Electronic Health Reporter

Healthcare technology continues to proliferate the sector, the developments almost too many to track. The sector abounds with innovation and push forward in the name of better – even the minutest – advancements of care and better care outcomes. The coming year will be no different. As we enter the final year of the 21^st century’s second decade, we’ve witnessed a tremendous amount of evolution in just 19 years. What role will our healthcare technology play in the healthcare industry in the next year?

A lot. And not just for a few, but members of many, many areas, even those peripherally involved with the boundaries of care. We must understand where current innovation is, but also the challenges these migrations attempt to solve. Being aware of the trends ahead can give us all a better grasp of how care delivery is changing and we can better understand how new areas can resolve real industry problems.

To help us navigate the year ahead for healthcare and its technology, the following are some of the trends that it leaders, observers, insiders, consultants and investors think are important or need to be taken notice of in 2019.

Dr. John Danaher, president of clinical solutions, Elsevier

The role of CDS tools will take on expanded significance to improve physician engagement. IDNs, or integrated delivery networks, will increasingly implement pathways, including treatment selection and care coordination, to reduce unwarranted variation of care. Boundaries between patient-led, home-based self-care and physician-led outpatient care increasingly blur, so these personal health logs will merge with primary care decision support tools in new and uniquely challenging ways. Additionally, real world evidence approaches will gain traction. Through data liquidity and third-party app integration with EHRs, there will be a refinement of clinical evidence based on clinical data captured through care delivery.

Mudit Garg, CEO, Qventus

Artificial intelligence will eventually permeate every part of the patient experience, but the first major victories will be behind the scenes, enabling doctors and frontline staff to provide high-quality care at a higher volume. The role of AI in healthcare is to achieve high reliability and allow staff to accomplish an ordinary day in their departments without Herculean effort. To date, we’ve seen real-world examples of AI having a positive impact on patient flow and satisfaction of care, and we expect even faster adoption of this technology throughout 2019.

AJ Abdallat, CEO, Beyond Limits

We can expect artificial intelligence solutions to unlock human potential and transform healthcare. Beyond Limits is already bringing sophisticated explainable AI to healthcare, combining conventional numerical AI techniques with advanced symbolic reasoning to provide human-like insight. We reduce risk, provide explainable solutions, and bring insights powered by human expertise and advanced AI. Clinical decision support is another area of AI advancement to provide more consistent care because it drives better insights from clinical data, scales expert knowledge, and distributes the expertise to the point of care.  Again, our AI system can monitor the treatment regimen to reduce adverse medical errors that might occur due to complex polypharmacy or co-morbidities.

Ashish Shah, CEO, PreparedHealth

Care is moving out of the hospital and into the home. We need to understand how to organize care this way because, when you do, it’s more affordable, more convenient, and it’s a better experience for the patient. Think about a hospital room. It has instrumentation, equipment, a nurse call button, and healthcare professionals who are quickly able to triage in the room. None of that exists in the home. We’re starting to see telemedicine solutions and virtual care solutions that allow a nurse or doctor to virtually “see” a patient in their home. Insurance companies are beginning to reimburse patients for home devices to monitor blood pressure, weight and other clinical indicators. Communication is another key. The next major step, and what PreparedHealth is doing with our en Touch network, is to create a virtual experience for the entire healthcare team so they can communicate with each other–and help patients and families stay connected—even though they may not physically be under the same roof.

Elizabeth Buckle, manager of interoperability solutions, Greenway Health

Value-based payment models, population health programs, and precision medicine are changing the healthcare market for providers and patients alike. Driven by data, these initiatives require effective communication across many systems, including the core EHR solutions. Today, the industry is still not fully interconnected, leaving gaps in the wake and reducing the positive impact of these initiatives. At the core of the issue is interoperability. As the industry pushes interoperability to the forefront of national initiatives, healthcare organizations must work to achieve advanced interoperability to succeed in the quality-driven healthcare landscape. In 2019, we anticipate more and more providers and practices will begin evaluating new and innovative solutions that help break down the silos preventing them from achieving their data exchange goals and delivering on the promise of value-based care and population health initiatives.

Rupen Patel, CEO, Influence Health

Today’s health systems have hundreds of millions of data records and as many as 15 other solutions harboring patient data within the organization that they don’t have easy access to for insights. As we head into 2019 and beyond, technologies that enable data interoperability will be a primary focus as providers strive to deliver precision, predictive and personalized medicine, in addition to engaging patient experiences at every touch point to foster loyalty and ultimately drive better outcomes.

Michael Morgan, CEO, Updox

In 2019, we expect digital health technologies to continue their adoption in the out-of-hospital market. Healthcare will become more personal and convenient as providers adopt solutions to remain constantly connected to their patients. These tools, such as texting and other mobile-based services, will not only improve access and quality of care for patients, but they will also help the healthcare industry keep up with the demands of consumers, who expect the same conveniences and access to information that they receive from other businesses. The move toward value-based care also means there is a real opportunity for out-of-hospital care providers to catch up with hospitals, where most technology investments have been made in the past decade.

James Song, Shadow Foundry

In 2019, we’re going to see more machine learning and blockchain-driven solutions in healthcare. The end consumer won’t notice it at all, but these will be buzzwords that providers will hear repeatedly. What ML and blockchain will bring to the table are easier access to medical records, cheaper insurance prices, and something we’re calling “predictive healthcare,” where the machines around us are figuring out if we’re getting sick and alerting your doctor before you even know you’re sick. These are technologies that exist now and will likely find significant traction later in 2019.

Kapil Desai, vice president, Catalyst Investors

2019 will be the year that telemedicine (finally) gains wider adoption. Patients are open to the idea of telemedicine, especially when it means more convenient, accessible healthcare. Capitalizing on increasingly favorable reimbursement policies, payers will embrace telemedicine to help stem swelling healthcare costs, namely from chronic health conditions and a rapidly aging population. Near-term, expect to see telemedicine help address access and convenience, particularly in rural or remote areas that lack specialists and primary care physicians. Longer-term, expect telemedicine to evolve from virtual visits to more comprehensive remote monitoring and preventive services.

Nick Semple, partner, PA Consulting

Increased data sharing is enabling better care delivery and coordination across the care continuum. This is driven by trusted exchange framework for interoperability from ONC, HL7, FIHR. Patient generated data is increasing, and often used in driving wellness and rewards programs. Challenges in data governance and the need for big data analytics is increasing. No letup on Cybersecurity. We are seeing continuing threats for patient data, ransomware and increased security focus not only on patient records, but medical devices. AI is delivering better diagnosis, supporting Dr. decisions, and increasing used in the home healthcare environment with devices such as Alexa.

Walter Jin, CEO of Pager

The convergence and consolidation of digital health solutions — with the healthcare industry at a tipping point, the proliferation of digital health solutions has led to a highly saturated market. We can expect further convergence of these solutions in 2019 to create robust end-to-end solutions that simplify the patient experience. Payers will invest in consumer centric digital solutions — focused on elevating their role to serve as a care partner to achieve the triple aim. In 2019, we will see more payers invest in digital solutions that provide more touchpoints to engage with their members throughout their care journeys. Making the connection between technology and outcomes — the big question: how can technology enable consumer centric experience for better patient care? Organizations are investing in digital solutions that will empower patients to be more proactive about their health. As digital health solutions increase utilization, the big question will be, what are the tangible impacts on outcome.

Dr. Art Papier, practicing dermatologist and CEO, VisualDx

Artificial intelligence: Each new year, AI tops the list of innovations that will revolutionize healthcare, but in 2019 using AI to mine the EHR for clinically meaningful data to advance the way we practice medicine will be much slower than the hype suggests. This is because AI requires good data to train on, and the EHR in the form of clinical notes is full of bad data. On a brighter note, machine learning of imagery will continue to advance at breakneck speed. Imagery typically has excellent metadata, in contrast, to the electronic record. We can expect to see new tools for radiologist in the form of automated “second read” algorithms and in our field of dermatology. Patient Care: Improving patient care will prove to be a top priority for health systems across the country in 2019, but in order for this to be successful, patients need to play a larger role in their healthcare. People are used to doing their own banking, travel, and restaurant reservations on their phones. It’s time to enhance the expertise of their healthcare information. This can only improve personal health decisions and enable their clinicians to provide better care. As we developed Aysa, our smart AI-enabled symptom checker, we realized improving health literacy was an important goal.

Dekel Gelbman, CEO, FDNA

As we’ve seen in the past, it can sometimes be challenging for organizations to separate the hype from the hope when it comes to AI. Looking towards 2019, we can expect a continued embrace of AI technologies and a deeper understanding of them, along with further exploration into augmented reality, biometrics, automation and health IT legislation. Continued shifts to alleviate the burdens on clinicians and healthcare professionals will also be in focus, making use of machine learning technologies in the clinical workflow with an emphasis on secure data sharing via the cloud to gain actionable insights and achieve improved health outcomes. All of these factors combined facilitate an environment centered around personalized care, serving as building blocks as we continue to create the full realization of it.

Anthony Jones, co-founder and CEO, Frontive

Patients will become more empowered: Today’s patients are being asked to be more engaged in their health by shouldering more responsibility, but lack the power to make informed choices. In the current model, patients are limited to which hospital, surgeon, procedure and price they can choose from. Transferring this power to patients is key. Anthony predicts new models like those in the hospitality industry will be applied to healthcare. Self-service will expand beyond appointments and lab results – Self-service has made tasks like going to get gas or going to the bank more convenient. However, when applied to healthcare, this feature has yet to provide real value beyond checking appointments or lab results. How are test results without any context or direction on what to do next helpful? Anthony predicts there will be a new wave of self-service tools, leveraging technologies like speech recognition and AI that will provide real value. New entrants in healthcare will forge unlikely partnerships – Amazon, Alphabet, Apple and Microsoft have made strong inroads into the healthcare space. Yet, before you go to the Genius Bar to check out your abnormal heart rate, let’s consider what role tech giants should play in healthcare. Tech giants will continue to develop their presence in healthcare by acquiring and partnering with unexpected luminaries from the medical technology industry. Largely driven by consumers who want health data available from their devices, we should expect a resurgence of healthcare moonshot initiatives coupled with unexpected acquisitions and partnerships.

Giang Vu, design consulting principal, Philips

Experience journey mapping will help combat urgent care competition – urgent care centers and retail clinics have gained popularity in recent years, as patients increasingly choose to treat low-acuity conditions in these types of settings rather than wait in the emergency room. Facing this growing competition, healthcare organizations are under pressure to increase ED demand and doing so requires improving the overall patient experience. While there are many approaches to enhancing the experience, hospitals and health systems can leverage an approach in 2019 that’s used commonly in other industries, including retail: experience journey mapping. By mapping and evaluating patient journeys, providers and their strategic partners will be able to develop experience touch points to enhance the overall patient visit with a holistic approach. Journey mapping will increasingly be adopted by healthcare organizations, as they look to decrease wait times and increase the quality of their services.

Susan Kanvik, healthcare consultant, Point B Management Consultants

In 2019, healthcare can expect to see continued M&A activity, requiring IT to realize the intended benefits including data integration to effectively care for the new population. There will be a demand for digital strategies to drive consumerism as patients continue to pay for more of their healthcare and as such, expect more of a retail experience. Data and analytics will be required to drive insights from the vast amounts of data in healthcare. This will become even more paramount as payers acquire providers and retail pharmacies to create new companies. And finally, there will be a continued focus on the delivery of services, such as telemedicine, to increase access to healthcare to millions of patients across the U.S.

Natalie Pankova PhD, COO, Shivom

The most pressing concern is that increasingly complex diseases are spreading, and healthcare costs are increasing. These two factors put tremendous strain on an already stressed system, which is ridden with inefficiencies (poor models for research/delivery, siloed data that could be valuable to researchers and low incentives for end users to contribute to improvements). The environment has never been better to resolve this, increasing smartphone, mHealth apps and wearables penetration, technologies for monetizing and adequately protecting data, advances in machine learning. The key to the future is the analysis of huge amounts of data, to enable identification of various diseases and enhance predictive and preventative medicines to remedy them.

Tom DeSot, EVP and CIO, Digital Defense

More healthcare organizations will begin conducting ongoing vulnerability scans and penetration tests on practice computer networks.  There is no way for a clinic administrator or physician to know if the systems in their office are vulnerable unless they are conducting ongoing scans (at least monthly) and conducting an annual penetration test. Hospitals, physicians, clinicians and practices will also continue making common mistakes that might put a patient’s sensitive health info at risk, like leaving workstations unlocked, running Windows XP after Microsoft stopped supporting it, not staying current on software patches, and keeping anti-virus up to date.

Assaf Halevy, founder and CEO, 2bPrecise

2019 will fuel significant progress in bringing the power of genomics and the promise of precision medicine to the point of care. With the FDA approving direct-to-consumer genetic tests, it will be incumbent upon providers to educate themselves about how to bring genomics into their decision-making processes. Many will turn to new technologies with the ability to integrate genomic insights into their existing clinical workflows to help their patients achieve the best possible outcomes.

Terence Maytin, vice president of market & commercial development, Medocity

Fueled by increasing evidence linking improved patient outcomes to connected health technologies, 2019 will see accelerating adoption of virtual care, telehealth, and remote monitoring solutions across all industry segments (providers, pharma and payers).  Major stakeholders continue ramping up significant investment in digital platforms to close gaps in care outside traditional clinical settings, improve patient-centric care delivery, and reduce costs in the post-acute environment. Foremost goals include: 1) connecting patients and providers to better manage chronic conditions between visits; 2) driving greater patient engagement and adherence to medications; and 3) enacting systematic real-time monitoring and proactive interventions.

Andrew Tyler, senior consulting engineer, Kelser Corporation

My prediction is that the healthcare industry will remain the number one target for hackers in 2019 as it was in 2018. The combination of how valuable medical data is on the black market and how low the defenses are on some medical practices makes the healthcare industry just too inviting for hackers–even more inviting than the financial industry. In 2019, healthcare organizations will have to reimagine all of their processes through a cybersecurity lens. For instance, granting access to patient data for third parties is a weak point hackers often exploit. There are tools to do this securely, but more often than not, providers aren’t ensuring these safeguards are in place.

Lee Barrett, executive director, Electronic Healthcare Network Accreditation Commission (EHNAC)

As the threat of cyberattacks continues to affect a diverse set of industries, organizations must look to close privacy and security gaps across networks; address compliance vulnerabilities; assure preparedness plans and increase both cyber protection and ransomware prevention. In fact, this will continue to be a focus in the healthcare space where accreditation non-profits, certification firms and industry associations are collaborating to establish new programs that align with national efforts to address regulatory requirements across identity verification, authentication and privacy/security frameworks. In 2019, we will continue to see the shift by healthcare organizations in turning to the use of process best practices and the application of blockchain, cloud-based data storage and other enabling technologies, not only to enhance cybersecurity adherence, but also improve interoperability, and reduce administrative burdens.

Kathy Ford, president & chief product officer, Rhinogram

Patients want to be engaged in their care and expect providers to deliver the information they need in a convenient method, which often includes their mobile devices. That’s why 2019 will be a year when great strides will be taken by many providers to enhance the patient experience by implementing a streamlined telehealth communications platform. In fact, a recent MGMA Stat poll revealed how 70% of providers are planning to adopt technology in 2019 in an effort to make their practice more efficient. This includes telehealth technologies, through which providers can directly engage with their patients via text-based clinical conversations, including images and document sharing in real time. In 2019, care providers must be ready to meet their patients’ demands for convenience and a comprehensive communications strategy that embraces telehealth messaging gives the patient the desired information quickly without sacrificing quality of care.

Valerie Barckhoff, principal, Windham Brannon

Artificial Intelligence and Robotic Process Automation are two technologies that will increasingly be applied in non-clinical areas, such as the revenue cycle. The ability to create digital employees who handle predictable, manual and repetitive processes is significant. AI and digital employees can help hospitals and health systems reduce costs and improve margins by eliminating inefficiencies and human error.

Jeff Fochtman, VP of global marketing, Seagate

According to a recent report, the healthcare datasphere, which is the fastest-growing industry, including critical and hypercritical (life-dependent) data, is expected to grow 13 percent faster than other industries. In fact, hypercritical data is expected to grow more than 47 percent on average, more than doubling every other year. A number of deficiencies exacerbate the problems with managing this aggressive growth in data. Blockchain, despite being in a relative state of nascency, could offer unique next-generational opportunity for healthcare to transform digitally, yet nearly 60 percent of healthcare organizations surveyed this year lack a strategy or have yet to implement.”