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7 Insights and predictions of the future of care delivery: Dumping data, disillusioned doctors, and other dilemmas

December 6, 2017

This article was originally posted on Becker’s Health IT & CIO Review

David Lareau is CEO of Medicomp Systems of Chantilly, VA.

In my over 30 years in health IT, I’ve seen my fair share of technologies come and go. I’ve been wowed by innovations that quickly flopped. I’ve snickered at products that achieved market greatness. Over the years I’ve observed a lot of changes in our industry, including a few I would never have predicted.

One thing that’s been consistent over the years is the continuous shift in policies and regulations that impact the priorities of healthcare providers – and this last year has been no different. While I can’t say that my insights and predictions have been spot-on over the years, I still enjoy thinking about what is coming next.

As we wrap up 2017 and head into 2018, here are a few of the bigger trends that I believe will impact health IT over the next year.

1) The inevitability of interoperability. We (finally) seem to be making progress in terms of health systems accepting the inevitability of interoperability. Organizations now realize they can no longer refuse to have their systems talk to the systems that belong to their cross-town competition. Fortunately, the growing acceptance of FHIR standards will help to advance interoperability efforts. Look for significant interoperability progress over the next three to five years.

2) The dumping of data. More data will be exchanged, thanks to better interoperability tools and growing enterprise acceptance. Unfortunately, many organizations will continue to struggle to figure out what to do with all the data. More health systems have the ability to dump buckets of data on providers, yet few have the tools to efficiently organize the data into actionable information that enhances patient care. This issue won’t be fixed in 2018.

3) Consolidation continues. Look for continued consolidation among vendors serving the ambulatory care market. EHR and billing companies will lose more clients as hospitals purchase physician practices and migrate them to their enterprise solution. Rather than make major investments in new products, smaller ambulatory vendors will consider exit strategies. The exception to this trend will be the specialty EHR vendors that cater to orthopedics, ophthalmology, and other specialties. Meanwhile, look for the large enterprise companies to continue struggling to find ways to make their systems more usable for physicians.

4) Doctor disillusionment. Physicians will remain frustrated with the administrative burdens of practicing medicine. Instead of strictly focusing on patent care, doctors must regularly adjust workflows to address ever-changing regulatory and reimbursement requirements. Adding to physician disillusionment is uncertainty about healthcare policy, including the future of Obamacare/Trumpcare/Ryancare/Senatecare, and about which political parties are most likely to control Congress over the next few years.

5) The forgotten physician. At the same time, while we are asking physicians to do increasingly more to satisfy quality and reimbursement initiatives, we are failing to adequately equip them with productivity-enhancing tools. With every new requirement, clinicians are asked to perform additional tasks that are disconnected from everything else in their workflow. Physicians end up frustrated because they spend more time figuring out how to fulfill reporting requirements than they do delivering patient care. While we’d love to say that healthcare is going to do a better job addressing the technology needs of doctors in 2018, we fear will that physicians will remain largely forgotten as health systems and vendors focus more heavily on revenue-enhancing activities.

6) Halting the AI hype. Over the last couple of years, we’ve heard a lot of hype about artificial intelligence (AI) and machine learning and their potential to solve the industry’s data and reporting problems. For example, providers are holding out hope that solutions that leverage natural language processing (NLP) and AI will have the ability to convert dictated chart notes to free text, and free text to data that is actionable for clinicians. Unfortunately, the technology is still insufficiently mature for healthcare applications, and error rates for converting speech to text to data are, at best, between 8 and 10 percent. We predict that over the next year that people will look beyond the hype and accept the likelihood that AI technologies won’t be reliable enough to support clinical decision-making at the point of care for at least another two to three years.

7) Changing chart ownership. One positive trend that we expect will continue into 2018 is a shift in mindset about who owns the patient chart. Not too many years ago, most people believed that each doctor owned his or her own patient charts. Today both providers and patients are realizing the need for sharing clinical data between everyone involved in a patient’s care, including the patient’s family. The growing recognition that information must flow seamlessly between caregivers is a huge step in the right direction and advances industry efforts to get the right information to the right person at the right time.

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