As we launch into 2018, questions remain about the healthcare policy environment and how it can impact many healthcare initiatives. As Yogi Berra said, “It’s difficult to make predictions – especially about the future.” I feel confident, however, about some fundamental trends in the healthcare landscape. These include a steady shift toward value-based care, an increased focus on data and analytics as a core enabler for digital transformation, and the all-consuming focus on the patient experience.
Here are my four key predictions for the healthcare IT trends that will transform the industry in 2018:
Patient Satisfaction Takes Center Stage
The era of healthcare consumerism is here. Patients are bearing increasing financial responsibility for healthcare costs, and seek improved experiences as a part of the value-for-money equation. In response, providers are taking a 360-degree view of patients, employing better analytics to leverage patient data such as demographic information, lifestyles and individual preferences, to personalize interactions and treatment.
Artificial Intelligence (AI) Becomes Entrenched in Clinical Settings
Despite the overuse of the term AI to describe many types of technology-enabled solutions, the adoption of AI has been steadily gaining ground in a wide range of settings. Deep learning algorithms will increasingly be used in clinical settings to support medical diagnosis and treatment decisions, predict the likelihood of patient re-admissions and help providers better leverage the data that has been accumulating in electronic health records. According to the 2017 Internet Trends Report by venture capital firm Kleiner Perkins, medical knowledge is doubling every three years, and the average hospital is generating more than 40 petabytes of data every year.
While all this accumulated information empowers more informed physicians, the growing range of data and knowledge sources creates a challenge as well, since physicians and clinicians must manage and stay on top of this information on specific conditions, especially in fields such as oncology. AI technologies are enabling time-constrained and overworked physicians to make sense of the vast amounts of data, helping them uncover hidden insights and supporting their medical diagnoses and decisions with timely and relevant input at the point of care.
Open Source Finally Takes Hold
Healthcare organizations have been conservative when it comes to open source technologies, largely due to concerns about data security and privacy. With the growing adoption of cloud-enabled solutions and a gradual shift of enterprise IT workloads to the cloud, they no longer have to worry about risks to the IT environment and can rely on mature cloud service providers, such as Amazon Web Services (AWS) or Microsoft Azure. And, open source architecture can now incorporate robust technology components with rich functionality. Our current collaboration with Partners Healthcare to build a digital platform for clinical care is based on an open source architecture. As the industry shifts rapidly to value-based care, cost pressures will force healthcare enterprises to transform their technology strategies, turning to open source solutions to rapidly build new solutions cost-effectively.
In an effort that could revitalize the EHR space (at least the mainstream market), the Veterans Affairs Department’s classic and still heavily used VistA (Veterans Health Information Systems and Technology Architecture) system is getting the open source EHR treatment.
In a move that is revolutionizing other technology sectors — like manufacturing, gaming and the device world and because of the success of such sites as Kickstarter (I know because I represent clients in this space and have seen their success first hand), which is a haven for open source projects, allowing volunteer programmers who are passionate about code and perhaps even passionate about healthcare, is really a pretty swell idea.
From the VA’s perspective, how else could it possibly bring a beleaguered and somewhat bemoaned product like VistA to the modern area after more than 30 years in use? Certainly, the government didn’t seem to have the funds or the necessary experience to overhaul the system by itself.
According to Rick Baker, chief information officer for the VA, even though there is a contract with a firm to make changes to VistA’s code to make it less complex and more readable, the open source community will be involved directly, day to day, with the EHR’s refresh.
The success of involving the open source community in healthcare, and in the development and maintenance of EHRs, is showcased at Oroville Hospital in Northern California, which recently passed on some of the mainstream vendors like McKesson and Meditech for a personalized, customer version of its.
Leaders at the hospital wanted the flexibility to make changes to its EHR system, and they wanted to ensure they received the attention they felt they deserved from their vendor of choice. Ultimately, they wanted total control over the hospital’s electronic health record.
The best solution to the problem for the hospital? Build its own EHR.
In addition to gaining every advantage over the creation and implementation of the home-grown system, Oroville Hospital plans to save a bunch of money by not purchasing a commercial system even though it is building a complete EHR soup to nuts.
The hospital chose to build the system with the help of the same open source folks who are working on the VistA system; the same folks the VA is using to update VistA. Once done, Oroville Hospital’s EHR was even certified for meaningful use and the hospital received more than $5 million in meaningful use incentives.
What all of this seems to suggest is that custom solutions are viable options in a sea of corporate technology offerings. With open source now breaching the professional world of electronic health records, this may only just be beginning of a wave of technology innovation, especially as hospitals and practices seek more efficient solutions and more control of their EHR technology.
Given the time, patience and buy in of leaders, healthcare facilities may be closer to independence than we’re used to in the regulated and oversight-driven world that has become healthcare.