Crystal C. Wright, MD, FASA, Committee on Governmental Affairs, and Associate Professor, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston.

Crystal C. Wright, MD, FASA, Committee on Governmental Affairs, and Associate Professor, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston.

The first industrial revolution was the most profound development in human history. It was an era during which the transformation to faster and more efficient production revamped our daily lives and the economy. The industrial revolution vastly raised the standard of living and gave rise to modern capitalism. Newly interlocking industries created by the industrial revolution led to the second industrial revolution, based on science and technology. In the last century, the technology revolution profoundly altered human life, creating our modern world.

Our current century has seen another industrial revolution: the digital revolution. Digital technology has permeated every aspect of modern life. This revolution led to life-changing innovations. Our world has shrunk as we are connected by an ever-enveloping web of data and information. News spreads around the world in milliseconds. The latest scientific findings are online within minutes of acceptance, if not before! We eat lunch with friends on other continents. However, this same omnipresent digital revolution has given those who wish us harm intravenous access to our innermost fears and emotions. Lies, bogus science, and disinformation travel at the speed of light. Our ability to think critically, and evaluate claims skeptically, has been challenged as never before.

The COVID-19 pandemic has now left us asking what is next and reflecting on how the landscape of society changed so fast. What does the pandemic mean for the future of advocating for our specialty?

Those working in health care facilities have already embraced the tremendous changes this pandemic has caused. Its shockwaves have spread across all domains of medicine. As anesthesiologists, our approach to providing health care to our patients has also changed, but this is just the beginning. The anticipation of the after-effects of this pandemic on care delivery by medical professionals is palpable. Nevertheless, the six domains of health care: 1) safety, 2) effectiveness, 3) patient-centered, 4) timely, 5) efficiency, and 6) equity will allow us to effectively treat our patients, despite the threats of COVID-19.

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 to be a global pandemic. This was immediately followed by cascading effects of illness, death, unemployment, health care delivery alterations, school closings, and many other events that altered every aspect of American life. Despite the catastrophic effects of the pandemic, we must consider and explore the notion that the digital revolution and the use of telecommunication has broken down barriers.

During the pandemic, social isolation helped to mitigate the disease. Fortunately, digital technology prevented the disconnection of business, social, educational, medical, and commercial sectors. The availability of various technologies at our disposal helped connect us with our friends and relatives. Digital technology enabled parents to educate their children. Businesses were able to conduct meetings and maintain employment. Americans shopped with apps, securing groceries, food deliveries, and other essentials. Swiftly, the delivery of health care changed to allow patients to connect with their physicians; they were able to connect in real-time, securely, and from their electronic devices. Telemedicine has been an unknown entity in the health care industry, but during the pandemic, it helped reduce barriers in diagnosis, investigations, and treatment – in addition to allowing patients the benefit of staying in their homes, decreasing risks of infection. Physicians have long advocated for telemedicine, which allowed the platforms to be readily available when needed. The need has never been so essential!

ASA has a rich history of advocating for various aspects of patient care. Medical societies consider physician advocacy to be a critical part of professionalism and a declaration of professional responsibility. ASA continues to be an advocate through many different entities, but as we move through this pandemic, many questions arise: what is the impact of technology on advocacy? How will technology impact advocating for our patients? What barriers will technology break down that will allow us to continue to advocate for our patients?

While we continue to focus on finding ways to simultaneously provide perioperative care for our patients suffering from medical diseases (as well as COVID-19), it will be necessary for us to remain effective advocates for our patients and maintain the safety of our physicians and health care providers. We will continue representing patients, our interests, concerns, and views to the government and media.

ASA understands that advocacy continues to be a critical component of our commitment to our patients and the medical community. The shuttering of the physician's ability to advocate for patients in the traditional offline setting is a challenge, yet the ability to continue advocating for our patients using technology is becoming increasingly important. The issues surrounding health care have not changed, but the way we effectively advocate are changing. Notable trends that are advancing advocacy include online platforms, video conferencing, and virtual town hall discussions.

ASA works hard to inform members. Our society acts at critical times when advocacy is necessary. The ASA website and its Education Center adapted to an increasing digital world, such as in the development of online learning modules, which are even more critical in empowering local advocates. The distanced and virtual climate can be as effective as a face-to-face meeting. ASA has managed to maintain a presence with town hall meetings for its members, and we will continue to see additional ways in which advocacy can still manage to take place at both the local as well as national government levels. The educational and informational resources of ASA will be of paramount importance as our members seek to use virtual environments. The most critical barriers to advocacy are knowledge and education, but technology has been essential in breaking down those barriers.

Social media has also been a useful tool in advocating for our patients, allowing ASA to expand its target audience and spread its message worldwide. While videoconferencing has been around for a long time and has been continuously improving, the number of people using this technology has expanded significantly. Again, this is a field where ASA will be able to break more barriers to educate members and advocate with policymakers. ASA's virtual tools allowed us to maintain connections with our state and national policy-makers, letting them know how we stand on specific issues. This system was in place before COVID-19, but during the pandemic, it became more important and will undoubtedly be a future tool for effective advocacy.

This spring, ASA developed its first-ever Virtual Federal Legislative Conference. Our society recognized the need to maintain advocacy despite public health restrictions. The virtual conference reached hundreds of anesthesiologists. Despite the online format, the conference provided information on federal issues impacting the specialty, and reinforced fundamental health policy advocacy skills as effectively as our previous in-person conferences.

Medicine is changing. Only by tirelessly advocating for our patients can we ensure that these changes serve the best interests of our patients. Digital technology is fundamental to the changes in medicine and is equally fundamental to our continued advocacy. ASA has been a leader in developing virtual platforms that will allow its members to remain up to date, educated, and connected. Leveraging new technology, we look forward to increasing engagement with our patients, our community, and key stakeholders in advancing anesthesiology as the practice of medicine.

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