18 health technologies poised for big growth

'Now that you have all this data, what do you do with it?'
By Mike Miliard
05:40 AM
Butterfly emerging

By now, everyone's got an EMR. And most providers are also making use of ancillary technologies to help harness patient data toward more efficient care and better outcomes. But many species of health IT are still surprisingly underused in the U.S. hospital market.

"While the EMR market itself is pretty saturated, and usage has really improved since the HITECH Act, the challenge for hospitals and health systems is, now that you have all this data, what do you do with it?" says Matt Schuchardt, director of market intelligence solutions sales at HIMSS Analytics.

There's no shortage of technologies out there to help hospitals improve operations. But it may surprise you to realize how relatively untapped they often still are.

HIMSS Analytics' hospital database keeps tabs on all manner of IT products, and its list of the tools with biggest positive growth potential points to where the market will be heading in the coming years.

It tracks technologies that have seen growth of 4 percent to 10 percent since 2010 – but have yet to be adopted by more than 70 percent of hospitals. In many cases, the percentage of potential customers far exceeds those that have a given product installed.

The reasons for this are varied, says Schuchardt. In some cases, the tools have just recently become sufficiently well-developed to make a difference. Some are still fairly new technologies. Some are more sophisticated than smaller hospitals really need. Some require significant shifts in strategy and workflow, and providers may not yet be willing to take the plunge.

But all offer the potential to help achieve the big goals: better care for more people at lower cost.

"I think the opportunity for vendors to provide solutions is now," he says. "There are technologies in place now that can really help, and hospitals need to be aware of them."

With EMRs by now well-established, he adds, "the next step of optimization is going to require analysis and utilization of all these large data sets, and really clear insights on best practices."

We asked Schuchardt to weigh in on the HIMSS Analytics list, offering his thoughts on the potential of each.

Bed Management

Remaining first-time buyers: 49.7 percent
It's surprising to think how few hospitals "know how their beds are used, and where they're in use," says Schuchardt. "Think about how expensive beds are getting: you have to staff them, of course, but the beds themselves are extremely expensive and you can't have them be empty." As such, "this is one technology that "has big growth potential." New software programs "are so much more sophisticated in terms of the data they're tracking," he says. "Knowing how many beds are empty, most hospitals probably do that on a spreadsheet. But really knowing how they're utilized – and which beds are the most expensive – is going to be incredibly helpful, in terms of the cost-cutting and savings people are hoping to get from these structural changes."

Business Intelligence

Remaining first-time buyers: 40.3 percent
Financial BI is fairly well-used, at least at larger institutions. But "clinical BI is still very lightly adopted, and there are lots of plans to purchase those tools," says Schuchardt. "You need the data, but once you have it, what do you do with it? You're going to need a tool to really analyze it. BI connects really well to population health, too: Population health is a series of components – it's integrating all those disparate data sets together to make the right decisions for patient care and from a business perspective."

Data Warehouse

Remaining first-time buyers: 39.7 percent
An EMR, too, is a series of components, "with a clinical data repository being the hub of that spoke," he says. But in its most basic form that only means the data inside that system – "it's not all of the external data that's available – pay data, etc. You need all of that to really start doing BI." That's a massive amount of data that needs a place to live and a means with which to be fed into clinical and business intelligence platforms. And that's saying nothing of all the new data sources emerging onto the scene. "Now there are intelligent medical devices that are able to load your blood pressure into your record when you're at the hospital or the doctor's office," says Schuchardt. "There's a ton, a ton, a ton of data, and machine learning is going to start letting us make hay of that sooner, rather than later – but only if you have access to that kind of processing power."

Dictation with Speech Recognition

Remaining first-time buyers: 44.4 percent
"This is another one where it's just a technology issue," he says, suggesting that many hospitals just have other competing priorities for their tech budgets. But the capabilities exist. "You can have Dragon at your house now. Everyone has Siri on their phone, although she's not very smart. You think about the kinds of words people use in healthcare it just increases the complexity. It's not, 'Hey, how do I get to here…' It's very technical and jargony – you need to make sure there aren't translation errors."

Enterprise Master Person Index

Remaining first-time buyers: 39.6 percent
"EMPI is sort of like the next level of CDR," says Schuchardt. "It's like putting patient data in an easily sharable manner. The data sets in different EHRs aren't even necessarily correlatable. One may have your birthday as three fields and another might have it as an eight-digit code. Those two data  sets are never going to talk. In that format, they're going to say, this isn't the same person – or you're going to have to build a very complicated query to connect those two data sets. It's getting to some standardization across vendors, and making the data much more sharable. Or allowing you to pull data into the EMPI as an interim step between connecting a physician office that's on one EMR to a hospital that's on another."

Enterprise Resource Planning

Remaining first-time buyers: 65 percent
"There are tons of hospitals that aren't using it," says Schuchardt. "It's the logistics part of every business: Looking for inefficiencies and duplicative efforts. If you don't know that's going on, it makes it very hard to cut costs – which is the first step in reducing expense. So I think that's an area the market could definitely use. As these health systems get larger and larger, knowing where your spend, knowing where you're inefficient is really the first step in any sort of merger. It's important to have that understanding. Clinical efficiencies are where the lion's share of the savings are going to come from, but you can't get there without getting efficient from a business perspective."

Executive Information Systems

Remaining first-time buyers: 30.7 percent
Executive information systems may be a bit of an outmoded term at this point – "cost/utilization analytics is how vendors are positioning that, as opposed to EIS, which is an older HIMSS Analytics name," says Schuchardt – but both names boil down to the same concept: dashboards, primarily aimed at C-suite decision-makers. "It's a dashboard, to say, 'Where's our spend, how many beds are full right now, what's patient throughput, what's days in receivable?'" he says. "It puts all of that into an easily consumable format for high-level consumption." He adds: "All of these things are becoming software-as-a-service, just like everything else."

Financial Modeling

Remaining first-time buyers: 51.6 percent
"This connects really nicely with executive information systems," says Schuchardt. In this new value-based world, this world of ACOs and risk stratification, you have to be able to model. "When you're making an agreement with Anthem or Blue Cross about risk, you have to be able to see what the risks actually are, and you need to start thinking about them across a variety of possible outcomes. You could call that cost/utilization analytics. Would be a more buzzy term for it. As these systems get larger and larger you're going to want to see that. Being able to model possible outcomes is critically important to entering into risk sharing agreements with insurance companies and not ending up totally owned by them."

Infection Surveillance System

Remaining first-time buyers: 49.3 percent
Most hospitals at this point have a "core," EMR-centric IT system, says Schuchardt. "But it's the surrounding applications, that allow you to gain efficiencies around all that electronic data that are very very lightly adopted." Technology that can help keep tabs on healthcare-associated infections can lead to big gains -- or at least prevent unnecessary losses. He points to a recent article showing that "more than 50 percent of hospitals in Florida are simply taking the readmissions hit" -- acceding to CMS payment reductions rather than staving them off. "That's a massive hit. If you're trying to make gains and you're not committed to a penalty of negative third-of-a-percent, how do you increase your revenue if your incoming stream has a break on it because you can't keep patients from coming back?"

Laboratory (Molecular Diagnostics) and Laboratory (Outreach Services)

Remaining first-time buyers: 48.2 percent and 41.8 percent, respectively
"These are interesting too," he says. "If you look at the number (of hospitals) that has acquired them, it's really high. The bigger hospitals have acquired a lot of this. But it's not universal by any means." Molecular diagnostics is clearly on the rise. And lab outreach – ensuring diabetics take their insulin, for instance – is critically important. "You could say it's lab technology, it's boring," says Schuchardt. "But it's about patient compliance, really."

Medical Necessity Checking

Remaining first-time buyers: 32 percent
"Should that test be ordered? Have you already had one?" Think of this one as "next-level clinical decision support," he says. "Not only just that the doctor orders a medicine for you but someone else says, 'Hey, that person shouldn't take that because they're on this,' or 'Hey, there's a cheaper one.' The medical necessity checking is diving deeper into the data repository to say, 'This person has had an MRI in the last six months. Do not do another one.' Or, 'The X-rays on this patient can show you an additional look from what you're requesting in this test.'"

Nurse Communication System

Remaining first-time buyers: 30.3 percent
This one represents a big change in workflow for some hospitals – but could lead to big gains. "A nurse call system, everybody used to have to have them," says Schuchardt. "But it was a wire in the wall that called down to an intercom in the nurse station. We have the technology now for that not to be a wire: for the nurse to wear that around her neck. For it to go to the next available person if someone doesn't answer. And then to log all of those calls. It gives you much more data to use, and helps create efficiencies in staffing as well as in quality of care. It's really taking it to the next level. A nurse can click on her pager and send the same call directly to an orderly, as opposed to walking down there to find out what you want and then going to find an orderly."

Nurse Staffing/Scheduling

Remaining first-time buyers: 30.7 percent
"Down here in Florida there's an interesting anecdote," says Schuchardt, who lives in the Miami area. "There are places here where, in the winter, the population doubles. But the number of nurses doesn't. And keeping them scheduled and rested is important. As nurses play a much larger role in care now, keeping them where they're supposed to be is important."

Patient Portal
 and Physician Portal

Remaining first-time buyers: 30.9 percent and 38 percent, respectively
Despite the technology challenges for meeting Stage 2 meaningful use patient engagement requirements, "most people have a smartphone now," says Schuchardt. "I think the interesting challenge for the patient portal now is the rural communities that don't have Internet." From a physician portal perspective, right now the use is around retrieving diagnostic results, entering orders and electronic signatures. In both instances, "even in places where they're installed, the usage is much lighter than what people who understand the technology capabilities would imagine," he says. "There are a lot of people who aren't using this, and even the people who are using it aren't doing much with it, other than the ability to see a lab result if you're a doc or pay a bill if you're a patient."

Single Sign-on

Remaining first-time buyers: 43.2 percent
"Single sign-on is a big deal," says Schuchardt. "For people who have the same EHR system across the continuity of care, it's not that big of a deal. But that's not a lot of places. And I think that as we think about accountable care and population health, and the network leakage that people talk about from the hospital side, and about keeping people in your ACO, having the ability to access that stuff very quickly is important for provider engagement. The flip side of that: Is there a more secure way of doing that, or do people have concerns about similar passwords across similar environments. I think single sign on keeps you from having the same password everywhere, by managing that from a technology perspective."

Staff Scheduling

Remaining first-time buyers: 42.2 percent
To some degree, this one speaks to the size of the U.S. hospital market, says Schuchardt: "There are a lot of hospitals and the majority of them have fewer than 100 beds. That is something that you may not need until you're a larger organization or you're scheduling people at multiple places – a campus with multiple buildings."  If you're a large organization, "it's more important," he says. "If you have three people in your billing office, you really don't care as much."

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