Thought about what might happen in the world of healthcare IT as the year unfolds? Jay Sultan, who serves as strategy consultant at Bellevue, Wash.-based health IT company Edifecs has. He recently released seven healthcare predictions for 2015. He has something to say about ICD-10, meaningful use and more. Some of his forecasts might surprise you.
Analytics will finally begin to drive operational and clinical change. For those few providers who have both access to the right data and the right financial incentives, 2015 will see the industry getting past basic organizational and attribution issues and focusing now on how to use the analytics that have been available. They will look to change practice and referral patterns based on the analytics. They will identify and start to be proactive in reaching out to high-risk patients. Efforts will be small in many places and sporadic in others, but the providers under meaningful accountable care finally have the time – and the tools – and the reason – to use the analytics in a more intentional manner.
Billions of dollars have been spent by the payer industry and CMS to prepare for ICD-10. Payers truly believe more granular data will significantly improve the ability to measure value and prevent fraud and waste. Heavy lobbying will eventually overcome AMA opposition and prevent a statutory delay.
Public support for the ACA will continue to be mixed. However, growth in the federal and state exchange participation will be modestly incremental. Billions of dollars in federal money is available, and millions of poor Americans are still without credible health benefits. States across the country will find ways to take ACA dollars to cover the disenfranchised poor under pilot project but they won't publicly embrace full participation in the ACA.
Payers will strategically invest in retail healthcare – despite the lack of immediate ROI. The investment in consumerism will outpace the opportunity for another few years as the shift from defined benefit to defined contribution continues to take hold with employers. Payers will spend more money on infrastructure to support moving large books of business to private exchanges and direct channels. With strategic plans to move toward defined contribution, payers will aggressively seek to diversity their insurance portfolio with some venturing far beyond health and wellness and even entering property and casualty. These moves are necessary for payers to compete and thrive in this new marketplace, but they won't see a return on investment for five to 10 years.
Some payers will (cautiously) start to pay for telehealth physician visits, but the overall hype and investment around wearables and telemedicine will again outpace their utilization or value.
We can expect more hospitals to embrace comprehensive patient profiles in the next year as a result of the wreckage brought on by meaningful use Stage 2. Unfortunately, there is a good chance these personalized treatment plans will be ignored by provider workflows as there are few incentives to start using them. Physicians distrust cookbook medicine in general and the challenges they have seen overall with the EMR means they are highly unlikely to "trust" or value anything the EMR has to say.
Meaningful use Stage 3 will be significantly refocused to reduce meaningful use Stage 2 intrusiveness in clinical operations and instead focus on increasing interoperability. In 2015 we'll see provider collaboration and communication increase but not necessarily because of MU, but because providers will be asking themselves, "are we leveraging our investment in this technology in a meaningful way?"