If there’s one thing that 2018 taught us, it’s that nothing in healthcare or healthcare technology is predictable. No one knows this more than hospitals, health systems and provider organizations.
As I was thinking about last year, I wanted to share a little bit of what we at LexisNexis have learned and think may bubble up as we push forward into 2019.
We held an early 2018 CIO focus group with the College of Healthcare Information Management Executives (CHIME). Their predictions for the year’s top priorities were pretty spot on:
- interoperability
- data security
- identity authentication
- the need for a national patient identifier
- patient record linking
- governance of patient and provider directories.
The goal isn’t just to implement the EMR anymore. It goes much deeper and is far reaching.
Interoperability Rules
Our CIOs started 2018 optimistic about interoperability, and they are usually the individuals charged with the task. It’s a daily challenge that affects their ability to exchange and govern all clinical data. When the Centers for Medicare and Medicaid (CMS) changes their branding for Meaningful Use to Promoting Interoperability, you know it must be a priority. The funny thing is, when we asked CIOs to define interoperability, it meant something different to everyone.
The key to success will be simple —the systems need to talk to each other—maybe with CMS driving the charge, it can be achieved in 2019, but the jury is still out.
The problem now is—they’re all different systems. Until we have a national patient identifier that makes medical records transferable, or a magic bullet to make differing EMR systems interoperable, there will be a disconnect. Pardon the pun.
This disconnect creates a ripple effect that spreads far beyond just healthcare technology systems. Disparate systems affect cost, outcomes, data security, patient safety, data integrity and governance—all topics that topped the list of our CIOs.
Population Health for All
Accountable Care Organizations (ACOs) are (finally) making money and showing that a risk-bearing care model can and may be more effective than bundled payments for risk, patient care and cost savings when targeted populations are better managed.
The success or failure of the Medicare Shared Savings Program has yet to be determined, but emerging data on reducing readmissions and cost-savings with these new payment models are a good sign.
I would argue that the risk stratification of covered patients is the secret weapon for ACO success. ACOs are well positioned to charge to the forefront of new care delivery models. The shift to value-based care is far from over and 2019 will prove to be the year that makes or breaks ACOs. And it will show how data insights like social determinants of health data will play into breaking down barriers to care, population health strategies, and care management and delivery.
Consumerism and Emerging Healthcare Technology
With players like Apple and Amazon entering the market, and CMS handing the management of medical records over to the patient, the healthcare patient as a consumer will further the need for better management and security of the millions of data points these big companies will collect.
Patient engagement will take on a new level of importance. However, the challenge is that the problems faced by providers in getting patients engaged in their care may not improve simply because it’s now coming from Apple. And, the difference in reaching or not reaching those patients/consumers could impact their performance metrics, care coordination outcomes and ultimately, costs. Just because a tech giant powers it, doesn’t mean the challenge of patient engagement gets any easier.
Another top priority of our focus group was data security. They worry that all these changes and new players entering the market puts data at even higher risk for breach. Provider organizations struggle enough to authenticate the identities of individuals coming into their portals and systems. How will that play out when records are handed over to patients or third party healthcare technology providers? As mergers and acquisitions cause data to become increasingly intertwined and shared, the opportunity for breach and theft grows exponentially. I believe data security is and will continue to be top of mind next year and for many to come.
2018 was a big year for healthcare providers. Federal regulations and requirements took a big turn. We’ll be talking to CIOs later this month to see how 2018 shaped up and what’s keeping them up at night in 2019. The one theme that ties all of these challenges together is patient care. It’s the shared driver for all of them that makes the state of change the one constant in healthcare.
