Even though the future in general may hold such promise for many, it may be easy to see why some in the healthcare industry remain skeptical now that the Patient Protection and Affordable Care Act’s enactment is more than a month old.
Certainly, new technology – particularly if it improves the twin titans of patient outcomes as well as fiscal and operational efficiencies – turns heads and attracts attention. But the dreaminess tends to deflate when reality sets in: Heightened regulatory scrutiny, legislative complications and the ability to pay for it all.
Yet the confines of reality in a reforming environment don’t stifle ideation. In the last edition of Health Management Technology, we asked a group of healthcare information technology company executives to forecast some of the technological developments healthcare organizations will use in the year 2020. This month, the healthcare IT executives expound on how those technological developments will affect patients and impact the facilities that serve them.
HMT: How will predicted new technologies benefit healthcare organizations and patients?
The greatest barrier to success in 2020 is to change the culture where patients feel comfortable as active participants in their health, contributing to their patient records in order to stay healthy. Many patients today are simply passive recipients of their healthcare, only contributing their personal health information to research in reaction to terminal diagnoses. But the more day-to-day information that we aggregate and analyze, through patient monitoring and real-time modeling, for example, the more healthcare organizations and providers will be able to analyze this data and make care recommendations in advance. This will ultimately lead to better real-time decision-making. The patient, in turn, benefits from having more critical healthcare data to make personalized care decisions as an active participant of the health journey.
Looking out to 2020, I believe we will have figured out how to make information move – from physician to physician, physician to patient, patient to physician and everywhere in between. It will be secure, rapid and, most important, seamless. Imagine this: getting a flu shot at the local retail clinic will be transmitted to your doctor, your Fitbit will let your doctor know you’ve been meeting your exercise goals and changes to your status-quo health will be measurable, trackable and shareable with your doctor instantly. Simply put, technology will give us the ability to take personal investment in our health and well-being to a new level.
Big data will enable the kind of real-time, actionable analytics that the healthcare industry has strived for. Merging the vast hitherto-silos of clinical, claims, genomics and patient-generated data will provide a perspective that can truly transform care delivery. Providers will be able to practice evidence-based medicine and make personalized decisions based on a patient’s genetic profile. Patients will be able to inform and engage their care team in a mobile, convenient way.
Exchange will provide the data liquidity that has been needed for efficient, longitudinal patient care. Healthcare organizations will be able to move beyond encounter-based care to practice population health management and, because of that, gain comprehensive insight into the patient’s past and present health. Obvious efficiency and outcome improvements will occur from reduced duplicate testing, adverse drug events, etc. Patients will benefit from this increased exchange by being able to own and move their data from provider to provider.
Healthcare organizations will be able to better manage their patient population, significantly improving outcomes and reducing overall cost. Preventive care in general, and chronic illnesses in particular, will be managed far more effectively than is possible with today’s healthcare information technology. Care providers across different healthcare organizations will be able to collaborate more effectively and will benefit from a more complete picture about their patient’s health without being overwhelmed by information overload.
Patients will benefit most from these new technologies. Preventive care will mean that many diseases will not develop as quickly or as early as today. Treatments will be more effective because they will be based on the patient’s individual characteristics, including genomics and proteomics. Patients will be able to accomplish many of the more simple healthcare management activities themselves from their home. They will be able to communicate with their care providers in new and effective ways that will reduce the need for in-person visits while helping in the personalization of medicine.
Left unchecked, unmanaged chronic health conditions could have a significant negative impact on the economy and the healthcare industry. A majority of healthcare spending – 75 percent – currently goes toward treating patients with chronic conditions, according to the Milken Institute. However, the Milken Institute’s analysis indicates that modest reductions in avoidable factors – unhealthy behavior, environmental risks and the failure to make modest gains in early detection and treatment – could result in 40 million fewer cases of illnesses.
Solutions like population health management and remote monitoring tools will enhance medical care by allowing a shift from a reactive model of care to a proactive model. Rather than waiting for patients to visit their physician or a local emergency room, medical centers will start using technologies that identify their highest risk patients, organizing teams around them, monitoring them outside of medical centers and intervening when new developments occur.
Healthcare providers will eventually be enabled to remind patients of upcoming preventive or scheduled tests, ensuring that most problems are identified early and properly managed before they become too costly or negatively impact a patient’s quality of life.
As healthcare providers embrace the emerging and evolving power of hardware and software, they will begin to shift to a new model of care that improves the overall health of various populations while reducing costs.
Advances that generate improved efficiency in healthcare will benefit everyone, not only by keeping costs down but also by better connecting physicians to patients so they can deliver better care. Connecting patients and the providers who care for them via mobile solutions, including those connecting geographically dispersed providers and those that connect patients from their homes, means more accurate care and faster intervention when required.
Intelligent systems will allow organizations to tailor care for the individual, manage a population of patients and better predict and plan to improve outcomes. Given the rise of chronic disease – almost half of all Americans live with at least one chronic condition, and 45 percent of adults over 65 have two or more – managing these populations for the best outcomes will be a major driver in controlling the costs of healthcare. For those living with chronic diseases, 23 percent are treated by at least four physicians, and the average physician can interact with 229 physicians in 117 different practices. Technology that connects providers to each other and to the most current information about a patient will generate efficiencies and better outcomes.
Telemedicine and the use of “big data” analytics in healthcare will ultimately support more efficient, informed decision-making for healthcare providers and better care for patients. This doesn’t just mean better episodic care; it can also help prevent a patient from needing in-patient care through predictive analytics, care plans, patient outreach and other existing programs, which are made more effective through these new insights.
Today, mobile speech is an enhancement experience and seen as a novelty. Physicians love tablets, but they primarily use these as viewers with EMRs, clicking and viewing basic information. Pad technology has advanced and is going to become widespread because the devices are about the right size, the screen resolution has improved and the EHRs have committed to them, making them easy to use through mobile speech. Nuance speech technology is embedded on every mobile EHR shipped by Cerner and Epic, and this experience will evolve. Things will get serious, and physicians will start using mobile devices for CPOE and really useful interactions to save them time and better care for patients. In the near future, doctors will walk in with a tablet and look at you while talking to a mobile device. They will have access to your problems and test results, and they will be able to communicate their recommendations instantly using speech and a tool that fits in their pocket – a tool that is as important to their personal lives as it is to their profession.
I believe the smoke will clear with Natural Language Processing (what we call Natural Language Understanding). People will know it’s there, but it will become a core technology that helps physicians do what they want to do while working quietly in the background. NLU will allow physicians to interact in a natural way in a digital healthcare environment while technology pieces together important information to help them solve problems. A lot has been done to avoid vague unstructured text in records by forcing physicians to use checkboxes and pull-down menus to get facts and structured data. NLU can help with that today by taking unstructured text (such as dictated patient charts) and distilling it into structured data for meaningful-use and ICD-10 compliance.
As NLU technology matures, use cases will explode and NLU will swing back and allow physicians to do much more, keeping their attention on the patient while capturing the structured data they need to support the organization. This is a novel experience not replacing anything that exists. For example, a physician can order labs or create a patient note and NLU will immediately digitize it, run that data through a knowledge base and feed queries back to the physician for real-time decision support. This is much more than just alerting them to an allergy in the record. NLU is the backbone behind real-time computer-aided physician documentation and quality analytics, as well as cool things like virtual assistants in healthcare that engage people through live dialogue and an advanced understanding of context. In the future, these could provide CPOE and could advance to telemedicine and patient uses to help patients self-monitor and manage care from home.
Interoperability solutions and mobile technologies will be a critical component to healthcare organizations and patients in the future, opening the door for new opportunities to enhance the patient outcomes and boost financial performance. Interoperability solutions, for example, will give providers real-time access to a more longitudinal patient record, enabling providers to collaborate on interdisciplinary treatments, engage in more accurate conversations and exchange detailed health information that is critical to patient care health information exchanges and more.
Interoperability solutions also address the need for providers to view both clinical and financial data to assess the health of an organization. Providers can use clinical information to analyze trends in diseases and provide faster treatments to better manage a population’s health. From a financial standpoint, healthcare organizations can use key performance indicators and business insights to understand staffing, training and technology needs.
Mobile solutions will also benefit healthcare from both the patient and provider perspective. Patients will consider it a necessity to access critical care information from patient portals and mobile devices. Providers will benefit from mobile technologies by having easy access to critical patient information at the point of care. Mobile technologies can reduce the risk of errors in data input and automate manual processes so that providers can focus on their patients. The overall healthcare industry savings is expected to climb to $35 billion over the next five years due to remote patient monitoring, and mobile technologies will play a big role in this shift in healthcare.
The early adopters of workforce management technology are seeing a tremendous value-add to both employees and patients because they have the ability to track, manage and optimize talent using employee data to predict staffing needs in advance. By 2020, this trend will be widespread, significantly reducing hospitals’ labor costs and improving staff transparency. Time and attendance and scheduling solutions used in a shared service environment as a result of affiliation and consortiums will also help to control technology investment costs.
Additionally, this staffing methodology enables clinicians to improve the process of evaluating patient care needs and making patient/nurse assignments. This creates an effective connection between the caregiver and patient that will ultimately lead to the best possible clinical outcomes and yield positive financial results. The integration between patient needs data and labor pool resources ensures optimal care delivery.
Healthcare organizations that span the continuum of care will be better able to optimize their mobile workforce while keeping labor costs under control. Patients will experience greater consistency in care, regardless of where they are on the continuum. Healthcare organizations will be better managed and find it much easier to mobilize their workforce – and employee satisfaction will improve.
An enterprise-class IT system that serves the EHR will result in a multimedia patient imaging record – a single, comprehensive, longitudinal and unified patient record across regions, facilities, departments and specialties.
Secure access to images and data from existing tablets, workstations or other devices anywhere on the network will ultimately lead to more informed clinical decision-making. Exams won’t be repeated, because finding older exams will be just a click away. Data from multidisciplinary departments across the care continuum will be called up on a single screen.
In one new scenario, a patient may go to a local emergency room with chest pain after he/she had diagnostic exams and work-ups in multiple locations. Clinicians can access all of those results and images from one location, in context to the local EMR without having to navigate out to various PACS portals, lab systems or disparate electronic content management (ECM) systems. No multiple log-ins, no discs to load, no calls to make; all of the patient information is in the right place at the right time for the clinician to quickly evaluate the patient’s full health record.
In addition to patient care, these technology changes will allow for a better return on investment for the healthcare providers through better use of IT infrastructure and less administrative overhead. Productivity gains, lower total cost of ownership and improved data security will all be possible with the goal of improved patient outcomes.
I believe that early detection of a variety of medical conditions will reduce acute and sub-acute lengths of stay, reduce co-morbidity rates and allow for early detection of health issues. As a result, this will reduce a number of issues from ever becoming more severe or chronic conditions. These technologies will allow a shift from early detection to early wellness.
True personalized healthcare will allow researchers and healthcare providers to create and deliver treatments that are finely targeted to the individual human being. This means fewer adverse events. It means that it will be possible to predict which patients will benefit from a particular treatment – and which will not.
