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Interdisciplinarity and COVID-19: Progress and challenges

The COVID-19 pandemic has caused millions of people to be ill and led to millions of deaths worldwide. This public health emergency has affected everyone’s life and well-being. Through the suffering, however, there is one silver lining: The pandemic has also provided motivation for different disciplines to come together and put up a united front against this crisis.

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How has the COVID-19 pandemic changed interdisciplinarity? VICTOR TORRES/Stocksy

Interdisciplinary and interprofessional collaboration are crucial to both research and care settings. When experts with different specialisms are able to come together and help each other, better outcomes are guaranteed for all.

As early as 2010, the World Health Organization (WHO) was stating the importance of interprofessional education — that is, mutual teaching and learning exchanges between healthcare professionals with different specialisms — for the future of public health.

“Interprofessional education is a necessary step in preparing a ‘collaborative practice-ready’ health workforce that is better prepared to respond to local health needs,” the WHO then stated.

“Collaborative practice strengthens health systems and improves health outcomes.”

– WHO Framework for Action on Interprofessional Education & Collaborative Practice, 2010

However, there are myriad obstacles in the way of interdisciplinary and interprofessional collaboration. These include a lack of targeted funding and rigid, incompatible frameworks.

Perhaps for the first time in many decades, the COVID-19 pandemic has provided the motivation necessary for specialists from varied disciplines and professions to come together and overcome existing differences and difficulties.

The public health crisis has also meant that researchers have had more access to national and international funding, as they strove to develop effective vaccines to prevent infection and severe disease and drugs that could help fight COVID-19.

When the rollout of COVID-19 vaccines started across the world, many people expressed hesitancy about receiving them, as they were used to a much longer timeline of vaccine development.

More often than not, in the past, the process of developing a vaccine and confirming its safety and effectiveness could take up to 10–15 years.

So, how was it possible to develop, test, and roll out several new vaccines — some of which use novel mRNA technology — in under a year from the start of the pandemic? The answer: interprofessional collaboration and generous funding.

In a talk they gave at the WIRED Health:Tech conference in 2020, both Tal Zaks, then the chief medical officer of Moderna Therapeutics, and Prof. Uğur Şahin, co-founder and CEO of BioNTech, strongly emphasized the importance of interdisciplinary, interprofessional, and interinstitutional collaboration in the fast development and testing of their new vaccines, which were then still at the stage of vaccine candidates.

“The way [in which] the whole industry developed vaccines against COVID-19 […] is the best performance of collaboration,” said Prof. Şahin.

“Moderna teamed up with the NIH [National Institutes of Health], we teamed up with Pfizer, [and] AstraZeneca teamed up with Oxford University. So, there are several models of collaboration, and we have the strongest transparency in the development of a vaccine,” he explained.

This strong collaboration was crucial to being able to develop new candidate vaccines within a matter of months, as a sense of urgency stemmed from the ever-rising number of COVID-19 cases in countries all around the world.

Funding was also key. Although funding bodies usually tend to split their funds a lot more between disciplines and projects, the pandemic made it necessary for more funds to go toward the development of vaccines and drugs that could tackle SARS-CoV-2, which is the virus that causes COVID-19, efficiently.

In the United States, Operation Warp Speed went full steam ahead to support the development, manufacture, and distribution of COVID-19 vaccines in as little time as possible. In Europe, the European Commission pledged $8 billion to COVID-19 research.

In a guest editorial that appeared in the Journal of Interprofessional Care in August 2020, a team of 11 health experts wrote about how and why interprofessional education and collaborative practice research are especially important during the pandemic.

They also outlined some of the steps and considerations that would be necessary to ensuring constructive interdisciplinary collaboration in a medical research setting.

These include not only combining different types of expertise but also combining methodologies and building teams that are racially, socially, and professionally diverse.

“Inclusive [interprofessional education and collaborative practice] research teams would envision practitioners/clinicians from an array of experiential/applied settings, learners, service users, community members, various academic disciplines, and civil society as partners in all phases of research,” the authors wrote.

Collaboration between different experts and institutions has become more important than ever, not just in research but also in clinical settings and in ensuring effective communication between health experts and the general public during what has become a distressing time for all.

In a statement from May 2020, Dr. Hans Henri P. Kluge, the WHO regional director for Europe, emphasized the importance of “[c]ollaboration, coordination, and communication across the public health community.”

He noted that:

“Strong and integrated management of public health services, primary care services, and […] hospitals and long-term care facilities is critical to [navigating] this delicate phase.”

Although healthcare systems everywhere have been under great strain due to the high number of COVID-19 patients requiring urgent hospital care, this has not negatively impacted healthcare professionals’ collaborative efforts, according to some recent studies.

Medical News Today spoke with Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, about the ways in which interprofessional collaboration in a clinical setting has changed since the start of the COVID-19 pandemic.

Interprofessional and interdisciplinary collaboration has been important to clinicians for decades, he told us, as health workers aim for stronger communication between specialists to ensure holistic care for their patients.

“Several forces are at play [that] foster greater interprofessional cooperation. First, there is the hospitalist movement,” he explained.

“Over the past decade, inpatient hospital care has transitioned from being mostly provided by physicians with practice outside the hospital who would see their few patients in the hospital daily to one where full-time, hospital-based physicians provide the primary care for inpatients.”

“Since hospitalists will generally have no prior knowledge of these patients or follow them subsequent to their hospitalization, there needs to be close collaboration between inpatient and outpatient physicians during the course of the hospitalization to optimize care,” Dr. Cutler noted.

During the pandemic, this spirit of open collaboration in the healthcare system has become all the more present, he went on to say. According to Dr. Cutler, that is because:

“[COVID-19] is treated very differently when it is mild/moderate/outpatient than when it is severe/inpatient. […] [R]ecognizing early on when hospitalization may improve outcomes requires effective and timely communication between primary care, urgent care, ER, specialists, and inpatient physicians. Getting patients to the right level of care can be a matter of life and death. Decisions regarding monoclonal antibody infusions, steroids, remdesivir, intubation, and ECMO [extracorporeal membrane oxygenation] therapy involve multiple physician specialties.”

Technological advances, such as having greater access to e-medical records, are also helping strengthen interprofessional collaboration in a clinical setting, added Dr. Cutler.

“The electronic medical record is perhaps the greatest force improving physician collaboration during the pandemic,” he told MNT. “Physicians who may even be in different healthcare systems can see prior testing and treatment done elsewhere, which promotes improved interdisciplinary care.”

“Electronic records also allow patients access to records generated by geographically diverse providers, which is a great boon to the quality of care,” he added.

Inevitably, the public health crisis that led to numerous lockdowns and travel restrictions across the world has also had a severe impact on the mental health of people around the globe.

This means that mental health care has also had to step up to the challenge. One key way of doing this has, once again, been pushing for more interdisciplinary and interprofessional collaboration.

MNT spoke with Lea Milligan. He is the CEO of MQ Mental Health Research, which is a United Kingdom-based charity funding mental health research. Milligan told us more about the challenges and successes of collaboration across fields and specialisms during the pandemic.

“On the eve of the pandemic, the mental health research community had performed the great task of agreeing [on] a set of ambitious 10-year goals for 2020–2030,” he told us. “They derive from recommendations in the ‘Framework for Mental Health Research’ published in [December] 2017, and [they] also build on previous research priority exercises.”

Milligan explained that the agreed-upon goals for mental health research and care require cross-disciplinary collaboration from the get-go: “Research to support the targets under each goal should be undertaken in partnership with the life sciences industries, charities, the NHS [National Health Service], voluntary, social and independent healthcare sectors, together with patients/ service users, their families/carers and clinicians.”

This need for collaborative mental health research and care has increased exponentially due to the COVID-19 pandemic, he went on to point out:

“Coordination across the [mental health research] sector is essential for the tide to be turned and for mental health science to become the super discipline it has the potential to be. Substantial investment is needed in both human capacity and infrastructural capacity. The emergent umbrella discipline of mental health science needs [an] opportunity to convene, develop a common language, and explore opportunities for collaboration between different approaches.”

The good news is that collaboration is already happening. According to Milligan, “Over the [past] year, in response to the pandemic, we have seen many groundbreaking projects with experts from psychiatry, data science, [and] neuroscience and people with lived experience coming together to tackle some of the biggest challenges faced within mental health care.”

As an example, he mentioned DATAMIND. This is a U.K.-based “hub for mental health informatics research development,” which makes new tools and mental health-related data available to researchers from all disciplines who may benefit from using them.

He also mentioned the Post-hospitalisation COVID-19 Study, which aims to look at the long-term effects of COVID-19 — including those on mental health.

“This holistic approach has resulted in a far more in-depth understanding of the virus’s impact and has opened the door to further areas of research into the long-term cognitive effects [that] many [people] are reporting,” said Milligan.

What remains to be seen is whether or not the progress in establishing and fostering interdisciplinary approaches that researchers and healthcare workers have made throughout the pandemic will persist beyond this public health crisis.

Some challenges remain. For example, although collaborative research has been intensifying during the pandemic — particularly in terms of vaccine development and distribution — there is still a sense that equitable collaboration, wherein all research partners are actively listened to and receive due credit, is often lacking.

A comment feature that appeared in Nature Human Behaviour in March 2021 emphasized the continued inequitability in research settings, noting that it hampers progress and ultimately harms global collaboration.

The authors write that although “[n]umerous academic organizations and departments of anthropology, psychology, and related fields reliant on cross-cultural data production have now declared commitments to combat racism […] and improve [the] representation of minoritized groups among their faculty and student body,” these commitments are often shallow, failing to address deep-rooted systemic inequities.

“Often missing from this discussion among high income country-based researchers, however, is the promotion of equitable collaboration in cross-cultural research with national universities and research [centers] in low and middle income countries,” they go on to note.

In terms of collaborations regarding clinical and mental health care, Milligan told MNT that future improvements should focus more on holistic approaches to treatment.

He also suggested that tackling structural racism and ingrained biases in healthcare remains crucial to building a true spirit of collaboration and to providing adequate care.

“Three areas we would like to see [a] more explicit focus on are: the need for truly interdisciplinary approaches, [the] requisite of seeing the whole person (not an isolated diagnosis), and [a] more explicit focus on addressing inequalities across all targets.”

Yet Milligan was hopeful. “Interdisciplinary working is here to stay, as it should be,” he told us. “When experts from across the spectrum of experience share views and knowledge, it gives us a more rounded approach to research.”

To achieve this “rounded approach,” he explained, it is important to include not just scientists and clinicians in the conversation about health research.

Those on the receiving end of care are also experts, thanks to their lived experience of ill health. Their unique expertise, Milligan added, can transform research and care for the better.

“The next step is to ensure that experts by lived experience are involved in the co-production of research so that their vital contributions are not missed out on.”

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