It's that time again. There's snow on the ground (in some places, at least), fir trees have been sawn down and adorned with bright flashing lights and people are beginning to make their predictions for the year ahead. The healthcare IT industry being just like any other in that respect, practitioners, providers and pundits alike are sounding off on what 2012 was all about, and what the next rapidly approaching year has in store. In addition to providing a reading list of some of the best (and most out of the box) year in review and predictions lists, we've compiled a list of our own here.
Patient engagement. That the Affordable Care Act (ACA) will be a massive game-changer is an almost universally recognized fact, regardless of which side of the aisle you're on. With its broad shift from pay-for-service to pay-for-quality of care, many in the industry see 2013 as being a year where more focus is put on staying involved with patients. This entails everything from higher-quality follow-ups, to regular electronic check-ins, to reaching out to patients that electronic systems may identify as being at risk. Mansoor Khan, MD, CEO of Lowell, Mass.-based clinical decision support and analytics firm DiagnosisOne, says that there is a spectrum of engagement, going from light, low engagement (with healthy patients) on one end to heavy engagement "with very sick people" on the other. "When you look at that spectrum, where you can make the most money is on the complex end," says Khan. "You're starting to see people delivering actual results, reducing readmissions, getting people to the treatment ranges," and other actions that improve quality of care by staying engaged with the patient.
At the same time, however, notes Fred Pennic, a healthcare IT consultant, "We have primary care shortages." That makes for bully mobile health and telehealth markets.
Data. It's big. It's bad. It's data. (It's not really bad, but most people are still confused about it and its place in healthcare, even as it's getting bigger by the day.) "We're scaling up to handle 30 terabytes of data every day," says Khan. Compare this to "Bank of America, their entire database is something on the order of a single-digit petabyte." For more perspective on those numbers, every day DiagnosisOne crunches the equivalent of roughly 3 percent of Bank of America's entire trove of data. (This assumes that BoA has a database of 1024 terabytes, or one petabyte.) The implications and uses for this monstrous amount of information are varied. "It's really just the tip of the iceberg," says Pennic. "The hard part is how do we analyze the data?" he says.
Khan says that increased focus on analyzing and interpreting big data will help identify segments of the patient population and look at the development of care and overall health in a new light. Big Data, he adds, will "allow you to see the progression of what happened to the population or a patient. It will allow you to make a judgment you would not be able to make before."
Payment reform & ACOs. As the song goes, "Your lovin' gives me such a thrill/ But your lovin' don't pay my bills." (If the Beatles covered it, it can't be wrong, right?) In more businesslike terms, however, "Now that Obamacare is going to be around, there's a lot of movement in this space now," says Khan. What many people don't realize, he says, is that when one organization decides to become an accountable care organization (ACO), all of the other organizations around it are affected by that and have to change their own business models to respond. He says that there are "about 300 ACOs in various stages of organization, and as far as we can tell there are 400 in the pipleline for 2013." Khan says these "ripple effects" are forcing other organizations to jump in to the fray, even if it's not on the top of their to-do list for 2013.
Meaningful use. "Stage 1 was not all that ... robust isn't the right word, but it certainly didn't demand much from the end user," says Khan. "Stage 2 is starting to tighten the screw a little." With organizations sweating over the second stage of meaningful use implementations, can we expect a maelstrom of grief when Stage Three drops? One change that the marketplace will see some turmoil, possibly squeezing out some of the smaller players. "It will be much tougher for smaller EHRs to deploy this technology," says Khan. "It's definitely getting much more stringent and much more complex." He notes as well that the market is pretty well saturated, and that as new regulations are imposed and developments are adopted, it is "only a matter of when" many smaller EHRs lose out. Khan notes that there are 700 unique EHRs today, "and the industry can't support that."
Pennic agrees, adding that, "Providers are going to have to spend more money, which is a bad thing because they're tapped out." He also predicts that a focus on better design in EHR software will be a trend in 2013.