Electronic Health Reporter

When the COVID-19 pandemic first began affecting the United States, the entire healthcare industry moved swiftly to leverage existing technology and practices to meet the intensive demands of the global health crisis. Amid this incredibly tumultuous year, however, the healthcare community has also been able to actively develop new solutions and approaches to address some of the biggest problems we face, both related to the pandemic and beyond.

We connected with some of the leading voices in health IT to find out what they considered to be the biggest innovations of the past year and how they expect the landscape will continue to evolve in 2021, from advances in patient experience to greater public health data connectivity and more widespread digitization.

Dr. Art Papier, CEO and co-founder, VisualDx

We saw prolific adoption of artificial intelligence (AI) solutions throughout 2020, particularly in the wake of the COVID-19 pandemic. For example, provider organizations leveraged chatbots and other rudimentary virtual symptom screening tools to decrease infection spread and address patients’ care needs without placing even more burden on the workforce. As we continue living in a global health crisis, we will see more provider organizations leveling up AI-enabled capabilities to help manage patient volumes as they ebb and flow during COVID-19 surges. Specifically, we will see providers bringing mature, AI-driven diagnostic tools into the exam room to provide reliable “second opinions” on demand.

As providers work to address the pandemic, they will also adjust their practice of medicine to better meet the needs of their BIPOC patients. In 2020, COVID-19 and racial injustice has highlighted serious racial disparities and underscored how important it is for health leaders to improve diagnostic accuracy and outcomes for traditionally disadvantaged populations. In 2021, I predict we will see greater inclusion and representation of patients of color in our medical education curricula and resources, clinical trials, and pool of medical students and residents.

Jeff Fallon, CEO, eVideon

2020 will be remembered for many things but in terms of healthcare information technology (HIT), it was the year of telehealth. 2021 will be the year that patients, providers, and payers blow the doors off the idea that “virtual” equals “video doctor’s appointments.” Virtual HIT enabling doctors and nurses to do their rounds virtually from down the hospital hall or the other side of the world will grow in popularity. It’ll be the year that hospital bedside patient engagement technology demonstrates its tremendous value in enabling higher quality and satisfaction from a pandemic-safe distance. We’ll also begin to see an increase of terrific HIT solutions integrating with the data plumbing that is an EHR to finally give nurses new efficiency and satisfaction.

Laurie Peters, HIE client director, Orion Health

As we look forward to 2021, healthcare IT will see a continued focus on the COVID-19 pandemic response, including the highly anticipated roll out of a vaccine. Vaccine administration is a key component of an effective pandemic response plan at both a local and state level. Health information exchanges (HIEs) have the ability to ingest and leverage data, including demographic information, from individual access points of care across the health system and will play a critical role in matching the COVID-19 vaccine data to the correct patient.  HIEs also have the potential to streamline the reporting of individual vaccination information to the state for analytics. Harnessing this technology to accurately track vaccine data in near real time will provide crucial insight around who has been immunized and who hasn’t; who has received which vaccine and any side effects in the event that multiple vaccines are available; the ability to target under serviced populations and support ongoing resource planning as we continue to navigate these unprecedented times.

Drew Ivan, chief product and strategy officer, Lyniate

While we will likely see an uptick in FHIR adoption as a result of the ONC and CMS interoperability rules and a continued move to the cloud, the most fascinating move in 2021 will be the increased demand for data sharing spurred by the pandemic. In the United States, the move towards greater interoperability is happening against a backdrop of a changing administration that will likely make significant reinvestments in federal and state public health agencies that could rival the tens of billions of dollars approved in the Heroes Act. This funding will be a boon for modernizing our public health infrastructure, including significant adoption of a cloud-first mindset, to prepare for future public health crises.

As federal and state governments prepare for mass distribution of COVID-19 vaccines, data interoperability will certainly play a role. Pressing issues with vaccine distribution, including the logistics of storing and shipping vaccines, and prioritizing vaccinations among different populations, will push traditional health information sharing boundaries, requiring health data and even employee data to interoperate. As this plays out, I hope to see the industry shift its perspective on interoperability as an evolving set of requirements, rather than a single, static goal. Health leaders will need to view interoperability as an evergreen initiative that constantly nurtures the information-sharing ecosystem in order to help healthcare providers make better decisions, ensure consumer data access, increase efficiencies, and improve patient outcomes.

Chris Caulfield, RN, NP-C, chief nursing officer, IntelyCare

The healthcare industry has been barreling toward a nursing shortage for years due to rising burnout and an aging workforce, but the COVID-19 pandemic has greatly exacerbated this issue. In 2021, we will finally see that bubble burst. Nurses from the baby boomer generation will continue to retire in droves, and the strains of the ongoing pandemic will drive others to seek employment in other industries.

To retain nurses and maintain safe, compliant staffing levels, healthcare facilities will trade Excel, pen and paper scheduling, and the whiteboards of yesteryear for integrated nurse staffing, scheduling, and training platforms. Leaders will increasingly turn to on-demand staffing solutions to reduce forced overtime for full-time staff – and in turn, foster work-life balance – while efficiently filling shifts with qualified nursing professionals. To further empower clinical staff, facilities will begin to flip the traditional scheduling paradigm, enabling nurses to pick their own flexible work schedules. As facilities become increasingly digital on the backend, they will also start leveraging insights from their staffing and scheduling data to intelligently fill shifts based on each nurse’s individual training, workload, and strengths they bring to the floor.

Stephen Lorenz, president, abeo Advisory Solutions

Similar to last year, 2021 will continue a theme around the need for health IT technology solutions surrounding the consumer, specifically related to their experience with the health system on the front end access point and the back end progress or departure point. Consumers are concerned about price transparency and have the continued expectation for the payment process experience to be simplified, as well as, digitized.

The pandemic has not only created the challenge of recouping lost revenue; it has also exposed problem areas that were already in existence. Hospitals must find ways to contain costs and integrate across their system. This requires data accompanied by a knowledge base to translate how they can solve these challenges. Health IT solutions and organizations that present data that assist health systems by understanding their cost structure associated with the delivery of care will be in high demand.

Dr. Emad Rizk, president and CEO, Cotiviti

In response to the pandemic, data scientists have uncovered new ways to leverage data in order to mitigate infection risk and improve care outcomes. Healthcare organizations can now use AI to predict the spread of COVID-19 in the United States and to identify vulnerable populations with comorbidities that increase the likelihood of mortality. Payers and providers each have unique data, and moving forward into 2021 they will need to work together to ensure the right care is going to the right people at the right time, especially as flu season ramps up. Payers will be able to leverage the influx of patient data to proactively identify instances of fraud, waste and abuse, which has dramatically increased with the rise of telehealth services and rapidly shifting regulations. Providers can leverage all of this data to get a complete picture of their patients’ histories and develop more accurate treatment plans. Through strategic data utilization, payers and providers will be able to manage risk, improve health outcomes and increase value in 2021.

David Shelton, CEO, PatientMatters

Although we’re all wishing the start of 2021 will magically bring us back to the pre-COVID-19 era, it’s clear that won’t be the case. The COVID-19 pandemic will continue to take the front seat as its negative impacts on healthcare will remain well into the New Year. Hospitals and health systems will need to reexamine their revenue streams to identify areas to improve operating margins and normalize cash flow.

In the coming year, a top area of focus will be the patient experience. Although we’ve seen momentum towards improved patient experience over the past several years, digital patient engagement will be a driving force moving into next year and beyond. Digital technologies with tailored workflows will enable providers to facilitate earlier, more personalized and transparent patient interactions that are essential to delivering a positive patient experience and creating patient loyalty.

Digital patient engagement will become the new norm of the patient experience. Recently, we’ve seen an acceleration in the digital movement on the clinical side of care with the expanded use of telemedicine. For revenue cycle management (RCM), digital transformation will come in the form of a digital front door strategy that will improve processes through streamlined workflows and patient-friendly digital tools. Providers will engage patients digitally at pre-service and every major touchpoint in the patient’s journey. Digital engagement such as online self-scheduling and patient price estimation; mobile pre-registration and check-in; and web and mobile payments will help patients navigate their care in ways they are already accustomed to in their everyday lives.

Dr. Erin Jospe, chief medical officer, Kyruus

The COVID-19 pandemic has undeniably added to the turbulence of the patient journey, but truthfully the patient access journey has been ripe for improvement for a long time. 2020 has enhanced patient empowerment significantly due to rising autonomy from self-service options. In the year ahead, health systems should accommodate patient autonomy to pursue their individual access needs at multiple levels – from access to vetted educational content about conditions to insightful information on clinicians, locations, and costs to online self-scheduling options for both in-person and virtual appointments. More than a trend, this is an extension of the evolution of consumerism in healthcare that consumers’ digital experiences in other industries are pushing. We know from research that consumers leverage multiple online resources as part of their healthcare journeys, with search engines, health system websites, and health plan websites the top three online sources. The innovation in 2021 will come in acknowledging the utility, both potential and realized, of those interactions and expanding beyond more myopic definitions of access to enhance the online consumer experience from education through online scheduling – and not just scheduling for office-based clinicians, but also for classes, virtual visits, COVID testing and, one day soon hopefully, COVID vaccinations as well.

Assaf Halevy, CEO and co-founder, 2bPrecise

I anticipate interest in and adoption of precision medicine strategies to grow rapidly in 2021, driven by three factors:

Lessons learned from COVID-19. One of the most startling characteristics of COVID-19 is the great variability in how patients respond to the virus. Some apparently healthy and young individuals became critically ill and died. Conversely, many elderly patients – those initially expected to be hit hardest – displayed only mild symptoms or recovered quickly. In others, the virus appeared to trigger a cytokine storm, an unexpected and excessive immune response. Scientific understanding about the virus is, of course, still immature. But it’s safe to say that this dramatic variability in patient response indicates that genetic factors may be crucial in preventing or treating COVID-19 successfully. An even longer-term gain is that these precision medicine insights are likely to translate more broadly to other disease areas, both rare and common.

Telehealth and telegenomics. Likewise, COVID-19 accelerated acceptance of telehealth and that will spill over into tele-genomics. Providers are able to undertake patient outreach, consult with potential candidates for genetic testing, order the tests and provide follow-up consultations virtually. Not only does this facilitate better and more precise care, it provides revenue during challenging times. Likewise, telegenomics will help limited in-house genetics resources scale more quickly. The industry suffers from a shortage of both genetic counsellors and clinical geneticists. Virtual care pathways will help address this and speed use of precision medicine tools at the point of care and in clinical decision making.

Validation and payer interest. Finally, point-of-care precision medicine initiatives undertaken in the past 2-3 years will begin producing measurable results and progress. Success correlated to precision medicine practices will be common and accelerate adoption in mainstream care. Consequently, payer interest in precision medicine will shift from theoretical to practical. They will seek ways to help front-line providers leverage precision medicine tools for preventive care, early intervention, better diagnostic practices and targeted therapies – as a valuable quality and outcomes strategy, as well as a way to better control costs.