From the launch of the Amazon-JP Morgan-Berkshire Hathaway health venture to more than $8 billion in digital health deals, 2018 was a year of transformation and growth in healthcare.
As we head into 2019, we will undoubtedly begin to see the impacts of these changes – both foreseen and unforeseen.
Aside from the major market shifts that have captured national headlines, there are changes happening behind the scenes on the day-to-day operations and decision-making in hospitals and health systems across the world that will evolve how we do healthcare in 2019. Recent conversations I’ve had with C-suite healthcare executives to discuss pressures across public and private sectors coupled with observations I’ve made on the past year’s trends have helped me develop predictions for the coming year.
Changing roles in the hospital C-suite
With the increased adoption of AI and machine learning to predict and treat conditions, expect many healthcare organizations to create Chief Innovation and Chief Data Analytics Officer positions. These new roles will quickly become essential as companies embark on data-based technology initiatives to lower costs and improve the patient experience.
The Chief Nursing Informatics Officer (CNIO) will also grow in importance alongside the widespread adoption of technology. Currently, 14 percent of hospitals have CNIOs – but look for that percentage to increase as CNIOs play a crucial leadership role in measuring the impact of innovative technologies on patients. Nurses will look to this C-level leader who resides at the intersection of clinical nursing expertise and information technology. They will work closely with the CNIO to uncover problems in clinical care and work with HCIT colleagues to achieve quality outcomes.
One other emerging role to watch is the Chief Pharmacy Officer. Pharmacists hold a very unique role in the healthcare continuum. Pharmacists possess direct relationships with patients who turn to them for care needs as well as information about prescriptions, changing drug prices and new practices. That aspect of care coordination coupled with special expertise in innovative care models, medication services and managing business profitability position them as a critical asset for success – particularly as providers and payers adopt at-risk reimbursement models. And with the opioid crisis unabated, pharmacists are also among those on the front lines. Their critical input can result in substantive improvements in opioid-related prescribing and filling policies while supporting clinicians as they work to implement evidence-based alternatives that provide effective care.
Drug spend will increasingly be targeted for cost savings in the hospital
Healthcare currently consumes about 18 percent of the U.S. gross domestic product, with $3.3 trillion in annual spending. Of that – prescription drugs constitute about 17 percent of the total and continue to be among the fastest-growing elements in healthcare spending. For hospitals, pharmacy spend is between 10-20 percent of a hospital’s operating budget and of that, 80 percent is the cost of drugs. But data-driven provider organizations have the power to reduce these costs by tracking and connecting drug spending with clinical outcomes.
With increasingly tighter margins, healthcare executives will be laser focused on managing prescription costs. Expect alliances to form among IT, pharmacy and clinical quality teams as they join forces to establish seamless, automated processes that can identify and quickly alert clinical leaders when prescribers are leveraging name-brand drugs over equally effective generics. Watch for benefits at a population level. For example, surveillance tools and insightful analytics can aid care team leaders as they increasingly watch for ineffective treatments, and encourage clinicians to stop prescribing antibiotics for patients who no longer need them, an effort that international organizations support as one of the key ways to prevent the spread of deadly resistant strains called superbugs.
Demand for skilled nurses will intensify
The projected nursing shortage is expected to intensify as the number of seniors rise. That means hospitals will need to find creative solutions to efficiently train incoming nurses and get them in the field and on the floor as quickly as possible. This is echoed by the U.S. Bureau of Labor Statistics, in that there will be a higher demand for nurses in long-term facilities as hospitals try to discharge patients quickly to reduce costs. Leading-edge learning technologies that are already available today will play a bigger role in this process, providing mobile, adaptive and scalable ways to quickly and effectively educate the nurses of tomorrow.
We can see the gravity of the nursing shortage reflected in politics too. One recent example can be found in Massachusetts’ midterm elections this past November. Residents ultimately voted against implementing a new law that would enforce a limit on how many patients a nurse could care for at once. A law like that could have meant pulling nurses from community settings into metropolitan areas, which would put a strain on this already projected shortage. Healthcare leaders will need to find creative ways to support nurses much like high profile Silicon Valley companies have done to lure tech talent – whether that is supporting transportation needs or housing costs – to ensure there is an ample number of nurses in places that need it most.
AI will transform patient care
As superbugs continue to be a real concern for physicians and patients – some health systems are turning to AI and machine learning to quickly and accurately identify these superbugs to improve patient safety. AI gives clinicians the ability to sift through patterns in patient data to possibly prevent outbreaks before they happen. AI is also coming closer to predicting patients who are at risk of getting sick during and after a hospital stay as a means of avoiding readmissions, which are problematic for patients and their families and costly to U.S. hospitals that will not be reimbursed for this care.
For early intervention, AI can also be leveraged on a population health level to identify patients or populations at risk. This could help payers and providers keep costs down by intervening with “rising risk” patients or populations before a high-cost event occurs. If a patient is battling a chronic condition for example, payers can connect them with programs to help them more effectively manage that condition. This leads to more clinically effective care, better outcomes for the patient and lower costs for the payer.
While AI will have an impact on patient care, its value will be in augmenting clinicians and optimizing their time, not in replacing clinicians. In addition to dramatic innovations such as AI-assisted robotic surgery, AI can complement more routine point of care interactions with patients. Decision making is improved through the smarter integration of the latest evidence and a patient’s unique history.
Personalized patient-driven engagement will accelerate population health
As providers look for innovative ways to drive better outcomes, we will see a surge in voice-driven patient communications. When paired with evidence-based education, phone-based Voice User Interface, or VUI, technology will become a core part of health system strategies to keep their populations healthy.
VUI is already being used to keep patients engaged after leaving the hospital or physician’s office, keeping them on track with their prescribed care plan. 2019 will bring a sharper focus on voice design, as it is meant to help the patient feel empowered about making informed decisions about their health. There will be a growing focus on tone, inflection and other elements that mimic natural conversation to more effectively shape behaviors or calm nerves of people anxious about a procedure. Patients are meant to feel like they are talking with a real human on the other line. The age of easily distinguishable “robo-calls” from a provider or payer may soon be long gone as these more personalized and responsive calls offer patients a more empathic dialogue. Whether it is to prompt patients to schedule appointments for vital screenings, help them prepare for a procedure so they feel more informed and less anxious or ensure they are recovering well after a surgery, VUI will help to engage patients outside of the clinical setting to promote better health outcomes on a scale that would be impossible with existing clinical staff.
From a changing C-suite to new technologies and new applications of existing technologies, 2019 will be another year of major transformations that will impact the people and machines that make up the healthcare system we know today.