Artificial intelligence, better user experiences, blockchain, and the social determinants of health are going to be top challenges in 2019.
2018 was nothing if not eventful for the healthcare industry, and 2019 is already shaping up to be more of the same.
Between the federal urgency around enabling patient access to health data, the meteoric rise of artificial intelligence, and the complicated dance of non-traditional technology companies looking to one-up each other as they enter the lucrative healthcare sector, just about everyone will have a little something to look forward to as they greet the new year.
There’s no question that big data will continue to be the star of the show.
The volume of available data in healthcare is projected to increase at a compound annual growth rate (CAGR) of 36 percent, said IDC in a recent report, outpacing the growth rate of nearly every other major industry.
More data hasn’t always meant better data in healthcare.
But the vast majority of enterprises have spent the last twelve months – or more – trying to reverse that trend.
In 2018, the overwhelming need to ensure these data assets are accurate, trustworthy, timely, accessible, and secure was the driving force behind big investments in new infrastructure, innovative partnerships, and workflow optimization initiatives.
In 2019, the focus on data is only expected to sharpen further.
As analytics rapidly become a competitive differentiator for providers and payers alike, and the inexorable shift towards value-based reimbursement continues, there will be even more pressure on organizations to whip their databases into shape.
Underpinning these developments is the rise of consumerism in healthcare, forcing organizations to get creative with designing delightful, personalized experiences for their patients – and their staff members.
In an environment so fraught with challenges and changes, healthcare organizations will have their work cut out for them to compete with a growing array of data-savvy rivals.
Here are our top 5 predictions for trends to watch as the calendar rolls over into 2019.
ARTIFICIAL INTELLIGENCE WILL BECOME AN EVERYDAY AFFAIR AS ACCEPTANCE GROWS
Mentions of artificial intelligence are nearly inescapable in the healthcare space these days, and for good reason.
AI is starting to move past its sci-fi reputation of job-destroying supervillain (at least, that’s what it wants us to think) and machine learning algorithms are simply becoming an integral part of the day to day applications and systems that comprise the modern technology experience.
Consumers are generally open to the idea that AI might play a role in clinical decision-making for serious conditions such as cancer, and are willing to trust that algorithmic decision support will measurably aid in the delivery of high quality care.
Americans are even more likely than consumers in other developed nations, such as Japan and Germany, to believe that robotic assistants have a key role to play in nursing and medical services, added a 2017 survey from Japan’s Nomura Research Institute.
Seventeen percent of Americans, compared to 12 percent of Japanese and 13 percent of Germans, would “very much want to use” robots to support nursing care, the poll found.
Twelve percent of US consumers want to see robots integrated into the delivery of medical services, compared to just 7 percent of Japanese and 8 percent of Germans.
And whether they’re truly on board with the idea of having an AI colleague or not, more than half of US healthcare professionals believe that widespread adoption of machine learning is inevitable within the next five years, according to a recent survey by Intel and Convergys Analytics.
AI tools are already proving their potential in high-value areas, such as clinical decision support, risk scoring, and imaging diagnostics – and the first wave of modern AI tools for many of these applications is now receiving FDA approval for commercialization and sale.
EHR developers are also moving very quickly to add AI to their products, recognizing that advanced AI is an attractive selling point for organizations that want to secure a position on the cutting edge of health IT.
Like the majority of consumer tech giants that power our smartphones and search engines, major health IT vendors are treating AI as just another tool for creating the personalized, intuitive experiences that have become the baseline expectation for technology users.
As a result, the perception of AI is shifting away from being a big, humming, ominous box in the corner that could start spitting out pink slips at any moment.
Instead, AI is becoming just another fact of life: a hidden engine powering the applications that clinicians and patients are now relying upon.
The feverish hype around AI is likely to die down in 2019 as the novelty wears off and developers start to get to grips with the real challenges of crafting sophisticated, reliable technologies that can solve real problems in the clinical environment.
IT’S DECISION TIME FOR BLOCKCHAIN: BIG OR BUST?
The healthcare industry has been flirting with blockchain for several years now, cautiously exploring how the distributed ledger technology could help to solve some of its data exchange problems.
Payers and providers have suggested that blockchain could support more trusted interoperability, improve collaboration, and eliminate much of the wasted time and effort currently devoted to an array of administrative tasks.
There has been no proof to the contrary, and blockchain is indeed gaining in popularity as an alternative to traditional data management techniques.
Yet early prognostications of a swift, broad uptake have not exactly panned out. Instead of leaping into the crypto-current, healthcare organizations have been much more cautiously dipping their toes into the water.
That’s not necessarily a bad thing. Healthcare enterprises have been burned before by moving too quickly towards unproven innovations, and blockchain is still in the pilot phase for many of its most promising applications.
2019 is likely to be a turning point for the methodology as organizations like Change Healthcare, the expanding Synaptic Health Alliance, Hyperledger, and Hashed Healthcollect and share more insights about the impact of blockchain on key healthcare operations.
Organizations will need to start to decide if they want to be blockchain leaders or followers, each of which comes with its own challenges and opportunities.
Earlier adopters will be charged with developing the best practices and governance techniques required to make blockchain work in the healthcare environment – tasks which have not traditionally been among the industry’s strengths.
However, those taking a wait-and-see approach may find themselves outflanked by more proactive organizations if they don’t move quickly to get involved in trust-based data exchange communities.
Success in 2019 and beyond may hinge, at least in part, on whether or not blockchain picks up momentum among opinion makers in the field.
THE INTEROPERABILITY ISSUE ISN’T GOING AWAY, BUT WE MIGHT MAKE PROGRESS
If blockchain does capture the healthcare industry’s imagination in 2019, it may become part of the solution to the question that never seems to have a good answer: how can disparate entities seamlessly exchange data in a safe, secure, timely, and appropriate manner?
Providers, regulators, and payers have been talking about interoperability for years – and depending on the ambient level of cynicism in your organization, it might seem like those conversations haven’t gone anywhere.
It’s still difficult to populate EHRs with a patient’s complete record; organizations are still struggling to interpret HIPAA in a manner that allows for impactful data exchange; CMS has had to crack down hard on entities that still haven’t managed to liberate individual health data to allow for patient-driven decision making.
Data simply isn’t working in the industry’s favor yet, despite assumptions from certain financial and regulatory frameworks that it should be a piece of cake to get the information required to succeed with population health and accountable care.
Will all that change in 2019? Maybe.
January marks the official deadline for MIPS participants to adopt 2015 Edition Certified EHR Technology (CEHRT), which might help to bump up standardized data exchange.
Certified 2015 Edition EHR technology must be able to exchange the Common Clinical Data Set (CCDS) with other sources, must include API capabilities to support consumer access to personal health data, and must support coordinated transitions of care.
These capabilities could mean that provider organizations are a little better equipped to send and receive data that has become vital for managing patients across disparate settings.
There have been plenty of other actions on the nationwide level to support a more fluid data exchange environment.
In early 2018, the ONC released the voluntary yet influential Trusted Exchange Framework and Common Agreement (TEFCA), outlining the rules of the road for interoperability stakeholders.
Ongoing work by CommonWell and Carequality has resulted in participation from the majority of popular EHR vendors, creating a shared network of data exchange that reaches coast to coast.
Combined with the general recognition that sharing data is now a prerequisite for success with value-based reimbursement, the stage may be set for interoperability to surge forward in 2019.
Of course, that’s what everyone said in 2018…and 2017…and 2016…
But this year is definitely going to be different.
ICYMI, SDOHS ARE THE NEXT BIG THING FOR PATIENT CARE
A somewhat more sophisticated data exchange landscape, coupled with the rising adoption of value-based care models, have prompted providers to turn their eyes towards the social determinants of health (SDOHs).
Suddenly, something that clinicians have always known – that food and housing security, interpersonal relationships, transportation, and educational attainment have a drastic impact on a population’s health – is getting some formal attention from regulators and payers.
Over the past two years or so, there has been a flood of investment in community-based programs to address socioeconomic factors that can drive up costs and cause outcomes to plummet.
Putting the socioeconomic puzzle pieces together is allowing providers and payers to proactively treat the whole person – or the whole family – instead of being forced into a defensive posture when an individual shows up in crisis at an emergency room.
Getting ahead of chronic diseases by tackling SDOHs is a smart economic move for payers who must still cover individuals with pre-existing conditions and higher risks (at time of publication, at least).
And now, with more and better data analytics tools at their disposal, payers and providers are working collaboratively to improve risk stratification, collect information on non-clinical factors, and launch novel programs such as prescriptions to a farmer’s market or permanent housing for homeless individuals with mental health concerns.
The trend of treating patients more holistically is likely to continue in 2019, as fee-for-service dwindles further, Medicaid expansion builds steam in some hold-out states, and pressure to control the nation’s runaway spending increases.
Payers and providers will need to develop new strategies for working with public health departments, community service organizations, faith-based groups, school systems, and first responders to connect needy individuals with the services and resources they need to maintain wellness.
This multi-faceted approach to population health management could put some strain on healthcare entities that don’t have much experience with extending their scope of influence into the community, but health IT may be able to come to the rescue.
EHR developers and analytics companies are also focused on equipping their customers with the SDOH data they need to deliver proactive, preventive care – for providers without the right tools in place already, 2019 will certainly be an important year for choosing a population health management company that can support an SDOH-centric future.
HAND OVER THE KEYS: THE CONSUMER IS IN THE DRIVER’S SEAT
Last but not least, there’s the one trend to rule them all: the consumerization of healthcare.
Passive patients are morphing into proactive, choosy consumers, emboldened by trivial little things like $5000 deductibles and a nagging sense that maybe healthcare should start to offer intelligible pricing, convenience, and a higher degree of customer service.
To its credit, healthcare has tried to take the hint.
Consolidation among hospital systems has started to produce larger entities offering repeatable, standardized experiences across care sites, and many organizations are starting to turn their patient engagement technology suites into truly effective health management hubs.
Mobile apps, convenient telehealth options, electronic payment tools, retail-style urgent care clinics, and price transparency initiatives are slowly but surely gaining popularity among providers and payers – at least among those who understand that they cannot cling to the status quo.
The industry is not known for the ability to pivot speedily, but nothing helps a business pick up the pace like the threat of some serious competition from a rival with more financial resources, more data savvy, and more experience with what consumers want to see.
That threat, of course, is Amazon – or perhaps more so what Amazon represents. “Customer obsession” is the key to the company’s success, founder Jeff Bezos has repeatedly stated.
That means using data to deeply understand the consumer and his or her wants – sometimes to a sort of creepy degree, let’s be honest – and delivering on those desires as quickly and comprehensively as humanly possible.
Always-on speakers in our homes and cars, near real-time grocery delivery, the almost fictional-sounding Amazon Key to allow deliveries right into your living room – there’s nowhere that Amazon doesn’t want to be in order to fulfill the consumer’s every wish.
Healthcare seems like a natural extension of Amazon’s mission to be everything to everyone. After all, at its core, healthcare is just another service to be purchased. And Amazon has gotten very good at helping people decide what to buy.
The company’s uncanny ability to insinuate itself into the everyday decision-making of the average American has created an expectation that all services in all sectors offer Prime-like convenience, personalization, and service.
Amazon isn’t the only technology company gunning for healthcare – not by a longshot – but its unrivalled success at pretty much everything it has tried makes it a force to be reckoned with.
Microsoft, Google, Apple, and even Facebook are eager to churn the healthcare industry’s information through their data mills, generating new insights into how health happens and what they can do to improve it.
The intensifying rivalry between these companies will only drive more power to consumers: organizations are now being forced to compete on user experiences in addition to outcomes.
A recent survey from NTT Data found that 59 percent of consumers expect their healthcare experiences to be similar to what they find in the retail sector. Half of patients would leave their current healthcare provider for one that offers better technology options, more personalized interactions, and easier ways to complete administrative tasks.
That sounds like good news for patients…but maybe not so much for providers and payers still bewildered by having the upper hand suddenly taken away.
Keeping up with the growing demand for experiences that mirror those in other industries will be challenging for healthcare stakeholders – including health IT developers who are finding that physicians, nurses, and other staff members are now adamant about having good user experiences, too.
User-centered design is going to be healthcare’s biggest hurdle in 2019. Some entities may need to reinvent themselves from the ground up – literally, in the case of organizations operating in outmoded buildings – to become organizations that consumers want to interact with.
That’s a very different way of thinking for organizations that are used to a much more paternalistic approach to rendering their services.
Organizations will need to undergo a fundamental culture shift if they are to rise to the challenges presented by outsiders entering the wellness arena – not to mention a few healthcare mainstays taking on new forms to muscle aside the competition.
Whether or not Amazon follows through on all its rumored healthcare projects, 2019 will be the year of the consumer.
Everything in the industry – changing financial structures, advanced AI, improved data analytics and data management, a focus on holistic health – is coalescing in support of a more person-centered approach to delivering care.
Good UX is the only thing missing, and if providers and payers wish to stay in business past the end of the decade, it won’t be missing for long.
For entities to succeed in this bold new world of consumer-driven care, they will need to make a concerted effort over the next twelve months to learn more about what their patients want and invest in the technologies, strategies, and mindsets that will allow them to deliver on those desires.