Plenty of top ten predictions on any number of topics, but it is rare to find one focusing on healthcare IT, Chilmark Research’s bailiwick. And while we may be just a little late in getting this out there onto the streets, it is mid-January after all, our quick search on the net did not turn up any other posts with such a finely tuned agenda so here goes…
1) HITECH Act Suffers Birthing Pains: Despite the hard work of many to create clear guidelines (meaningful use & certification of EHRs), roll-out extension centers, and establish Health Information Exchanges (HIEs), we have only just begun. The devil is in the details (implementation/execution) and 2010 will be marked by a number of stumbles and most likely a significant amount of wasted tax dollars.
2) Hospitals and Large Practices Bite the Bullet, EMR Vendors Cheer, Small Practices Look on with Jaundiced Eye: With a clear signal from Washington on what will be required to get HITECH funding/reimbursement for EMR purchases/upgrades to meet meaningful use, hospitals and large practices will begin seriously evaluating and buying EMR solutions and ancillary solutions to meet those guidelines and capitalize on ARRA incentives (HIMSS will be hopping this year). That’s the good news. Bad news, most small practices, where estimates of 80% of all patient-physician interaction occur, will still be behind the eight-ball on EMR adoption and struggle to meet HHS-defined time-lines for reimbursement.
3) Consolidation will Accelerate: Large HIT vendors will acquire smaller firms to meet meaningful use guidelines (e.g. acquire PHR company to meet 2013 requirements) and move into adjacent downstream markets. Don’t be surprised if a large IT vendor from outside the industry makes a buy to move into this now lucrative market.
4) Regulatory Crackdown Increases: Not a tough prediction as the new administration has signaled that it will enforce laws on the books that the previous administration simply ignored. With more stringent HIPAA guidelines now in play expect to see some significant fines such as the one levied against CVS for $2.25M in 2009. IT security (software & services) will be another hot market in the healthcare sector in 2010.
5) Second Gen mHealth Apps Enter Market – Melding of Smartphones and Devices Remains Nascent: With literally thousands of mHealth apps now available, most of them crappy one dimensional apps, we will begin seeing more sophisticated mHealth apps enter the market. These apps will also command a price, but their value will easily justify the purchase for many consumers. In 2009 there was also a lot of buzz around the melding of med devices and smartphones, (remember the iPhone 3GS intro with J&J on stage demo’ing Lifescan). That buzz faded rapidly when FDA showed up to inquire about compliance. FDA approval requirements/process (and aforementioned strengthening of enforcement by this administration) will limit introduction and thus proliferation of new innovative devices hinged to a smartphone.
6) CMS Still Twittles its Thumbs Regarding Remote Monitoring, Payers and Large IDNs Step-up: For some ungodly reason, CMS just can’t seem to get its mind around the concept of remote monitoring/telehealth and will not open its purse to reimburse for such services. That leaves the elderly out of the equation, however, increasingly, large IDNs will adopt such care modalities to improve care of patients after discharge and capitalize on pay for performance incentives offered by payers. A much small market will be services/systems that baby boomers will purchase to assist them in caring for their elderly parents.
7) Baby Boomers Struggle Caring for Their Parents – Seek Solutions: Over the last week, in casual conversation the topic of caring for elderly parents among my baby boomer peers has come up on several occasions. This is quickly becoming a very big problem for many of us as we struggle to insure our parents are healthy, or at least being well taken care of, while we reside in the next city, state or maybe even country. There are no easy ways that I or my peers (some of those I have spoken to are senior leaders in the HIT market) know of to address this issue. We are seeking solutions, we want system changes (e.g., proxy sign-offs, Social Security Admin releases, etc.) that will simplify our ability to care for our parents.
8.) HealthVault Continues to Put Distance Between Itself and Other Personal Health Platforms (PHP): While Dossia struggles to get its founding members to on-ramp to the Dossia platform (still only Wal-Mart today though have been told 2-3 others should go live in Q1), and Google messes around with Android and Chrome while virtually ignoring Google Health, Microsoft’s HealthVault continues to push ahead becoming the de facto PHP in the market much like Apple’s iPhone is the de facto smartphone today.
9) Telecom Companies Struggle to Define Their Role in the Healthcare Sector: Virtually all of the major telecom providers in the US have a healthcare strategy, but to date, they have little to show for it. While we expect that they will become more vocal (i.e., more press releases) these PRs will be more show than substance and telecoms will continue to flounder in this market.
10) I will “Podium” at the Northeast Spring Classic Cycling Roadrace – Tour of Battenkill: This is a real stretch goal for me for two reasons: First, I have never raced this race before and reports are, its a tough one at 62 miles, mix of paved and dirt roads with some serious climbs. Second, it has been awhile since I’ve done some serious racing – a lot of training ahead. I do have one thing going for me though, I am a “climber” and this is a climber’s race. Hmm, maybe this warrants a trip back out to San Diego for some good climbing workouts with my friend’s club, Slow Step.
Opps, looking at the title noticed I promised 10 HIT predictions, so that last one didn’t count. Here’s te 10th, HIT prediction, drum roll please…
The Health Internet is a Stillbirth as Beltway Bandits Maintain Tight Control of the NHIN.