New to-do lists loom for 'post-EHR era'

IDC sees big changes afoot for 2014

As the electronic health record becomes "just another app," more and more providers are setting their sights on an array of complex future needs. IDC Health Insights' latest report sees big changes coming for care delivery in 2014 and beyond.

The "U.S. Healthcare Provider Predictions for 2014" report, authored by IDC Research Director Judy Hanover, spotlights the technologies and strategies that will be top-of-mind in the coming year, and shows how new realities will be shaping investment priorities in an era of regulatory burden and increased risk.

Chief among those big changes will be a reshaped role for EHRs, Hanover tells Healthcare IT News.

"What I've seen in hospitals is since 2009, and starting in earnest since 2010, is they've been laser focused on getting to Stage 1 meaningful use, and then expanding use of the EHR and related functionality to get to Stage 2," she says. "For the larger organizations that have been successful with EHRs, that started to pull away in 2013 – and what I'm seeing for 2014 is that they're really maturing and moving on to the next step."

That means they're looking for "infrastructure and platform options that will help augment functionality, perhaps to go beyond what's available from the basic EHR in order to meet the needs of their workflow and how that's changed with accountable care," she says. "They're looking at backup and disaster recovery solutions. They're looking at storage environments that start to centralize and organize clinical and imaging data. They're pulling away from an EHR application-centered focus and looking at the broader IT ecosystem."

As shown by the following 10 predictions from IDC, 2014 looks to be something of a pivot point, as provider IT departments start to look beyond the basic commodity of EHRs and toward a more complicated and demanding future.

1. First-generation EHR will continue to fail

"'Fail' is probably a little dramatic," says Hanover. "But what we're seeing is that U.S. providers are feeling themselves in a place where they may have implemented the full functionality of an EHR, and they look at the roadmap for their EHR supplier and do not see the types of tools they need in order to restore productivity. They're looking at communication and care coordination, and at things that go beyond EHRs. So in that case, the EHR is just becoming an app on the platform. In that sense, the EHR as the go-to place where providers will work, in a sense, is failing. We're seeing EHRs getting replaced with other EHRs that support broader platforms, more apps, more capabilities. As well as EHRs being incorporated into larger IT initiatives to create platforms that allow new apps for specific populations or care situations and go beyond the functionality of the EHR. The EHR as the be-all, end-all for care delivery, I think that idea has failed, and we're seeing providers continue to realize that."

2. The industrialization of healthcare will accelerate

By "industrialization," Hanover says she means "the transition of healthcare from a one-off experience with a patient to a repeatable, standardized process of care where we have more uniform outcomes and approaches to care delivery." That translates to "better-quality care with improved productivity for providers, so we can really begin to create some value in healthcare delivery."

3. Healthcare cloud adoption will flourish

"Cloud aligns so well with accountable delivery and these communities of care we're creating," she says. "And I think the security issues that have surrounded the cloud have proven to be largely unfounded. The majority of CIOs we talked to in this survey felt that they could provide better security in the cloud than they could in their on-premise deployment. And with the HIPAA omnibus rule, and the ability to sign BAAs, that reservation about security in the cloud has decreased. I think adoption is flourishing: We're seeing more and more use of virtualization, desktop, server, storage in hospitals even when they're hosting their entire data center on-premise. We're seeing that architecture creating a pathway for those organizations to move to the cloud. And as they add new capabilities, they're resourcing them to the cloud."

[See also: Has the cloud found its moment?]

4. The criticality of analytics will grow

"We're looking more and more at costing, which is definitely going to be front and center," says Hanover. "I'm speaking to more and more hospitals about activity-based costing, cost accounting. And those systems really aren't available. We're seeing a rush to make those systems available so providers can understand their costs. And then performance analytics: The analytics we have now is not as precise as we'd like, but providers are still learning a lot about their costs, doing clinical and financial analysis. They're identifying high-risk patients to better understand their outcomes. They're looking at specific populations to develop analytic tool sets to keep track of those patients and reach out to them. And to really communicate and collaborate via those analytic applications – whether it's sharing patient documentation across a health system or aggregating and doing some reporting to identify gaps in care. Analytics is being applied to all those and we're starting to see some success from it. It will continue to be an investment priority."

[See also: Analytics means we 'roll up our sleeves']

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