20 Top Stories of 2015, 20 Predictions for 2016
It’s not too hard to choose 2015’s big stories, but I’m annoyed by people who make obvious “predictions” that are intentionally vague enough to evade accountability, like psychics who boldly proclaim that their client will have “a change in fortune” or “family developments, some good and some bad” in hoping desperately not to lose business by being proved clearly wrong. My predictions will be specific and I’ll publicly recap them this time next year even if they make me look silly.
What are your predictions for 2016? Send them my way and I’ll list them here.
- The Department of Defense chooses the team of Leidos, Cerner, Accenture, and Henry Schein for its $4.3 billion EHR project.
- High-flying Theranos and Turing Pharmaceuticals go down in flames, at least temporarily.
- NantHealth continues its acquisition streak and PR push, but temporarily shelves its IPO plans.
- ICD-10 finally goes live with barely a ripple thanks to the in-the-trenches folks who modified systems to accommodate it.
- The Supreme Court upholds the Affordable Care Act, but poor-performing state exchanges, increased insurance company costs, and increasingly higher deductible and narrower networks leave the middle class footing the bill for a bold experiment that has mostly helped providers gain paying patients without improving overall health.
- Just about everybody pushes back on Meaningful Use Stage 3, either by complaining to Congress or exiting the program, and doctors increasingly say their EHRs are the top source of their dissatisfaction.
- Industry mergers increase dramatically at all levels – health systems, health IT vendors, drug companies, and insurance companies.
- Epic CEO Judy Faulkner pledges to donate her multi-billion dollar fortune to a charitable foundation upon her death or direction.
- Epic and Cerner continue to dominate the inpatient systems market at the expense of their only significant competitor, Meditech.
- Data breaches become commonplace, including hackers who accessed the identities of 80 million people associated with Anthem.
- Cerner completes its acquisition of the former Siemens Health Services, but sees its financial results tarnish slightly immediately following.
- Athenahealth acquires software from RazorInsights and Beth Israel Deaconess Medical Center as it increases its push into the inpatient market.
- CVS and Walgreens continue to lead health IT with innovative apps and services.
- Epic wins several impressive customers, but struggles in the UK, loses the DoD contract, and will be displaced with Cerner following Banner Health’s acquisition of financially strapped University of Arizona Health Network.
- The OpenNotes project to allow patients to review clinician documentation gains ground with positive study findings and new funding.
- Expectations increase for the FHIR standard as the best way to integrate EHR information with other systems.
- ONC releases its Interoperability Roadmap that calls for EHR vendors to expand their API support and for the government to streamline privacy and security policies.
- Mobile apps show considerable promise for diagnosing and monitoring mental health conditions, especially depression.
- Apple announces ResearchKit for clinical study enrollment.
- Major healthcare systems and payers pledge to migrate most of their business to value-based payments by 2020.
- The cooled-off IPO and funding markets will leave nearly all of the unprofitable startups that graduated from the overabundance of accelerators and incubators in the past few years struggling to gain or maintain momentum and customers. Companies with IPO intentions will postpone their plans due to market conditions, but Health Catalyst will do so anyway with decent but comparatively unspectacular initial share price results as wary investors wait for a couple of good quarters to convince them.
- Healthcare costs will become a contentious topic in the 2016 presidential elections as the millions of Americans who purchased health insurance are stung by low utilization and high costs due to high deductibles and co-insurance, leaving them both poorer and less healthy than before. Medical bankruptcies will increase significantly and hospitals in particular will find it difficult to collect the money owed by under-insured patients. At least one presidential candidate will timidly suggest cost controls – both provider and pharma – as the only remaining option in trying to manage the increasingly damaging costs of healthcare in the US. Provider mergers will continue and national brands such as Kaiser Permanente that combine insurance and care delivery will gain prominence.
- Consumers will lose interest in fitness trackers and wearables as 2015’s Christmas presents gather January dust just like they did last year.
- The CEOs of Epic, Cerner, and Meditech will start to pull back from day-to-day company involvement as they approach retirement.
- ONC and Meaningful Use will become increasingly less relevant and more contested as ONC replaces Karen DeSalvo with a new National Coordinator who lacks her experience and bipartisan support.
- Several mid-tier consulting firms will be downsized or acquired as their implementation and advisory business dries up.
- At least three big health systems will experience a data breach that results in exposure of the information of 100,000 or more their patients. The industry will realize that collaboration to identify and mitigate breach threats is essential and of mutual benefit. The government and organizations such as HIMSS will attempt to create and manage an information sharing and risk assessment platform.
- The VA will announce plans to eventually replace VistA with a commercial product. Congress will push Cerner since the Department of Defense will be implementing it, but the VA will favor Epic just to be different.
- At least one Epic and Cerner customer will switch to the other company’s product in trying to get a better deal on crippling software maintenance fees. Epic will also expand its hosting service to compete with Cerner’s successful offering.
- The terms “telemedicine” and “mobile health” will become antiquated as they simply become another accepted aspect of care delivery. “Information blocking” will also fade away as a hot term when everybody realizes the concept involves speculation without proof, but consumers will increasingly demand that their providers share their information – both with their other providers and with themselves – without charging per-page fees for information that exists in electronic form.
- IBM Watson will continue to produce mostly hype. No convincing studies will demonstrate its value, but newly announced, high-profile partnerships will keep IBM shareholders hopeful.
- The dark horse publicly traded company best positioned to succeed in health IT and related areas without a lot of fanfare will be Premier.
- Athenahealth won’t get much inpatient traction with the former RazorInsights and BIDMC’s WebOMR.
- McKesson will consider packaging and divesting its many health IT offerings as non-core business.
- Epic will not join CommonWell, but will leapfrog its competitors in offering APIs and slowly building a carefully controlled third-party ecosystem.
- Software for population health management and analytics will enter Gartner’s Trough of Disillusionment as providers implement it poorly and without a commitment to truly change their profitable business models.
- Cerner and Epic will continue to poach the business of Meditech, CPSI, and best-of-breed vendors whose small-hospital customer bases are being acquired by larger health systems.
- “Big data” will support a few meaningful clinical studies performed using only aggregated electronic information, but “little data” will provide more impressive but less-publicized results as doctors design the treatments of individual patients by reviewing the outcomes of similar patients.
- Consumer healthcare apps will continue to be plagued by inconsistent use, questionable design, and an unremarkable impact on health or outcomes.
- CHIME and AMIA will follow the HIMSS model of increasing conference attendance and revenue by catering to high-paying vendors willing to buy access to prospects.
Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.
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Regarding Top Stories #2, I called it in March 2015:
March 4th, 2015 at 12:55 pm
“Elizabeth Holmes, founder of lab provider Theranos. is the youngest self-made woman at 31 years old (#360, $4.5 billion). ”
Smoke and Mirrors
Re: Predictions. Congressional interest in interoperability and information blocking will dissipate as they find other windmills to tilt at in an election year.
RE: Prediction 6. “Several mid-tier consulting firms will be downsized or acquired as their implementation and advisory business dries up.”
Mr. H, would you be willing to be more specific about this prediction in whatever manner is reasonable?