Will 2021 see health information interoperability? When you hear this, do you find yourself in the backseat of a car on a family vacation yelling at your parents, “Are we there yet?”. Has the pandemic derailed us yet another time? Although the pandemic did draw back the curtain on yet another reason why this is so essential to the future of healthcare. Compliance of the final information blocking rule has been pushed out but the industry still seems bullish on solutions. Here is what we might see in 2021.
As COVID-19 fast-tracks the digital transformation, many enterprise IT vendors are quickly adapting to meet customers’ needs. Advanced technologies and the rapid pace of change will be good for health IT in general. Interoperability will gain more focus amid mounting pressure on teams dealing with this pandemic. Large EHR players must agree to a level playing field for the new technologies to take root. Further, data democratization will likely result in tangible outcomes that enable patients to become the custodians of their medical records. While CTOs have remained focused on creating an effective remote workforce, their teams have worked to keep the lights on. Finally, we can expect more adoption of automation in the testing areas. As we move into 2021 and beyond, IT teams would like to be part of this meaningful journey of digital technology adoption and transformation.
By the end of 2021, we’ll be surprised at how much progress we will have made on adoption of the CMS Interoperability and Patient Access final rule. Even as the implementation deadline was extended for hospitals to help them cope with COVID-19, the key point is all the requirements of the law, including the data blocking provision, remain the same. We will see payers and providers alike build more applications to manage patient and provider data than they did in the past. In addition to helping them comply with the rule, this will allow them to build data infrastructure for multiple business uses. As a result, data will finally begin to “flow” in healthcare. Patients will gain access to and control over using and sharing their own healthcare data.
No one believes that interoperability is a bad thing. Very few believe that it’s good for their business. This doesn’t bode well for the future of interoperability even under the increasingly strict government mandates. The problem is the value of data, which is both clinical (contributes to good outcomes) and commercial (represents my customer list). Stakeholders are willing to pay for data that improves outcomes. Enterprises are unwilling to share data that discloses their patients to competitors. Over the next few years, regulators will need to reconcile these issues around data value before we see truly interoperable systems and information. And healthcare entities will have to come to grips with the fact that business models that rely on the value of data to subsidize the costs of their technology to customers will not be available in a truly interoperable healthcare environment.
2021 will be a year where we see continued advancement across several fronts impacting the health IT landscape. For one, interoperability will continue to dominate HIT as ONC implements several of their delayed rules on information blocking while CMS looks to implement its interoperability rule. HL7 FHIR APIs and TEFCA will now be used to implement the EHR digital highway with Qualified Health Information Networks (QHINS’s) and Participants. The implementation of these mandates set forth by ONC and CMS will impact consumer and patient access and accessibility to data which will ultimately result in comparison shopping for services and pricing, portals, mhealth apps, smartphones and devices such as Fitbit, Apple watches, etc.
As the industry continues its march towards total interoperability, Social Determinants of Health (SDOH) will be a term more healthcare professional will become much more familiar with in the year ahead. Having factors available in a patient’s record during clinical encounters that can influence health (financial resource strain, transportation needs, alcohol use, depression, intimate partner violence, social connections, physical activity, tobacco use, stress and food insecurity) provides important factors for clinicians and other care givers to reach the ultimate goal of improving health outcomes for patients.
Big data’s impact will continue to grow in 2021 including the use of AI, predictive analytics and other technologies to analyze, trend and predict geographic and demographic indicators. These technologies will reduce costs and increase/improve the reach, scale, appropriateness and outcomes of care.
Finally, with ransomware attacks becoming common in hospitals and other health care settings along with breaches of patient health data, cybersecurity should be front and center as we turn the calendar to 2021. This very inherent risk in healthcare requires vigilance in assuring rigorous “cyber hygiene,” the use of Third-Party Assurance (TPA) and certification and accreditation of an organizations policies, procedures and controls by organizations such as EHNAC and HITRUST.
The coming year’s predictions for healthcare IT are focused around smart hospitals and healthcare networks aiming at better outcomes concerning patient centricity, healthcare quality and equity, and workforce experience. IT system changes will also go hand-in-glove with initiatives already underway due to COVID. In what is sure to be a positive outcome of the pandemic, it’s knocked down barriers about sharing data, which will be 2021’s most valuable asset.
Healthcare systems will exchange data and knowledge more readily. Hospital data will be shared and analyzed. On the other hand, healthcare networks will turn to data to understand the impact of surges on ER, track critical inventory, or to make staffing decisions.
Medical devices will continue to be augmented by software services and data. Medical devices will be more integrated with innovative, data-driven software and use AI models. We’ve seen exciting innovations where AI is helping doctors assess medical images. More inventions are on the way that will positively influence the work in the operating room as well as enable decision support along a patient’s healthcare journey.
Predictive analytics will help smart hospitals improve patient care and reduce operational costs. A single hospital can have more than 40 million data records. As medical data, operational data, financial data, experience data, and third-party data is combined, decision makers will turn to predictive analytics to understand how they can improve operations, workforce management, patience experience, and more.
Clinical trials will flourish from improved supply chain management. By adding analytics, AI, and cloud based platforms, organizations will be able to address key pain points, including demand forecasting, manufacturing, packaging, labeling, and shipping clinical trial materials. Stakeholders can base their supply and demand decisions on clinical trial parameters such as study types, dose escalation, planned and active enrollment rates, shelf life, location, and more.
Interoperability will continue to be front and center in healthcare as we look to 2021. The pandemic has shined the spotlight on the critical need for data interoperability — there is a lot of pressure on healthcare organizations to comply with the CMS and ONC rules. The rules will fuel an uptick in FHIR adoption and continued move to the cloud, while federal and state governments respond to surges in COVID cases and prepare for the eventual roll-out of the vaccine. The vaccine roll-out will require coordinating logistics of storing, shipping and prioritizing vaccinations among different populations, and may even require healthcare and employee data to interoperate.
This will all take place against the backdrop of a changing administration that is expected to expand investments in federal and state public health entities in order to modernize existing infrastructures so that the US healthcare system can be better prepared for future public health crises. As healthcare leaders navigate the challenges of the pandemic, vaccine distribution, and the interoperability rules, I hope to see a shift in the collective industry mindset about interoperability. Interoperability has the ability to nurture information sharing and lead to improved care management, consumer data access, workflow efficiencies, and improve patient outcomes. It cannot be achieved once and forgotten about — it has ever changing requirements and therefore must always be prioritized.
What will 2021 hold for healthcare IT? COVID-19 places increased pressure on the healthcare system to be more efficient in so many ways. 2021 will see a continued focus on the response to the pandemic, including managing the highly anticipated introduction of vaccines.
Areas of the health system that need attention include the capacity and capability of public health agencies, the fragmentation of clinical information, a non-coordinated delivery system, misplaced incentives (mostly around fee-for-service vs. value-based funding models) as well as planning, logistics and implementation science.
The value of HIEs will be increasingly realized. For instance, they could be leveraged to collect COVID-19 vaccine data and, importantly, vaccine outcome data. They could play a major role in the development of a so-called “Big Data Immunization Registry” to support critical resource planning and decision-making.
Interoperability, including the timely collection, aggregation, and interpretation of accurate data and the use of tools such as AI and machine learning to make informed healthcare decisions will be more important than ever.
We should expect further expansion in the adoption of virtual care models and on-demand technologies to cope with increased patient loads and the calls from patients for further participation in their care. The “digital front door” concept could well play a major role in this regard.
Organizations will continue to look at addressing systemic inequities in the healthcare system and prepare for increased demand for mental health support. The importance of understanding and addressing the social determinants of health as well as structural racism will increase.
We should also anticipate 2021 will see organizations will continue down the path to comply with the upcoming CMS and interoperability rules.
In 2021, the healthcare industry will become more attuned to the need for a fully digital exchange of documents that can be handled anytime, from anywhere. This will be driven by the lessons healthcare organizations learned in 2020: document exchange is no longer only about process improvement, operational efficiency or better patient care – it’s now about life and death. Recent ransomware attacks in the form of malware embedded into email attachments sent to users in hospitals lead to organizations blocking inbound email attachments altogether and thus not being able to access their own patient documents, let alone those from other institutions. As a result, emergency patients may have to be taken to other hospitals and surgeries and other procedures postponed. Moreover, COVID-19 revealed the need for more flexible healthcare operations, including needing to perform patient intake and other referral management and claims processing remotely. 2021 will see CIOs looking to ensure their organizations do not find themselves in this position again with a fully digital document processing strategy.