Day 11: Our Experts are Piping Up About Next Year
It’s Christmas eve and not a creature is stirring not even a mouse. But not so in health IT land. We never sleep and never stop thinking about tomorrow. (Isn’t that a song?)
On Day 11 of our 12 Days of Christmas Posts we ask some industry experts what they say is in the pipeline for health IT in 2019.
Will you be following any of these pipers?
Consumers Will Expect Affordable Financing Options from their Providers—Spurred by Growing Use of HDHPs – Over the past few years consumers have gone from being worried about how they’ll pay their out-of-pocket healthcare costs to now, expecting their healthcare provider to offer affordable financing options. In 2019 we’ll see more consumers express their voice and choice in healthcare provider by evaluating the financial experience equally with convenience and care outcomes. According to the ClearBalance® 4th annual Healthcare Consumerism study, 94 percent of respondents expect their provider to tell them about payment options, including long-term financing. Consumers also will share and compare their healthcare financial experiences with friends. More health systems will adapt their revenue cycle and patient access process to be consumer-friendly, communicating options to #makecareaffordable.
James P. Fee, M.D., CCS, CCDS
With the continued focus on transparency and accountability, 2019 will bring growth in healthcare blockchains, especially in population health. As a result, there will be advances pertaining to security and privacy as well as data integrity. Regulations will target industry vulnerabilities driving payor and providers to ensure the reliability and integrity of patient data. Gaps identified will propagate ongoing financial penalties, which will strain already tight margins. 2019 will be the year where healthcare organizations work collaboratively to unite the patient record such that high quality cost effective care is depicted across the continuum, starting with the bedside clinician.
Healthcare will make measurable progress towards addressing patients’ demands for more convenience and digital experiences. – I believe healthcare payers and providers will concentrate efforts on creating a “digital front door” where their patient and member communities can coalesce. Consumers want a more connected, personalized healthcare experience. They want access to test results via their smart phones within minutes of leaving a medical center. They want the ability to receive push text communications from their provider organizations. When we can add real-time, connected healthcare to the other digital services we take for granted and use every day, we will have arrived.
With the enormous, and appropriate, focus on new IT initiatives there will be a continued uptick in the number of new vendors and business partners engaged by hospitals, health systems and medical groups. As organizations add third-party vendors, new privacy and security risks emerge. 2018 witnessed a long list of breaches instigated by third-party vendors, with the year’s biggest incident caused by a cyberattack on a business associate.
In 2019, healthcare organizations must have a process in place to more effectively manage their vendors. They should challenge vendors on new requirements, new OCR definitions and heightened requirements for HIPAA compliance. Vendor management challenges and OCR focus will continue to be an important healthcare focus in the year ahead.
Technological innovations have helped us solve problems and become more efficient over the past three decades, but our tools are siloed. They don’t communicate with one another. They’re part of a disconnected portfolio of clinical communication tools.
In 2019, I believe we’ll start bringing these disparate pieces together. We’ll start down a path to more efficient care team collaboration that leads to better patient outcomes. Tomorrow’s care has to transcend geographic and organizational boundaries, and that requires a purpose-built CC&C platform that facilities intercommunication between compartmentalized systems and eliminates the friction in patient care. We’ll see a lot of progress on that front in the coming year.
Empowering the clinical community to do their jobs as efficiently as possible is more than a trend — it’s our duty.
We predict an increased focus on protecting PHI in all known locations, both internal and external. Covered entities will conduct risk assessments for every location that contains PHI and PII, both internal and external. More often we see attacks coming in from third-party vendors and business associates – we think this will continue as attackers search for the most vulnerable locations. Covered entities must also know where their vulnerabilities are (including externally) and make sure controls are in place to protect them. Every physician practice, every medium- to high-risk vendor, every information asset, will be assessed, audited and included in the overall risk mitigation plan. We predict that covered entities will recognize more and more that information security is the foundation – not an afterthought – for information technology as it continues to evolve.
Its been 10 years since the Recovery Audit Contractors rocked hospital providers world with a record number of audits and overpayment determinations. Commercial health plans took notice and refined the art of audits and denials, creating even more administrative burdens and financial liabilities for hospitals and patients to shoulder. 2019 will be no different, commercial health plans will continue to deny short stays, experimental procedures, high cost drugs and common costly procedures for lack of medical necessity. There will be even more growth in clinical diagnosis validation denials which are not only costly but time consuming to appeal. More and more hospitals will escalate their payment disputes and look for settlements to alleviate some of the burden brought on by heavy denials. Hospitals need to work together within their internal departments to fix true denials and externally with their peers to identify egregious behavior and look for wins to stop the abuse from payers.
In 2019, more patients will close their browsers and pick up their smart phones to dial up better care. Healthcare consumers are already using their mobile devices to find health professionals and facilities for care much like they do when booking a ride to the airport or reserving a table at their favorite restaurant. And in 2019, providers will finally capitalize on the existing relationships that their patients all have with their smart phones. We’ll see a shift in where hospitals and health systems spend their patient engagement dollars – investing in mhealth much more so than in the patient-facing websites – which are quickly losing momentum.
While consumers continue to embrace mobile apps in unprecedented numbers, the healthcare sector still lags behind other industries in adopting a mobile-first strategy for patient experience. However, the times they are a changin’ as hospitals and health systems will learn how an agile mobile strategy can increase engagement, education and loyalty, all while improving patient outcomes.
Patients are ready for the next step in the evolution of healthcare. They want to be engaged in their care and expect providers to deliver the information they need in a convenient method, which often includes their mobile devices. That’s why I believe 2019 will be a year in which great strides will be taken by many providers to enhance the patient experience by implementing a streamlined telehealth communications platform. In fact, a recent MGMA Stat poll revealed how 70% of providers are planning to adopt technology in 2019 in an effort to make their practice more efficient. This includes telehealth technologies, through which providers can directly engage with their patients via text-based clinical conversations, including images and document sharing in real time.
Care providers must be ready to meet their patients’ demands for convenience, not just in 2019, but in the years to come. And a comprehensive communications strategy that embraces telehealth messaging gives the patient the desired information quickly without sacrificing quality of care. The communications future between providers and patients is here!
In 2019, healthcare providers will need to keep their focus in two areas: 1. performance and 2. patient engagement.
- The movement toward pay-for-performance has been happening in healthcare for years, but the incentives/penalties are finally hitting the bottom line for many practices. Those not using the right tools to measure performance, utilization and patient outcomes will find themselves being left behind by the competition.
- Simultaneously, with insurance rates and deductibles continuing to climb, patients are fighting their higher out-of-pocket expenses through tools like Zocdoc, Vitals and RateMDs to compare physician reviews and identify quality. Providers will need to sell their value to these savvy shoppers more than ever before, and I see the convenience of patient portals and online bill pay becoming standard in 2019. Practices not providing these types of patient engagement services will be at a disadvantage.
In 2019, I predict we will witness the convergence of social determinants data, health plan benefit design, and consumer demand in creating the most widespread provision of health services in effectively targeting and addressing patient needs beyond clinical intervention. The stage was set in 2018 through a number of innovative housing pilots and CMS guidance expanding the definition of health-related supplemental benefits. This freed Medicare Advantage plans to more creatively address the functional needs of their most vulnerable populations.
Health plans have long collected social determinants of health data on populations, but the question has remained how to use that data in ways that are both targeted to member needs and scalable. 2019 will give us our first glimpse of plans attempting to use such data through coordinated supplemental benefits. And thsi only marks the beginning. It creates the opportunity for health plans to learn more about the customers they serve and become smarter at designing care programs. Utilizing member data beyond claims history will become increasingly important, and care organizations who fail to embrace the expanded potential to impact the health and social well-being of consumers risk falling behind in an ever-evolving market.