How The Pandemic Flipped The Default In Healthcare

Aline Holzwarth
4 min readMar 1, 2021
By flipping the default from in-person to remote care, healthcare systems decrease friction toward the preselected option, and imply that the defaulted option is recommended. Getty.

The coronavirus pandemic has upended our lives in so many ways. And while it’s not easy to find a bright side, one silver lining of the pandemic has to be the prevailing switch to a “digital first” mentality in healthcare. While health systems used to approach digital care with risk aversion and resistance to change, remote models are increasingly becoming the standard of care. (In all kinds of work, the switch to remote doesn’t appear to be going anywhere.)

If you wanted to schedule a telemedicine appointment in 2019 to save time and money, you would have had a hard time getting your provider to accommodate you. (It’s hard enough scheduling an appointment in the first place!) But with the swift and critical changes ushered in by the 2020 pandemic, your options now look very different. As a pregnant patient myself, I have had only 6 in-person visits over the past nine months, a number that would have been at least double in the past. I have saved time and gained tremendous convenience with the same quality of care and zero adverse consequences. With the necessity of reducing in-person healthcare visits in order to lighten the strain on systems fighting coronavirus, digital care options are now a standard part of the mix. According to Rasu Shrestha, Executive Vice President & Chief Strategy and Transformation Officer for Atrium Health, “ what was the norm in 2019 is now archaic.”

But remote care options are not only added as new alternatives to in-person care. They are what behavioral scientists consider “defaulted,” or selected as the primary path for all patients unless overridden by necessity. The response of health systems to the coronavirus pandemic has entirely flipped the default for providing care, moving from in-person care as the default to remote care taking its place. While the pre-pandemic model was characterized by friction (e.g., allowable technologies restricted to a few) and misaligned incentives (such as the lack of reimbursement for telemedicine), the pandemic served as the catalyst for a new paradigm where remote models of care have become the norm. In an article just published in BMJ Leader with Janet Schwartz, we argue that healthcare leaders can leverage strategies from behavioral science, such as defaults, to gain better short- and long-term outcomes.

Aline Holzwarth

Aline Holzwarth is an applied behavioral scientist, primarily focusing on digital health research and scientifically informed product design.