Readers Write: Healthcare’s Crystal Ball – Predictions for 2013

Healthcare’s Crystal Ball – Predictions for 2013
By Terry Edwards

As many have noted, there’s been more innovation in the past five years than in the last 50. But it’s onward and upward, and I spent quite a bit of time over the holidays thinking about what 2013 will look like. With Obamacare here to stay, healthcare executives certainly have more clarity into what their future will look like than they did for most of 2012. Investments in IT and communications are going to continue at a steady pace and likely even increase. But here a few of the biggest shifts that will take hold in the year ahead:

EMRs will be upstaged/usurped by population health management tools. In 2012, the industry finally came to a consensus that EMRs are simply data repositories, and also remembered that they were originally created so that hospitals could capture information to send a bill – and really nothing more. As we move toward business models based on maintaining the health of populations, EMRs will become an afterthought, while population health management, predictive analytics, and actuarial capabilities take center stage. Health systems are going to be focused on putting the technologies, people, and processes in place around the EMR that will enable true population management by 2014.

Clinical integration will take hold. Call me an optimist, but 2013 is going to be (finally!) the year of the integration. Hospitals will continue to reduce the number of systems they manage by making sure the ones they do keep can easily share data. Mobility is going to be key to pushing vendors to collaborate, because it’s going to be more and more critical that clinicians receive patient data on smartphones and other mobile devices, both within and outside the walls of the hospital.

Population health will push healthcare into the cloud. I see a huge opportunity in new applications moving to the cloud – specifically those that facilitate the freer flow of information that’s going to be required under a population health model. An ideal example: there’s a device or application that allows me to manage my weight, and I’m a patient with a chronic condition. I weigh myself every day or take my blood sugar, and that information goes from my smartphone to a database in the cloud, then accessed by my care manager. Or maybe there’s an alert that goes off if there’s a change of a certain percent over a set period of time. That’s an ideal cloud-based healthcare application, and we’ll see more of those move to the cloud in 2013.

Patients will be financially incented and will vote with their pocketbooks. To be blunt, patient accountability is an area where Obamacare really whiffed. Under the ACA, everybody is responsible except for the patient. But in the year ahead, the market will introduce more ways to incent and motivate patients, with financial pressures and rewards related to their health. We’ve already started to see new health plan designs where smokers pay more, putting a price tag on making better lifestyle choices. For those who are already more involved in their care, we’ll see them opt out of private or government-run insurance programs and gravitate toward concierge-type services. They’re also going to drive demand for better access to care, as they pay for faster, easier access to “retail” health care in CVS MinuteClinics, etc. – especially as primary care physicians continue to be spread thin.

Health systems crack the (scarily complex) code on clinician-to-clinician communication. I’m always fascinated by the different methods hospitals and health systems have in place to get information from one clinician to another. I’ve seen everything from NASA-level flow charts to third-party call centers to systems that seem like a step away from carrier pigeons. Effective clinician-to-clinician communication is essential to nearly every initiative a hospital has on its plate these days – meeting new regulations, driving new quality initiatives, moving to new models of care, etc. – but it has often been an afterthought, or as I’ve seen all too often, completely overlooked.

In the year ahead, hospitals will begin to gain an understanding of the complex processes between clinicians both inside and outside the walls of the hospital, and also start to see that there’s no technology solution that will improve efficiency. It’s not about smartphones or text messaging or pager replacement software, but about the process of who needs to talk with whom and when – and what changes need to be made in the current workflow to make that happen in a reliable way. With all the competing priorities hospitals are facing today, many don’t even understand their current workflows – and certainly don’t know what it should or could be. But sticking technology into a flawed workflow will only lead to an automated, flawed workflow. Hospitals need to identify the current state and the needs and concerns of clinicians, make improvements to processes as necessary, and then apply technology to the new and improved workflow. Only with an understanding of the process will hospitals be ready to start thinking about and implementing a successful clinical communications strategy.

Now that my tarot cards are on the table, what are you healthcare predictions for 2013?

Terry Edwards is president and CEO of PerfectServe of Knoxville, TN.