to which their taxes contribute much to the budget of the national government. It is a lose-lose situation.
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I also work in a private setting and can share some perspectives on it.
Social: I agree with the Lack of communication due to WFH and social distancing strategy. We need to work from home since the beginning of the pandemics. Some people in field-based roles found it is difficult to engage with both internal and external contacts which may affect their work performance. For example, some clinical trials need to be postponed due to the difficulty of including/monitoring study groups and social distancing reasons.
Technologies: I have the same thought as Anawat. Right now, my organization also uses online meetings instead of physical meetings and there are some struggles at the beginning too. We also try to use other electronic tools such as signature online, virtual webinars, a new education website for webinars and resources collection.
Environment: Due to the social distancing strategy, I neither go to the office for a long time nor have a physical meeting with my colleagues. It does affect the work environment. In my opinion, it doesn’t change much for the physical environment, except less pollution due to fewer cars/people/travellers.
Economic: People tend to spend less and some people were laid off due to economic hardship.
Political: As we mainly WFH and manage everything online, we focus more on policy related to digital tools and collecting personal data online. There are also supportive policies about the vaccine and infected employees within my organization such as sick leave, leave for vaccination, and compensation during medical leaves.
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I also working in the private sector, I think there are some similarity and differences between private and government sector, here is my point of view;
Social: Social distancing strategy makes people keep more space between each other, the communication between each sector need to adapt to the situation. Some patient ward need to be spared in case of emergency situation.
Technologies: Patient tend to adopt more technology to take care their health. Healthcare provider need to provide and promote new technology to use in healthcare services such as telemedicine, health care application, that need more manpower and also knowledge training to proceed the project.
Environment: Due to social distancing strategy, uncrowded environment should be provided to increase the airflow and reduce the risk of disease transmission.
Economic: Hospital revenue has been decreasing due to the outbreak. Some health promotion activities need to postpone such as annual health check up or other procedures other than remedying health state which cause some clinic in the hospital need to be temporary closed. From these reason, resource allocation is the main topic that need to be considered along with strategic marketing plan.
Political: Hospital need to response the policy and plan according to government policy such as medical treatment expense, vaccine allocation etc. -
I would like to share some of STEEP factors which affects the healthcare resources in my setting, as a community pharmacist.
Social
According to social distancing, we set up the counter in the front and talk to the patient through plastic screen. There also a panic about COVID-19, so some patient tend to buy the products they believe that would protect them form COVID-19.
For example, Andrographolide which is not approval for COVID-19 prophylaxis. We need to correct their misunderstanding. These make Andrographolide running out of stock for a while.Technologies
There’s a telemedicine application that allows the patient to consult the physician and then prescription will be sent to the registered drug store to delivery the medicine. Due to the lack of our workforce and ethics issue, we are not implementing this technology to our store.Economic and Environment
The COVID-19 outbreak results in recession, the purchasing power is declined. Seasons change also comes with the certain disease. These will dramatically affect the stock management plan, we need to revise the plan more frequently -
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Please allow me to share my observations on the current situation in Japanese society following the COVID19 pandemic based on the STEEP factors, although some of these are not related to the health sector.
SOCIAL
– Increased optimism about the pandemic due to the decrease of the newly confirmed cases and progress in the national vaccination campaign
– growing negative feelings about further social restriction
– Behavioral change to prevent infection of the general public
– Increased teleworking policiesTECHNOLOGICAL
– Development of vaccines and medicines against COVID19
– Development of technologies enabling telemedicine
– Growing need to develop disease early warning systems for the next pandemicECONOMIC
– Increased government subsidies to support various sectors including health care providersENVIRONMENTAL
– Concern over increasing microplastic problems due to improper disposal of personal protective equipment (PPE) especially disposable masks
– Decrease in carbon dioxide (CO2) emissions and improved environmental indicators related to global air and water pollution
– Increased consumption of electricity at home due to teleworking system that may lead to other environmental issuesPOLITICAL
– Increased government’s political commitment to address the pandemic
– Deregulation in various fields, including the realization of telemedicine and online education -
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As classified in STEEP, the following challenges are expected by the Pandemic COVID 19;
Social- Due to the lockdown, social distancing, and restrictions on different sectors vulnerable people, children are mostly affected because of the Pandemic. Social gathering activities like wedding ceremonies, funerals, recreational activities are limited to a few people. This all affects social behavior and mental health.
Technological- There was a rapid increase in the use of technology due to pandemics in all aspects from surveillance, treatment, prevention, and also in research and information dissemination.
Environmental-There were reports of positive effects on the environment due to the lockdown and restrictions for many days due to pandemics. A good air quality index was reported in different countries.
Economic- Due to the pandemic, there was a lot of economic burden in the business sectors, a lot of people were laid off from their jobs. On the other hand, the government spent a lot of money on the mitigation of the disease, providing vaccines for prevention and surveillance for identification of disease.
Political- The government used different policies and strategies to aware public by properly disseminating the information about the Pandemic, involving different private stakeholders in the testing and vaccines distribution, and regulating the emergency health rule. More resources were implemented. -
In regard to healthcare sectors
Social: The social distancing protocols to minimised Covid-19 risk has change several habits mainly in seeking healthcare or consultation. Telemedicine is now used widely by the population.Technologies: Related to the social distancing, technologies really help this telemedicine to grow. It is really easy to use the health application that can be installed in your mobile phone. Technologies also enable easier communication through instant messaging and video call application.
Environment: Because of Covid-19, many people are now aware of the air quality. Many offices, and possibly also at home, installed an air purifier to clean the air in the room.
Economy: Agreeing with classmates, during the pandemic a lot of people cut off from their job or being demoted so people tend to save the money and not spending on anything that unnecessary. This could also affect the healthcare seeking behaviour, people won’t go to the hospital or seek treatment until the symptoms get worse.
Political: Government has been changing their rules during the pandemic and adjusting to the current situation. While this is a good thing, sometimes the changes timeline is not clear enough and make the public confused.
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I would like to share the factors related to my work. As a manager of COVID-19 vaccine clinic manager, here are STEEP factors of my context
Social: Trends about getting vaccinated change rapidly and change over time depending on the situation that occurs in that time period (eg. news about adverse reaction from vaccine tend to change people’s mind about vaccination, news about the new cluster in the area tend to increase the number of patient in the clinic.
Technology: Using technology really impacts the workflow of the COVID-19 vaccine clinic. It helps in decreasing the workforce, improving the accuracy of the data, and increasing the number of patients we can serve per day.
Environment: The environment of the setting must be considered in order to maintain social distance. We have known some of the high-risk patients that visited the clinic, and we want to protect others from infecting COVID-19 from our clinic.
Economics: While the clinic runs well with the support of the hospital and the Ministry of Public Health, this COVID-19 situation still keeps going, and vaccinating people must be an ongoing service. Vaccinating a large group of people continuously (not only high-risk group such as influenza) is a big task that needs resources in order to continue the service.
Politics: The uncertainty of the vaccine supplied by the government and confusion about the policy about vaccine formula sometimes makes it harder to plan forward in vaccinating everyone in the area
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According to the STEEP analysis that related to healthcare resources during the pandemic.
Social:
– Decisions for seeing the doctor may be deferred until the disease is worsening
– Patient might look for telehealth or other platforms of disease consultation rather than physical visiting
– Remote working, Virtual meeting, Lack of communication among healthcare teamTechnological:
– Telehealth and telecommunication have increased significantly
– Robotic assist may have an important role in the future to reduce close contactEconomic:
– The unemployment rate has increased which may impact the self-pay service of patient
– The hospital budget may spend on the facilities that support the treatment of COVID-19 rather than other specific diseases.Environmental:
– Work environment has changed to more safety to prevent airborne transmission (distancing, more space)Political:
– Regulation about disease control and prevention might be change
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