Presidential healthcare policy and the rise of health IT like artificial intelligence and precision medicine will all have a significant effect on how healthcare is delivered in the U.S.
Holly Buckley, partner at law firm McGuireWoods, spoke about the eight most disruptive issues facing the healthcare industry in a keynote speech during the Becker's 16th Annual Future of Spine + The Spine, Orthopedic & Pain Management-Driven ASC Conference, which took place June 14-16 in Chicago.
Here are the eight most disruptive issues in healthcare:
1. Presidential healthcare policy. Ms. Buckley noted healthcare has become an increasingly prominent political topic throughout the 20th and into the 21st century. She noted healthcare officials under each administration have attempted to create policy consistent with their own beliefs. For example, President Donald Trump's former HHS Secretary Tom Price, MD, made bundled payments his top priority, while current HHS Secretary Alex Azar is focusing on value-based care and drug pricing transparency. However, Ms. Buckley said while there have been many proclamations for change under the Trump administration, there has been little action on any major issue thus far.
2. Private equity investment in healthcare. According to Ms. Buckley, PE firms are ready to invest roughly $1 trillion in the healthcare industry to make care delivery better and more efficient than before. While investment has typically been on the provider side, Ms. Buckley noted many experts hypothesize PE investment is "in the second round of activity" and will see more investment in behavioral health and health IT, among other areas.
3. Artificial intelligence. While AI is often regarded as the "future of healthcare," the use of such technology "is also very challenging for physicians, given the physician culture of autonomy and decision-making. … The idea of having computers dictate how medical care should be delivered is something that I think is very difficult for a lot of people in the medical community to really embrace," Ms. Buckley said. However, she noted such technology may prove useful, particularly with regard to robot-assisted surgery and dosage error reduction, among other issues.
4. Precision medicine. Like AI, Ms. Buckley said precision medicine "is still in [its] infancy, but [holds] so much promise" for the healthcare industry. The idea of treating patients based on their individual biology may lead to the development of one-shot cures for certain diseases, which would prove incredibly useful in potentially treating those conditions for good. However, the use of genetic medicine would also lead to a lack of revenue under the fee-for-service model, she said, as tailored care would eliminate the need for patients to visit physicians multiple times for any conditions they may have.
5. Retailers as primary care physicians. Retail health clinics like CVS Health aim to provide patients with acute care services at a lower cost, eliminating the need to visit the typical hospital for primary care, Ms. Buckley said. The shift in care delivery has caused traditional hospitals and health systems to re-evaluate how they use PCPs and has led many systems to focus more resources on the development of their urgent care facilities. While the downfall of such urgent care clinics is that they typically are not able to provide care for patients' long-term health issues, retail clinics have begun to partner with PCPs and larger hospital organizations to begin providing those services, Ms. Buckley noted.
6. Millennials as consumers. According to Ms. Buckley, today's workforce is composed of more than 83.1 million millennials, whose health needs and the ways in which they obtain care differ vastly from previous generations. For example, 93 percent of millennials prefer retail health clinics over PCPs, and their collective health-conscious lifestyle incentivizes them to seek out annual healthcare checkups and preventive care. Their reliance on technology like telemedicine will force traditional hospitals and health systems to change how they offer and deliver care.
"While the impact, I think, has been relatively small, in terms of millennials' impact on healthcare … I think in the next 10 years the drive to please millennials … is really going to change the way the [system] works," she said.
7. Internet of things. The "internet of things" refers to medical devices and applications that connect healthcare IT systems through online computer networks, Ms. Buckley said. Such devices include technology that can track vitals, body systems and sleep, among other functions. The biggest risk with IoT devices, she noted, is their potential to succumb to a large-scale cybersecurity attack. "Providers and developers are really going to have to work on that [aspect of IoT]," Ms. Buckley said.
8. Nontraditional entrance into the market. Ms. Buckley discussed two tech companies' foray into healthcare: Amazon and Apple. Amazon, along with JPMorgan Chase and Berkshire Hathaway, announced its intent in January to form a healthcare venture to help its employees navigate the health industry. "The alliance is a sign of frustration by those parties," she said, noting that since the companies' joint announcement, little detail is available as to how they plan to revolutionize the industry. Apple, too, has made significant strides in the healthcare market, including a recent update of its Health app to allow patients to access and share their medical records with their providers.