Data liquidity took hold in 2019 as one of the most consequential themes in healthcare. That is the idea that healthcare data should flow to where it is needed, when it is needed, for better healthcare.
In 2019, the federal government drafted two rules, created a healthcare data exchange framework, and launched a data pilot. Healthcare payers and providers increased the flow of pricing data. Big Tech made news-worthy moves. And, industry-wide, we’re seeing double-digit growth in data flow, nearly 30x the rate of population growth.
Looking forward to 2020, the most important new voice on this topic will be the consumer. After the government has regulated, and the industry has responded to make healthcare data even more accessible and portable, we will see how consumers act. Will there be massive consumer-directed outflows of data from healthcare incumbents to new entrants? Or, will consumers pause and consider the unintended consequences of releasing their health information? Data security and privacy will be debated vigorously by all stakeholders. And, without question, trust will take center stage.
Here are my predictions for health IT in 2020:
- Trust emerges as a major competitive differentiator. Personal health information resides with different stakeholders. Providers have some. Payers have some. Pharmacies have some. Employers have some. Health apps have some. Health information networks like ours have some. Ironically, one value of data silos is that no one entity has a patient’s entire medical record. When the regulatory and technical frameworks are in place to connect the silos, then patients must decide which stakeholder they trust with their entire medical record. In 2019, we saw breaches of patient trust play out in the public. In 2020, we anticipate trust will take center stage. We believe it is a question of transparency and intent. Different stakeholders vying for the patient’s trust will lay out how they will find, validate, collect, and store their data, and more importantly, what they intend to do with the data. The patient will decide.
- Information blocking rules will matter. A survey of healthcare executives showed the industry is mostly unaware of the federal government’s draft rules on information blocking. We anticipate the industry will wake up once the consequences of the rules on information blocking become clear, in particular, the cost of non-compliance. Expect a flurry of industry activity by providers, health IT vendors, health information exchanges, and health information networks to test their business and operating models for compliance with the rule.
- The real-world impact of price transparency becomes evident. We saw substantial progress in 2019 in the rollout and adoption of price transparency tools in the industry. The concept is simple: tell providers and patients what the price of a drug is so they can choose the best drug that is affordable. The execution is anything but simple. In 2020, all aspects of prescription price transparency will be studied: what information to show, how to show it, when to show it, whether to show alternative options, which options, what price difference matters and so on. The biggest learning of all will be how price transparency will influence patient choice, and improve satisfaction, affordability, adherence, and outcomes.
- Time to therapy for specialty medications decreases with better information flow. Getting a diagnosis of a complicated health condition is difficult and stressful. Waiting to get on therapy only adds to the stress. Studies show time to therapy, between prescription written and the first dose taken, can take weeks, or even months. Up to 2019, efforts to reduce time to therapy have typically been manual, requiring teams of people to overcome process constraints. In 2020, we should begin to see increased clinical data flow reduce the often-frustrating back and forth between providers, pharmacies, payers, patients, and other stakeholders in the approval process. Streamlining prior authorizations will be a welcome change.
- Artificial intelligence chips away at the cognitive burden on physicians. Health IT is partly to blame for the increasing burnout that physicians face. Giving more data to physicians and putting more tasks in their queue leads to hours of computer-based work daily. In 2019, we saw a growing number of startup and established technology companies deploy artificial intelligence to automate work and reduce burnout. It is still early days for AI. Teaching a computerized tool to discern what to do clinically is one thing. Embedding this tool in the daily workflow in the clinic is totally another thing. In 2020, we anticipate some of these tools, like clinical event alerts or form automation, will begin to take hold in clinical workflows.
- Opioid prescribing becomes smarter. In 2019, several major events occurred related to the opioid epidemic. The federal government released seven years of supply chain data. Some large settlements to lawsuits were announced, while others are pending. Meanwhile, the industry continues to make progress on the technology front. Over half of all states now have laws requiring electronic prescribing for controlled substances. As of January 1, 2020, five more states (eleven in total) will begin enforcing the law. Electronic prescribing will continue to replace paper prescribing, giving prescribers more accurate medication histories to ensure the right patients get on the right medications.
- Pharmacies become sites of care delivery. Patients visit their pharmacy at least as often as, if not more often than, their provider. In 2019, major pharmacy chains launched new health clinics offering both in-store and virtual care services. This is not a new phenomenon. Pharmacies have offered or experimented with different care delivery models for years. But, lacking knowledge of their patients’ medical history, they have typically served as an adjunct site of care addressing a narrow range of conditions. With better information flow, pharmacies can know their patients’ medical conditions better and become more essential sites of care. In 2020, pharmacies will ride the wave of information sharing and increase their clinical value proposition for patients.
- Consumer-oriented digital health services are challenged to mature. The healthcare industry has been slower to adapt to the digital revolution than other industries, but the wave is coming. In 2019, we saw an increasing number of online and mobile companies wanting to connect to our health information network. Many of them are attempting to build viable business models by disrupting traditional healthcare. For patients and consumers, these are exciting times for innovation. At the same time, these are also concerning times when it comes to information privacy and security. Medical records are among the most valuable pieces of personal information to buy on the black market. In 2020, we anticipate the industry will test different models of consumer identity proofing and authentication. The goal will be to strike the right balance between privacy and security on one side, and usability on the other side.
Of course, the 2020 election will dominate everything next year. We can expect the headlines to continue to focus on demands for greater price transparency, calls to repeal the Affordable Care Act and rallying cries for Medicare for All. Additionally, look for healthcare data liquidity and healthcare data privacy to be on opposite sides of political debates in the 2020 presidential election year. There’s no question the entire industry will be preparing for whatever may come next.
Picture: Getty Images, AndreyPopov