The need for greater cybersecurity protection is sinking in. The desire to better understand mountains of untapped data is on the rise. And the necessity to start improving the health not just of patients but of whole populations is being taken quite seriously.
These are some of the conclusions from “2017: The Year Ahead in Health IT,” a new survey of healthcare organizations from Healthcare IT News. We polled 95 healthcare executives in October 2016.
Asked which technologies they are planning to upgrade in 2017, 52 percent of survey respondents said security, 51 percent analytics, 44 percent patient engagement, 44 percent population health, 31 percent EHRs, 24 percent remote patient monitoring, and 22 percent revenue cycle management.
Joe Fisne, associate chief information officer at Geisinger Health System, observed that this spread makes sense.
“From the standpoint of security being No. 1, it certainly is one of the most critical things in healthcare today,” Fisne said. “We are in an age where technology has extended so far into the realm of healthcare that it has become one of the most critical things, so the heightened need for security follows. And analytics is key, as well. We are investing in some of the Big Data platforms to take information and demonstrate trends, practices and patterns of care, as well as patterns of illness along the way. And that goes hand in hand with population health.”
2017 also will see the arrival of technologies at many healthcare organizations. Asked which technologies they plan to introduce or investigate in 2017, 45 percent of survey respondents said analytics, 45 percent workflow improvement, 44 percent telehealth, 41 percent population health, 41 percent smart medical devices, 34 percent remote patient monitoring, and 21 percent precision medicine.
“What stands out here is the increasing importance of telehealth as a different form of access as well as a different form of connecting with consumers,” said Brian Kalis, managing director of the health practice at research and consulting firm Accenture. “Seeing telehealth with increased importance can help address labor productivity challenges in healthcare.”
Though lower in the survey results, Kalis said he finds the interest in precision medicine quite promising.
“This foreshadows what we might see accelerate in 2017 – the focus on precision medicine and the initial investments in using precision medicine to improve care,” he said. “This is an early stage trend. As well as the survey respondents’ fairly high prioritization of smart medical devices; we’ve heard from a number of health systems looking at new strategies to use patient-generated health data to improve care.”
2017 will be no different than years past with healthcare organizations will be working on their electronic health records. But the priorities for 2017 are unique to the time. Asked which types of EHR development projects are or will be in the works within their enterprises in 2017, 60 percent of survey respondents said improving interoperability, 55 percent improving workflow, 47 percent improving usability, 37 percent adding population health tools to the EHR, 28 percent migrating to the cloud, 24 percent performing a major EHR system upgrade, and 21 percent replacing the EHR at one or more sites.
All of this adds up to a very natural evolution based on the healthcare landscape today, said John Halamka, MD, CIO at Beth Israel Deaconess System and a professor of medicine at Harvard University.
“When you look at the quality programs and MIPS and MACRA, suddenly you are seeing a realignment of incentives where doctors are paid for wellness and quality as opposed to quantity,” he said. “Unless you are collecting data about patients across the population, it’s really hard to control expenses, enhance quality and improve workflow. EHRs were put in basically as dumb data communication systems without emphasis on exchange and workflow. But because of payment reform, we have incentives to do data exchange. Different things are bubbling to the top.”
One aspect of EHRs many healthcare organizations continue to work on is caregiver acceptance. Asked what actions will they take in 2017 to get more physicians and nurses to fully embrace EHR technology, 60 percent of survey respondents said integrate EHRs with other technologies that, for example, advance population health or best practices, 47 percent improve EHR system interfaces, 40 percent clearly show EHRs help the organization profitably manage value-based care, and 38 percent clearly show how the technology markedly reduces time spent on tasks outside of direct patient interaction.
The “2017: The Year Ahead in Health IT” survey found population health to be a high priority with a great many healthcare organizations. Asked if their organization plans to implement a population health system in 2017, 20 percent of survey respondents said yes, they are planning to deploy a new system, a big 42 percent said yes, they will be adding tools to existing systems, 9 percent said no, they have finished their population health project, and a significant 29 percent said no, population health is not in their plans for 2017.
Healthcare organizations working with population health technology anticipate the tech will help their organizations in various ways. According to the survey, 58 percent said the technology will help enable a better patient experience, 54 percent said it will enhance the efficiency with which the organization can deliver healthcare, 51 percent said it will help reduce healthcare costs, 44 percent said it will improve the health of individuals and thus the population, and 41 percent said it will help enable a better provider experience.
“There are many early adopters that have population health systems in place and for them there now is a need to enhance the systems and optimize them to integrate them into other systems, hence the increased focus on adding to existing systems in the survey,” said Kalis of Accenture. “For organizations that are launching a new population health system, these are the organizations lagging behind some of the others to get their first implementations in place and thus increase overall market adoption.”
On the extremely important cybersecurity front, application security and network security top the list of areas of focus for 2017, according to the survey. Following are security issues healthcare organizations face in 2017, the percent of survey respondents that leans toward labeling the issues a lower priority, the percent that labels the issues smack in the middle on the priority scale, and the percent that leans toward labeling the issues a higher priority, the survey found (totals may not add up to 100% due to rounding):
Like cybersecurity, interoperability is a major subject of concern for healthcare organizations. According to the survey, interoperability projects healthcare organizations will be working on in 2017 include connecting to external databases, such as health information exchanges (65 percent); connecting applications within the organization (58 percent); and adding connections from medical devices to existing systems (37 percent).
Asked to identify the single biggest inhibitor to greater interoperability in 2017, 40 percent of survey respondents said a lack of industrywide standards, 27 percent EHR vendors, 18 percent a culture of data hoarding, 12 percent financial concerns, and 3 percent other issues.
Some of the other issues, which may be profound, include making a strong business case for interoperability, said Halamka of Beth Israel Deaconess System.
“I have never seen information blocking when there is a combination of a business case for sharing information and competent technical people,” he said. “I only see it when there is a lack of alignment to share data. The data standards we have today are quite sufficient and EHRs are quite sufficient. Meaningful use gave us the standards and interoperability constructs. It’s just the motivation to move forward.”
One of the biggest areas of investment in health IT appears to be analytics. Asked about their analytics plans for 2017, 24 percent of healthcare organizations said they are planning to launch a new analytics system, 59 percent are adding tools to existing analytics systems, only 8 percent have completed their analytics deployment, and a mere 9 percent do not have analytics in their 2017 plans, according to the Healthcare IT News survey.
Of those organizations working with analytics, 76 percent expect analytics technology will help improve the quality of healthcare, 67 percent expect it will help enhance the ways in which care is delivered, 62 percent expect it will help reduce healthcare costs, 52 percent expect it will help successfully manage the shift from fee-for-service care to value-based care, 30 percent expect it will help free up time for caregivers to spend with patients, and 1 percent does not use analytics, according to the survey.
“The consistent trend across many of these technology categories, including analytics and population health, is that larger organizations have put in place the first wave of solutions, this already has happened,” said Kalis of Accenture. “Now, these organizations are optimizing their investments and adding to them to maximize the value of the foundation already in place.”
Looking forward, healthcare organizations have a variety of emerging technologies in the pipeline. Asked which emerging technologies they are planning to invest in during 2017, 63 percent of survey respondents said prescriptive analytics, 34 percent artificial intelligence, 21 percent genomics tools, 21 percent machine learning, 19 percent cognitive computing, and 6 percent Blockchain.
Further, when asked which emerging technologies they consider to have the most promise, 26 percent of survey respondents said prescriptive analytics, 22 percent genomics tools, 18 percent artificial intelligence, 13 percent machine learning, 10 percent cognitive computing, and 4 percent Blockchain.
“Prescriptive analytics is right on the money, which ties in with some of the artificial intelligence and machine learning, the things we do to look at the volume of information we have collected,” said Fisne of Geisinger Health System. “The data gives us a lot of the patterns and information, and by seeing those you see ways to provide better patient care.”
Kalis of Accenture agreed that prescriptive analytics is a big next step for healthcare organizations.
“Health systems have invested in putting some of the foundational building blocks of analytics in place; the emerging technology here, prescriptive analytics, is the next step of trying to derive insights from the information and foundational assets in place,” Kalis said. “Also interesting from this list is the fact that Blockchain is even on the radar of some CIOs; it’s telling that there is interest in exploration to understand where Blockchain platforms can be applied and what the implications can be long term.”