For the better part of a decade, the drive to adopt health information technology was focused on just that, adopting technology. Now, the push seems to be twofold: actually finding value in the billions spent on health IT and, equally as significant, trying to keep pace with consumer demand.
That means an increased focus on telehealth and virtual care; deploying consumer-friendly apps; experimenting with artificial intelligence; and collecting, analyzing and pushing out actionable data. Hospital executives, vendors and others gathered here last week at the Healthcare Information and Management Systems Society's annual meeting were adamant in their belief that healthcare organizations need to stop nibbling at the edges and pick up the pace of embracing consumerism.
That push, however, has to be balanced with the reality that provider revenue streams are tightening, as well as the fact that payers, employers, consumers and the government are clamoring for more preventive and population health-based care.
"We're moving toward technology that connects and engages the member," said Steve Burrill, national sector leader for Deloitte's Health Care Providers practice. Virtual care, including telemedicine, is one way health systems are connecting to patients. Virtual care technologies have a clear return on investment, Burrill said, since they're less expensive but boost engagement—which in turn improves outcomes.
At Stanford Children's Health, virtual care is being used to improve care for patients with Type 1 diabetes. The health system has deployed the service deep into the community, including schools, said Dr. Natalie Pageler, chief medical information officer at Stanford Children's Health-Lucile Packard Children's Hospital, Palo Alto, Calif. In one instance, she said, a child and parent gathered in a school nurse's office had conducted a remote conference with a physician. That interaction, Pageler said, will help the nurse respond if an incident occurs in schools and thus likely avoid an expensive trip to the hospital.
Stanford is also rolling out telehealth services to its 28 primary-care sites, adding two specialty services a month. And, Pageler said, the system is looking at building an app that will connect home monitoring with its EHR.
While virtual care has some immediate and obvious value, AI has yet to fully take off in healthcare. Instead of going all in on AI technology, at this point hospitals are investing in getting clean data—a requirement for AI, said Brian Kalis, a managing director of digital health and innovation for Accenture's health business. But even that step should help providers and payers interact with patients in new ways.
Venture capitalist Vinod Khosla pointed to a unique primary-care clinic model being tested in the San Francisco market. Forward, which was built by former staffers of Google, Facebook, Uber and Palantir, uses AI to analyze biometric and lab data in real time, giving patients and physicians instantaneous access to the information. As more quality data are collected, AI could be used to offer predictive and personalized care.
This kind of approach is what excites Khosla, the founder of Sun Microsystems; he's invested in both the insurer Oscar and Forward. He said the industry needs to move from traditional medicine, which tends to be reactive, to "new medicine," which takes data analytics to a different level.
Meanwhile, ambulatory providers are still putting some of their capital into more basic technology, like EHRs, said Naomi Levinthal, practice manager with the Advisory Board Co., while hospitals are able to spend more on other digital tools since they already have EHRs in place.
These technological investments don't necessarily come at the cost of other investments, but they do come alongside a decrease in investments in new buildings, Deloitte's Burrill said. "As the technological need changes, the physical space you need changes too."
Technology may also be used to help address one of the more pressing issues facing healthcare organizations—social determinants of health. Epic Systems Corp., for instance, is rolling out a service that is designed to enable providers to not just collect data relevant to social determinants, but help guide patients toward such services as food pantries, childcare programs and transportation. Epic founder and CEO Judy Faulkner said it is time to stop thinking about the "electronic" health record and move to the "comprehensive" health record in order to help providers in the shift to value-based reimbursement.
"The more we use technology, the more humanity returns to the business of healthcare," said Dr. Chris DeRienzo, chief quality officer at Mission Health. He said the Asheville, N.C.-based system will continue to invest in tools that ease workload for staff, so "they can get back to doing what brings them joy" with the ultimate goal of improving care. For example, the system recently purchased technology that allows certified nursing assistants to monitor up to 20 beds at once through video as opposed to having them individually check on patients in their rooms. This creates efficiencies and allows staffers to better prioritize their time.
Marc Probst, Intermountain Healthcare's chief information officer, predicted consumerism will transition HIMSS into something very different in as soon as three years. Probst thinks that'll mean companies like Google, Apple and Amazon will boost their presence at the show, and position themselves against providers. "They're not going to be doing cardiac surgery," he said, "but they'll find some way to compete."
Besides Google, which had space on the exhibit floor, Uber Health made its debut at HIMSS18. The ride-share company launched its health transportation platform last week and plans to grow its partnerships with providers. The message: New economy companies are coming, and they aren't waiting for permission.
Probst advises his peers in the C-suite to be ready. "Your whole role as a CIO is changing," he said, "You've got to be way ahead of the game."