Healthcare providers continue to find themselves with more initiatives and opportunities for innovation than actual capital to deploy to IT projects. Health IT projects have become more integrated with clinical and business areas, which is driving more complexity and alignment than ever before. 2020 will bring a continue focused on the following trends and one growing concern:
Defining and rightsizing AI for your organization. Additionally, organizations will begin and expand the ethical debate as to how broadly to use AI within their organizations. RPA/robotics will continue to expand, followed by deeper machine learning opportunities.
Big data and advanced analytics will continue to be a strong focus as clinical and business users seek the right data at the right time to help make the best decisions possible.
Back office and shared service technology means many organizations have not modernized their ERP platforms in 15 or 20 years. Organizations have gone through numerous transitions, mergers, consolidations, etc., with no core technology changes. Healthcare organizations now have the ability to adopt and deploy next-generation and cloud-based ERP solutions. After spending five to eight years deploying EMR/RCM solutions, organizations now need to focus on ERP modernizations and enterprise data standardization.
Data interoperability will continue to be at the heart of clinical care and enhancing healthcare operations. No one vendor can offer all the necessary functionality needed for healthcare providers; as such, organizations need to spend the necessary time and investment in not only deploying leading clinical, revenue cycle, and ERP solutions, but also an enterprise data interoperability platform. Point-to-point interfaces must be phased out in order to manage the complex enterprise multi-cloud ecosystems that all healthcare providers find themselves living in today with an enterprise data interoperability platform. These platforms offer APIs to help reduce development / connection time, but they don’t always lessen the complexity of business.
With the continued trend toward cloud and hybrid cloud environments, cybersecurity needs to be front and center in all conversations. Organizations need to continue to invest in the development of the correct skills and partnerships to effectively manage cybersecurity in 2020 and beyond.
Health IT resourcing will continue to be in a short supply. The IT resources of 2020 and beyond are not your traditional database administrators or network engineers – they need to have project management skills, business / clinical skills, the ability to manage third parties and actual knowledge of the applications and tools the business uses. Health IT resources need to transform into health IT partners, helping the operations transform by supporting technology enablement.
Jordan Pisarcik, vice president of account management and business development, DocASAP
Providers and health systems will look to more unified, omnichannel solutions to close gaps in care. Health systems will invest in tools and technologies used to streamline the patient journey, including elastic provider search, navigating patients to the right care setting and engaging with patients between visits.
Gone are the days of the adversarial position between payers and providers, replaced now by integrated “payviders.” Through collaboration, “payviders” are expected to reduce financial risk, increase profitability and provide higher quality medical care to patients. Payers also represent a digital channel for providers to improve access to care that can help them meet these objectives.
Health systems will continue to see an increased demand for non-traditional visit types, such as telehealth/virtual appointments, walk-ins, home visits and phone appointments.
In 2019, voice search dominated the news as a major trend; however, consumers won’t see mass adoption of this new technology quite as quickly as anticipated. Still, healthcare systems are working to utilize this new medium as a way to close gaps in care.
Sean Price, EMEA industry solutions director (public sector and healthcare), Qlik
There has been a shift in focus from a traditional use of data and analytics where it has been used for compliance and performance, to a use where operational users are driving decision making and better outcomes at the point of service. The Analytically Powered Command Centre is a great example of this. Healthcare organizations will look to maximize the value of their data by bringing patient flow information into a near real-time environment command center to efficiently manage the end to end process of patient safety, experience and cost. This will enable strategic and tactical management of demand, resource and capability that can lead to process improvement, improved outcomes and notable efficiency savings.
However, moving data to the point of operational front-lines does challenge traditional support and continuity for these systems. Traditionally they would not require 24/7 support – this shift moves big data systems into a new support and maintenance style model.
As more data and insight is being provided to staff, there is the topic of data literacy. A key trend this year will show when you skill up staff in analytics it provides better outcomes and realizes significant productivity gains. Sometimes data literacy is channeled towards just using a system, rather than understanding statistical significance in data. Arguing with data means you present a case with data, and this requires an understanding of significance and goes way beyond system training.
Although electronic health records (EHR) are firmly established in the medical landscape, ongoing progress necessitates that providers keep up with emerging trends. Here are five of them.
1. Combining Artificial Intelligence and Voice Recognition with EHR
Artificial intelligence (AI) has already shown promise for assisting doctors with making diagnoses or recognizing historical trends about a patient’s condition. However, several companies are investigating bringing AI to EHR via voice recognition capabilities.
At Vanderbilt University Medical Center, providers can query the tools by posing questions in natural language. For example, a physician could ask a voice-enabled EHR system for details about a patient’s last recorded iron levels from blood tests. The system would inform the doctor of those levels, plus tell them whether they’re in a healthy range.
Allscripts and Northwell Health also recently struck a deal for a platform that blends AI with EHR and collects data from clinicians. Using voice commands within patient care could be especially useful for providers who have their hands full.
2. An Increased Emphasis on Mitigating EHR Errors
When the ECRI Institute released its 2020 report containing the top 10 health technology errors to be aware of in the coming year, EHR issues were mentioned multiple times. The first instance related to providers potentially being overwhelmed with notifications from EHR platforms, ignoring some of them and perhaps overlooking a genuine issue with a patient as a result.
The report also brought up the risk of medical data not including information about implants in patients that are sent for medical imaging. The study recommended providing a single place to enter or check for the presence of implant data in an EHR. Finally, the ECRI Institute cautioned that EHR mistakes could happen when a medication administration order sent by an EHR platform does not match the dosage time the provider intended.
This coverage of such mistakes will likely cause health care facilities to assess their systems and see if the issues exist there. If so, they’ll look for ways to reduce those problems.
As the country’s baby boomer population continues to age, the healthcare industry is gearing up for a whole new level of demand that it has never before gone through. With greater numbers of people requiring doctor visits and hospital care, the industry is looking for ways to be even more productive and efficient to ensure that the quality of healthcare that people are receiving doesn’t suffer.
One of the most exciting advances to hit the health sector is artificial intelligence or AI. This technology is looking to have a huge impact, not just on healthcare in the immediate future but moving forward. Here’s a closer a look at just how it’s changing the course of the industry.
Medical records and data are benefiting from the technology
When it comes to the areas that AI is having the largest impact, medical records and data keeping is a big area to focus on. When you think about the vast amount of information that needs to be collected, stored, and analyzed for each and every patient it can seem rather overwhelming. This is exactly why data management has become such a priority for AI.
Robot technology is now being used to actually collect the information, store it, find specific data when required, and allow for quick and seamless access across the board.
Wearable medical devices
Wearable medical devices are another area where AI is having an impact and bringing about some really exciting and promising products. It’s not just about devices that provide potentially life-saving alerts and information, it’s also devices that can help the wearer better their own personal health by tracking various details. Devices such as the Apple Watch and Fitbit are great examples of this kind of technology that can be useful to everyday people.
Now as for the devices that can actually offer life-saving capabilities and tools, look to options such as the Bay Alarm Medical which is a great medical alert system. While this device isn’t going to track any information or take readings, it can be worn 24/7 and with the push of the button, it connects you to a live operator that can get you the help you need.
Looking back at 2017, we see some of the same significant trends that have been gaining momentum, along with a few newcomers. Together, these top-five trends will impact hospital medicine in 2018 in both traditional and unexpected ways.
Growth Despite Reimbursement Parity Confusion
The telemedicine industry’s growth continues rapidly despite the widespread confusion over reimbursement for telemed services from state to state. Why? Because most hospital leaders understand they face far more significant costs from the lack of proper physician and specialist coverage than they ever would by a less-than-optimal reimbursement rate for telehealth. A teleneurologist consult in the ED might be reimbursed at a lower rate than an in-person visit with an onsite neurologist, but keeping the stroke patient in the hospital could mean a $10,000 DRG reimbursement that the hospital would lose if the patient had to be shipped to a tertiary referral center for treatment. Which is the smarter investment? And more importantly, which scenario better serves the patient?
Expansion into New Types of Inpatient Settings
As micro-hospitals and long-term acute care hospitals (LTACHs) grow, they are looking for single-source providers of solutions, with one point of contact, one operating system, and one set of tools and processes. Telemedicine fits their models very well, helping them avoid contracting with a wide array of specialists to meet their patients’ needs. Micro-hospitals are already established in 19 states, and LTACHs are growing since a federal moratorium prohibiting their expansion expired on Sept. 30, 2017. Being able to access a variety of specialists via telemedicine, depending on the needs of patients on any day, is something these facilities need in order to fulfill their commitment to the communities they serve.
Increasing Use of Telemedicine in Metropolitan Hospitals
Rural hospitals have long been a sweet spot for telemedicine. The physician shortage is certainly more acute in rural areas as community hospitals struggle to recruit physicians, keep beds filled and, in many cases, stay solvent. Recently, however, more metropolitan hospitals have seen the advantage of telemedicine in two key areas. When cross-coverage calls are handled by telemedicine teams, it takes considerable pressure off night hospitalists who may already be overwhelmed with admissions, and yet their phones are ringing constantly with requests to respond to patient issues on the floor.
By the same token, telemedicine offers “surge protection,” providing assistance with patient admissions during ED bottlenecks, and cost-effective relief from hospitalist overload.
Virtual Partners for Solo Specialists
Individual specialists in pulmonology, cardiology, nephrology, and other areas might be on call with a local hospital 24/7/365, with no backup for nights, weekends, holidays, or vacations. Telemedicine specialists share coverage with these physicians—individuals and small practices alike—to help ease the demands on them. For example, a community hospital has a local cardiologist on call 15 days a month, and a telecardiology team on call the other 15 days of the month. This is just one real-life example we’ve seen as hospitals find new ways to meet the challenges of another trend that just keeps growing: physician burnout, coupled with a greater value placed on work-life balance than in generations past.
Healthcare jobs are plentiful, and at least through 2024, the demand for healthcare professionals such as nurses, anesthesiologists and physicians will only continue to rise.
The Bureau of Labor Statistics has said that healthcare jobs are “expected to have the fastest employment growth and to add the most jobs between 2014 and 2024.” Given the healthcare industry’s propensity for increased growth, hospitals need to embrace scalable IT—for their own sake and for the sake of their patients.
Fortunately, there are options.
Healthcare organizations increasingly rely on cloud-based IT solutions, and SADA Systems has reported that the number of organizations living in the cloud could be as high as 89 percent. There’s a reason for the high percentage—cloud solutions are safe, scalable, and efficient.
Hospital data safety is no small concern.
In 2008, 9.4 percent of hospitals used EHRs. By 2014, the percentage had skyrocketed to 96.9 percent. The switch to digital records was necessary, but in the rush to modernize, hospitals were left more vulnerable to data theft than other industries that had migrated more slowly.
According to Niam Yaraghi, healthcare systems are left with an additional concern. “Hospitals cannot tolerate the consequences of computer lockdowns,” writes Yaraghi. “If Wal-Mart gets attacked, it will likely shut down for a short period of time and fix the issue…Hospitals on the other hand, are dealing with patients’ lives.”
Further arguments for cloud IT include the sheer number of patients hospitals see every year. Hospitals treat 136.3 million patients in the emergency room alone, according to cdc.gov, and believe it or not, that number is growing. Cloud IT accommodates growing demand seamlessly.
The healthcare industry remains at a crossroads as providers and healthcare IT professionals confront a rapidly changing business and regulatory landscape. With factors like rising patient cost obligations, growing payer complexity, and the inevitable shift to a value-based payment environment weighing on them, medical practices nationwide are in search of new IT solutions to support them. The rapid pace of cloud adoption across all sectors is a prominent example. The market for cloud solutions is one of the fastest growing areas within healthcare, but it’s not solely a private sector phenomenon; the federal government’s cloud-first strategy finally gained traction in 2015, prompting a FCW analyst to predict accelerating momentum for federal cloud initiatives over the next three to five years.
One of the strongest factors driving cloud momentum among medical practices today remains security concerns: with growing IT complexity increasing security risks, cloud options remain an attractive plug-and-play alternative to on-site servers that allows healthcare providers to minimize vulnerabilities. But modern cloud solutions also allow providers to maximize practice management capabilities and offer faster time to value. And, with features like pay-as-you-go pricing, cloud solutions don’t require a big upfront investment, making them a popular choice with budget-conscious healthcare organizations.
Another key factor driving practice adoption of modern, cloud-based solutions is the need more efficient workflows to support effective patient billing. The patient share of healthcare costs is growing rapidly in the US. According to a Kaiser Family Foundation report, out-of-pocket costs have grown three times as fast as overall healthcare costs. And, the average deductible has skyrocketed from $584 in 2006 to $1,318 in 2015. Practices need solutions that can help them implement controls and analytics as patients become responsible for a greater share of costs.
As a result of these and other factors, cloud technology now plays a pivotal role in healthcare, and cloud-based healthcare IT solutions are becoming increasingly important in helping practice successfully navigate this new environment. So what’s in store for 2016? Here are some healthcare IT trends to watch:
A more modern, intuitive software experience: The consumerization of healthcare IT has begun in earnest, and that means practices are looking for design-centered products that deliver intuitive solutions. Cloud-based healthcare IT solutions that move beyond Web 1.0 to provide a consumer-focused user experience (UX) will be the clear winners.
Everybody knows that the US healthcare system is in trouble. Issues ranging from cost, to quality and access of care are rampant and only getting worse. On a macro level The Affordable Care Act (ACA) has solved some of the previous access issues, but has added tremendous cost within the system, and at the same time it has not solved the quality issues that exists.
Research suggests that the cost situation is becoming increasingly worse, which is causing firms to scramble for viability. Waves of cost cutting efforts have led payers and providers to capture some, but not nearly enough of the costs necessary for long-term survival.
There are two main cost challenges that both healthcare payers and providers share:
Wildly inefficient operating models and processes. The Harvard School of Public Health projects that of the $2.8 trillion the US spends on healthcare each year, 30 percent or $840 billion may be wasted. For organizations that function on small operating margins, this alone represents the boundary between success and failure.
Large stranded infrastructure and costs combined with declining revenues – The ratio of hospital expense vs. revenue has increased from just under 15 percent in 2011 to nearly 30 percent in 2014 with 25 percent of hospitals reporting an operating loss. For nearly 49 million enrollees in Medicare, hospitals receive only 88 cents for every dollar with lower reimbursement rates predicted in the future.
These pressures have led organizations to make hasty decisions about how to fundamentally solve the problem. Merger and acquisition activity among both payers and providers is at an all-time high, and the ACA appears to have been the catalyst for this M&A activity. Since its enactment, hospitals started merging with competitors at unprecedented rates. In 2009, pre-ACA, there were 52 announced transactions involving 80 hospitals. That number more than doubled by 2012, with 107 announced transactions involving 244 hospitals. The M&A frenzy among healthcare payers has also increased with Anthem’s announcement to acquire Cigna, and Aetna’s acquisition of Humana. Both of these were announced last year and are two of the largest payer M&A deals in history.
Guest post by Cathy Reisenwitz, content specialist, Capterra.
Every year at Capterra we predict the top trends in business technology. Last year we predicted gamification, wearables, telemedicine, mobile medicine, and 3D printing would be the top 5 medical technology trends for 2015.
This year, we expect wearables, telemedicine, and mobile medicine to continue to advance. They’ll be joined by cloud computing, patient portals, and big data.
Telemedicine has come a long way, from remote villagers using bicycle pedal-powered, two-way radios to communicate with the Royal Flying Doctor Service of Australia to helping recovering stroke patients in rural Minnesota avoid hours-long (and often snowy) drives for follow-up care.
As the technology has improved, the investment has increased. Transparency Market Research valued the global video telemedicine market at $559 million in 2013. Today, they predict it will grow to $1.6 billion by the end of 2020. Walgreens, the largest U.S. drugstore chain, and telehealth provider MDLive recently expanded their virtual care collaboration to 20 more states in November, bringing the total to 25.
Telemedicine offers tons of value to a large, growing segment of the population: seniors. Telemedicine improves care by getting it to remote patients who live far from hospitals. It also enables homebound patients to get high-quality care. It makes care cheaper, and allows seniors to stay at home longer. It benefits providers by making their jobs more flexible. And it also eliminates picking up new illnesses in a clinical care setting.
In rural Minnesota, nurses check motor skills by asking patients to push, pull and squeeze with their hands and feet. A doctor, located further away from patients, can advise on care onscreen.
Going back to wearables, their mass adoption has made store-and-forward telemedicine much easier. Devices like Fitbits automatically collect valuable health data. Store-and-forward telemedicine just means that data goes to a doctor or medical specialist so they can assess it when they have time. Watch for more EHRs learning to connect with wearables in 2016.
More EHRs will provide patient portals
Patient portals grew in popularity in 2014 and 2015. Twenty-six percent more patients received lab tests via an EHR patient portal between 2013 and 2014. Patients also received 50% more health and disease education through their portals in that time. “Patient engagement through health technology such as patient portals is rapidly increasing,” Craig Kemp, leader of innovative partnerships for Merck Vaccines, told mmm-online.com.
While about half of physicians offer patient portals right now, almost another fifth of them plan to offer one in the next 12 months. In a 2015 survey of more than 11,000 patients, 237 physicians, and nine payer organizations representing 47 million lives, almost a third of patients said they were interested in using a patient portal to engage with their physician, track their medical history, and receive educational materials and patient support. However, almost 40 percent said they’d never heard of a patient portal.
Educating patients on how and why to use portals will be key to getting them to use them in 2016.
The health IT revolution is here and 2016 will be the year that actionable data brings it full circle.
Opportunities to achieve meaningful use with electronic health records (EHRs) are available and many healthcare organizations have already realized elevated care coordination with healthcare IT. However, improved care coordination is only a small piece of HIT’s full potential to produce a higher level synthesis of information that delivers actionable data to clinicians. As the healthcare industry transitions to a value-based model in which organizations are compensated not for services performed but for keeping patients and populations well, achieving a higher level of operational efficiency is what patient care requires and what executives expect to receive from their EHR investment. This approach emphasizes outcomes and value rather than procedures and fees, incentivizing providers to improve efficiency by better managing their populations. Garnering actionable insights for frontline clinicians through an evolved EHR framework is the unified responsibility of EHR providers, IT professionals and care coordination managers – and a task that will monopolize HIT in 2016.
The data void in historical EHR concepts
Traditionally, care has been based on the “inside the four walls” EHR, which means insights are derived from limited data, and next steps are determined by what the patient’s problem is today or what they choose to communicate to their caregiver. If outside information is available from clinical and claims data, it is sparse and often inaccessible to the caregiver. This presents an unavoidable need to make clinical information actionable by readily transforming operational and care data that’s housed in care management tools into usable insights for care delivery and improvement. Likewise, when care management tools are armed with indicators of care gaps, they can do a better job at highlighting those patients during the care process, and feeding care activities to analytics appropriately tagged with metadata or other enhanced information to enrich further analysis.
Filling the gaps to achieve actionable data
To deliver actionable data in a clinical context, HIT platform advancements must integrate and analyze data from across the community—including medical, behavioral, and social information—to provide the big picture of patient and population health. Further, the operational information about moving a patient through the care process (e.g., outreach, education, arranging a ride, etc.) is vital to tuning care delivery as a holistic system rather than just optimizing the points of care alone. This innovative approach consolidates diverse and fragmented data in a single comprehensive care plan, with meaningful insights that empowers the full spectrum of care, from clinical providers (e.g., physicians, nurses, behavioral health professionals, staff) to non-clinical providers (e.g., care managers, case managers, social workers), to patients and their caregivers. Armed with granular patient and population insights that span the continuum, care teams are able to proactively address gaps in patient care, allocate scarce resources, and strategically identify at-risk patients in time for cost-effective interventions. This transition also requires altering the way underlying data concepts are represented by elevating EHR infrastructures and technical standards to accommodate a high-level synthesis of information.
Looking back at 2015, we see significant trends impacting inpatient telemedicine that will gain strength through 2016. Here are the Top Five: How they impacted healthcare, and how they will change hospital medicine moving forward.
More Legislation and Regulation Activity
A recent report from the National Conference of State Legislatures showed there were 200 telemedicine bills introduced in all but eight states in 2015. The federal government also introduced the TELEMedicine for MEDicare Act of 2015 and the Veteran’s E-Health and Telemedicine Support Act of 2015, which are aimed at creating an interstate license for those practicing telemedicine for these patient populations. Last year, 32 states and the District of Columbia enacted telemedicine parity laws, requiring health plans to reimburse telemedicine the same way—and at the same cost—as in-person service. We expect to see more of this activity as telemedicine becomes an increasingly integral part of healthcare in America.
Easier Licensure Across States
Currently, if you have a group of physicians caring for patients in hospitals in four or five states, they must become licensed in each of those states. As noted above, recent legislation (along with new telehealth licensing compacts between states) will make it easier for physicians to get a license across state lines. This will clearly help facilitate the use of telemedicine services
Growing Financial Support
Today, the payer response can best be described as a patchwork. Medicare typically doesn’t reimburse for inpatient telemedicine (except in rural areas as Medicaid), and the commercial payers tend to vary from state to state. There isn’t a uniform basis for reimbursements. Many hospitals end up financing most of the costs of inpatient physician services delivered with telemedicine?and we all know healthcare dollars are tight for everybody. However, the physician reimbursement is moving, albeit slowly. The state parity laws will help. So, too, will having more commercial payers recognize the value of telemedicine services. For example, UnitedHealth Group announced plans to expand coverage for virtual physician visits to employer-sponsored and individual plan participants, increasing those covered from approximately 1 million to well more than 20 million. Better reimbursement structures will help fortify hospitals’ financial underpinnings and alleviate some of the burden they’ve been forced to bear.