A New Age for Healthcare & Medicine in the USVI

The Global Head of Healthcare Investment Banking estimates that by 2025, the compound annual data growth rate for healthcare will reach 36 percent, 6 percent faster than manufacturing and media.

The future of healthcare and medicine in the U.S. Virgin Islands could be transformative. 

In a June hearing, the 35th Legislature of the U.S. Virgin Islands received testimony from public servants administering the territory’s Medicaid program. One of the testifiers told Committee on Budget, Appropriations, and Finance members that the territory had only one cardiology specialist available, a recent hire. The only available option for patients suffering cardiac complications or gunshot wounds is a medivac off-island to Puerto Rico or Florida. 

It was difficult testimony to listen to. Much of the fiscal shortfall discussed in the June hearing results from Washington’s yeas-long dysfunction and a U.S. Congress unable to pass meaningful healthcare reform.

Although lawmakers approved additional funds for the program, many acknowledged that residents who rely on the Medicaid program would feel the brunt of changes to life-saving programs.

A Treasure Trove of Data and Scientific Discoveries

It’s undeniable a new era of scientific discovery and technological innovation is unfolding. The world’s modern economy and healthcare institutions produce and rely on large quantities of scientific data, and the situation is only getting worse. 

Humans need novel storage solutions for growing data needs, and governments and medical institutions also have to make sense of more data than ever before. The Global Head of Healthcare Investment Banking estimates that by 2025, the compound annual data growth rate for healthcare will reach 36 percent, 6 percent faster than manufacturing, surpassing financial services, media, and entertainment.

Forgotten scientific advances made decades before the COVID-19 pandemic helped researchers rapidly produce vaccines. Dr. Anthony Fauci estimates these advances prevented an additional 3.25 million American deaths.

By October 2021, scientists succeeded in rapidly developing a COVID-19 vaccine after researchers estimated development and broad approval could take years. The vaccines approved by the FDA in the weeks that followed built on years of RNA research and allowed labs to develop the first-ever RNA vaccine just a year into the pandemic.

In the last two years, groundbreaking advancements have been made in fusion physics, biochemistry, artificial intelligence, and human immunization. One area that continues to see advancements and new techniques emerge is cancer treatments. 

Chemotherapy can eradicate cancer cells, but the treatment also kills perfectly healthy cells, making for a complex recovery in cancer patients. 

In pre-clinical testing, FLASH proton therapy has been shown to potentially reduce the side effects of radiation treatment compared to conventional radiation. Flash radiation therapy is not widely available to patients, but if regulators greenlight the method, manufacturers would be incentivized to invest in the new tech. The new therapy targets cancer cells without damaging or killing healthy tissue.

Puerto Rico’s Pharmaceutical Edge

Puerto Rico has been a global leader in biopharmaceutical manufacturing for half a century. 

A report published in 2021 by Invest Puerto Rico in collaboration with the Pharmaceutical Industry Association of Puerto Rico found that Pharmaceuticals represent 30 percent of the territory’s GDP, 30 percent of all manufacturing jobs, and employ over 78,000 people. 

Puerto Rico is not just one island. Pasquines writes, “It is an archipelago, or island chain, composed of over 143 islands, cays, islets, and atolls. Technically speaking, the main island is also called Puerto Rico, but from a geopolitical, practical, and historical perspective, it is important to recognize the other islands, especially Culebra and Vieques. Sometimes called the Spanish Virgin Islands, these islands are permanently inhabited, and have been pivotal to the territory’s evolution into its present geopolitical form.”

Like her sister territories, Puerto Rico and the smaller islands in its jurisdiction were hit hard by the global pandemic in 2020. The territory’s footprint is so massive in the pharmaceutical industry that it ranks as the world’s fifth-largest producer of pharmaceutical manufacturing.

Aside from having a massive footprint in medicine and pharmaceuticals, Puerto Rico also boasts the Caribbean’s only medical center for Veterans. The VA Healthcare system is the largest integrated healthcare system in the United States providing care at 1,321 healthcare facilities, including 172 VA Medical Centers to over 9 million Veterans. 

The VA Caribbean Healthcare System, headquartered in Puerto Rico serves nearly 71,000 Veterans in Puerto Rico and the U.S. Virgin Islands. In 2019 alone, it had 990,460 outpatient visits.

Federal Investments in Healthcare (Saint Croix)

Since 2017, the Federal Emergency Management Agency has committed more than a billion dollars in repairs for medical facilities throughout the territory.  

FEMA approved replacing all seven buildings comprising The Charles Harwood Medical Complex: the main building, annex, clubhouse, motor pool building, storage building, and the Emergency Medical Services maintenance buildings.

Through FEMA’s Public Assistance program, $251 million has been obligated for architectural and engineering costs, the installment of modular facilities, a walkway, and a temporary parking lot. The federal agency obligated $111.4 million for a 101-bed temporary structure at the Governor Juan F. Luis Hospital, as well as for architectural and engineering design costs to increase space for administrative purposes.

Last year, Congresswoman Stacey Plaskett announced FEMA agreed to provide $834 million for the Juan F. Luis Hospital. “The changes in law I was able to obtain allow FEMA, for the duration of the recovery from Hurricanes Irma and Maria in the Virgin Islands, is to rebuild critical infrastructure like JFL to incorporate resilient design and features, up to the latest industry building standards and notwithstanding pre-disaster conditions in the Virgin Islands (the standard that normally applies),” Plasktt said in a statement last May. “This standard was markedly different than the standard for the mainland.  In this instance, JFL was evaluated for prudent replacement and found to be eligible.  Work to be completed therefore includes the demolition of the existing 231,655 square feet (SF) hospital facility and replacement of a 426,609 SF facility that will incorporate current building codes and standards.” 

Federal Investments in Healthcare (Saint John)

Following the 2017 storms, Saint John’s Myrah Keating Smith Community Health Center has relied on temporary modular facilities for medical care. The medical center serves as Saint John’s primary healthcare resource. The health center provides 24-hour emergency and outpatient services to residents and visitors, including maternal services, and services to mothers expecting, pediatric patients, and newborns.

FEMA provided $1.4 million to the U.S. Army Corps of Engineers to install the 11 temporary modular units. 

Then, in 2021, FEMA approved the replacement of the permanent facility. FEMA obligated $695,000 for the architectural and engineering design costs to the replacement facility. “The redevelopment of the Myrah Keating Smith Community Health Center is equally important to our healthcare system territory-wide,” Darryl A. Smalls, Executive Director of Territorial Hospital Facilities and Capital Development, said. “While the final design will be unique to the island of Saint John, it is imperative that we take on a collaborative approach across all of our territorial healthcare facilities to ensure that we achieve the standardization of our critical hospital systems.”

Federal Investments in Healthcare (Saint Thomas)

In February, the Federal Emergency Management Agency announced a $928.7 million investment to support the Roy Lester Schnieder Hospital on Saint Thomas. 

The new investment will demolish and replace the Roy Lester Schneider Regional Medical Center (SRMC) on Saint Thomas. FEMA said the rebuild marks a milestone in the agency’s collaboration with the territory to rebuild the healthcare infrastructure across the U.S. Virgin Islands damaged by record tropical cyclones in 2017. 

In the release, FEMA said the federal government will spend $976,520,000 to replace SRMC and repair the Charlotte Kimmelman Cancer Institute in Sugar Estate, where both buildings physically connect. 

The project to repair the cancer institute includes demolishing the facility’s interior and $170,791 in hazard mitigation measures to make it more resilient to extreme weather. The Bipartisan Budget Act of 2018 will fund the demolition of the five-story, 254,270-square-foot concrete masonry building and the construction of a new 439,910-square-foot hospital on the existing site.