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Health care is a fast-paced industry defined by dramatic shifts in regulations, technology, care delivery and patient-physician interactions. This year, we will see changes to the health care landscape that offer possibilities and opportunities in the march toward smarter, better care that is higher quality, more efficient, affordable and personalized. The accomplishments leading up to 2019—such as the digitization of health care, an increase in patient-centered care and the promotion of evidence-based medicine—are the foundation for even more innovation and improvement to come.
As health care evolves and organizations evaluate their strategies, here are some of the continuing and emerging concepts that will shape health care in 2019:
1. Value-based care drives improved consumer experiences
The concept of value over volume was much-discussed in 2018, and the push for outcomes-based care will continue to progress in 2019 as the industry strives to lower costs and provide higher quality care for individuals and populations.Additionally, Centers for Medicare and Medicaid Services will implement changes to the Quality Payment Program in 2019. These adjustments will impact the Advanced Alternative Payment Model and the Merit-based Incentive Payment System, and further accelerate the move to value-based care and payment.
Along with these organizational implications, consumers, armed with more information and choices than ever before, will demand greater transparency into the quality and cost of care. Building and sustaining trust and loyalty will be a top priority for providers and facilities due to these increasing expectations. Provider organizations will create differentiated experiences that extend traditional episodic care to more personalized care. New care delivery processes, such as care management, virtual care and other mobile self-service options will be used to provide greater health system efficiency and streamlined consumer experiences.
2. Milestones toward open and interoperable systems
2018 saw a major step toward nationwide interoperability with the connection of two of the largest interoperability communities — CommonWell Health Alliance® and Carequality. The sense of urgency in advancing open and interoperable systems and technologies is at an all-time high as the industry makes strides with data standards such as Health Level Seven International’s Fast Healthcare Interoperability Resources and SMART Health IT.
In 2019, leading technology companies will fight alongside the health care industry in the push for interoperability, providing fresh perspectives and additional resources. New challenges and opportunities will present around consumer consent models. As consumers gain more control of their data, privacy questions surrounding the “mobilification” of personal health records will become relevant. As Qualified Health Information Network requirements are finalized under the Trusted Exchange Framework and Common Agreement, more educated and empowered consumers are likely to create the second-order effect of driving increased data use by providers across health networks such as CommonWell.
As the industry continues to embrace advanced interoperability strategies, the volume of exchanged information will scale, making it critical to have the right data infrastructure to create actionable results.
3. Rise in home health care
Already a $103 billion industry, home health is projected to grow to $173 billion by 2026, according to analysis from the Centers for Medicare and Medicaid Services Office of the Actuary. The federal agency also found that the growth rate for spending in this sector is higher than any other health category tracked, at 6.7 percent by 2020. The biggest contributor to the boom in this area is the rapid rise of the 65-and-older population.
Experts in the field foresee more tech investments and increased collaboration between home health and hospitals in 2019. As the industry faces an extensive labor shortage, optical sensors, wearable monitoring devices and other technology will help fill the gap. To better manage the transitions of care and quality across care venues, using near real-time analytics and observational insights for a holistic perspective of each patient will be key as value-based care initiatives drive new quality and payment requirements.
4. Emphasis on outpatient care
Outpatient care, also known as ambulatory care, will continue to rise in 2019. Economics are the biggest driver of this shift, as a new report shows the average health care cost for an outpatient visit is about $500, compared to more than $22,000 per inpatient admission.
In addition to financial savings, outpatient care also provides greater convenience and access for consumers with nonurgent needs — another indicator of consumer demands driving industry change. Hospitals are increasing their investment in modern, multispecialty clinics to meet these demands and in theory, will attract more insured patients and boost revenue.
Additionally, the emergence of urgent care, specialty clinics and ambulatory surgical centers will drive new requirements and amplify the need for better care coordination capabilities and data interoperability.
5. Small data > big data
The health care industry will continue looking for ways to turn data into more applicable, timely and personalized insights that provide increased value to patients and physicians. Instead of gathering more data, hospitals will look to get the most useful body of information. One example of this, is the movement toward more sophistication in identifying biomarkers to optimize diagnostic power over multiple diseases.
Health-related wearables, such as Apple watches and Fitbits, will be a key motivator as we climb to 20 billion connected devices by 2020. The combination of near real-time data from wearable sensors and data from longitudinal health records will increase demand for new predictions that can turn insights into action.
6. The growth of health cloud apps
A HIMSS Analytics study shows that approximately 65 percent of health care organizations are using the cloud or cloud services. In addition to being more cost efficient, the cloud offers greater reliability, security and accessibility. More health care organizations will move their entire IT infrastructure to the cloud in 2019, and the global health care cloud computing market is predicted to hit $35 billion by 2022.
The health care industry will continue to address new regulatory requirements, such as the European Union’s General Data Protection Regulation, to ensure the advantages of cloud computing can be optimized around these evolving requirements.
7. Focus on consumer engagement
The industry will continue to move toward prevention and away from reactive care. This proactive approach will mean greater use of portals, health apps, remote patient monitoring and other tools that empower consumers to be involved in and knowledgeable about their care. Consistency and communication throughout the care cycle will be key to maintaining consumer engagement.
Even changes in hospital design, such as the integration of smart rooms, will keep consumers comfortable, safe and informed during physician appointments and hospital stays.
Technology, such as smartphones, laptops and tablets, that facilitates patient-centered communication and mobile clinical workflows will ensure providers spend more time with their patients on the care that matters most.
8. Expanded use of predictive analytics and artificial intelligence
The health care artificial intelligence (AI) market is expected to see a compound growth rate of 40 percent through 2021, per a Market Report study. It’s easy to see why the integration of AI in the electronic health record (EHR) appeals to many health care providers. The technology shows promise in making the EHR more flexible and discerning, allowing physicians to spend less time in the EHR and maximize meaningful interactions with their patients. It also has potential to reduce health care costs by half and improve patient outcomes by 30 to 40 percent.
The benefits of AI will extend beyond the EHR. In the realm of population health, virtual assistants will automate the management of personalized care plans. Precision medicine and social determinants of health will take a front seat as health care becomes tailored to individual patients. In hospital operations, predictive models will be used to improve decision making processes across the health system enterprise from bed management to staffing. Robotic process automation, which represents a $11 billion market opportunity, could revamp revenue cycle.
The current AI offerings are limited, but 2019 will bring forward-movement toward the goal of improving the overall health care experience. Outside influencers such as Amazon, Google and Microsoft will continue to enter the space and partner with health care organizations to drive new transformations.
9. Greater attention to physician wellness
A recent study by Medscape shows that more than 50 percent of physicians are burned out or colloquially depressed. Statistically, physicians are twice as likely to die from suicide than the general population. Beyond physician health, this epidemic is also impacting patient care and health care operations.
In 2019, health care organizations will need to prioritize organizational changes and support physicians in individual interventions that address burnout. Research published in the Journal of Internal Medicine finds that efforts aimed at reducing excessive workloads, work inefficiencies, work-home conflicts and low morale can decrease overall burnout symptoms by 10 percent.
Additionally, advances in technology, such as voice recognition, automation and telehealth, will also play a role in lessening physician burnout.