2016 is heading for the doors, 2017 readily awaits. But what will this New Year bring? One thing for sure, a new president and administration that appears intent on rewriting the rules, be they foreign policy, environmental or healthcare.
But in the grand scheme of things in healthcare IT (HIT), what can we truly expect of this New Year? Collectively, we put our heads together here at Chilmark Research and came up with our annual baker’s dozen of 2017 predictions.
Risk-based contracting for HIT solutions accelerates. 2017 will see HCOs be much more conservative with their HIT spend. The care and feeding of their bright and shiny new EHR will continue to draw the vast majority of resources. What’s left to spend will increasingly be tied to shared-risk contracts between vendor and HCO.
HCOs demand clear ROI on their HIT spend. The billions of dollars spent over the last several years to digitize the healthcare sector has shown little, if any demonstrable ROI – call it healthcare’s own “productivity paradox”. HIT vendors will be put to the test to clearly articulate and stand behind ROI, something that athenahealth just announced. Expect many more to follow suit in 2017.
Progressive HCOs admit – their patient portals suck. With the potential unwinding of portions of the ACA and policies that push more responsibility on the consumer, HCOs will finally come to realize that they are not just an HCO but a health service addressing a wide array of consumer health needs. Houston-based Memorial-Hermann gets it and are launching a completely new consumer experience during the Super Bowl, which coincidently is being held in their hometown of Houston.
Despite the hype, healthcare Internet of Things (IoT) stays on periphery. IoT in healthcare has slid into the trough of disillusionment. HCOs have been unable to scale-up pilot efforts, which often had promising results. Simply put, workflow for a patient panel of 50-200 is significantly different than that for 10,000. Until that issue gets resolved, IoT will stay stuck in neutral.
Artificial intelligence (AI) and machine learning will remain outside of the clinic. AI, machine learning, cognitive computing and the like are getting a lot of attention. Yet, despite the aggressive marketing by some, we will not see any of it at scale in the clinical setting. Even the much-ballyhooed efforts in radiology will only see limited pilots in the coming year.
Consumers find AI avatars as valuable as they are personal. 2016 saw the limited launch of such consumer-centric tools as the Medtronic-IBM diabetes app Sugar.IQ. Many more will come to market in 2017 as these personal, virtual care coaches show efficacy and lower utilization costs. The level of “personalization” that these avatars are capable of will define their success.
21st Century Cures Act interoperability provisions a dead letter. Without enforcement, regulations are worth about as much as the paper they are printed on. Do not expect much follow-thru from the new administration in enforcing new regulations passed during the waning days of the Obama administration.
EHR vendors get serious about API programs. Savvy, EHR vendors are quickly realizing that they must migrate to a platform play, building an ecosystem to extend their value to an HCO. Allscripts and athenahealth have been ahead of the pack for years. Cerner just launched its API program (limited release) in October. More will follow in 2017.
Precision medicine fails to grow substantially outside of oncology. Despite the promise, precision medicine is actually a very tough thing to do in practice. We simply do not have enough data for a broad swath of diseases. Oncology is the exception where gene sequencing – often the keystone to precision medicine – is quite common. NantHealth is one company targeting the oncology opportunity for precision medicine.
Blockchain moves from hype to traction. By its very nature, Blockchain is nearly impossible to hack making it possibly the best cyber-security tool in the market today for personal health information. 2016 was the year of Blockchain hype. 2017 is the year Blockchain-enabled solutions start arriving in the market – maybe even one from a major HIT vendor. The relatively young start-up PokitDok had a good write-up earlier this month on the subject.
HCOs continue to expand regionally via M&A. In 2017, expect to see several M&As as HCOs move outside their traditional market(s) to build multi-State, super clinically integrated networks CINs. Example: Boston-based Partners Healthcare moves to acquire Maine Health and/or Dartmouth Hitchcock
Best-of-Breed PHM and analytics vendors continue to stay one-step ahead. EHR vendors are aggressively looking to penetrate this market and have made significant R&D investments. Yet, best-of-breed still have a leg-up on innovation – for now. 2018 may be a very different story.
HIMSS’17 will be far calmer and less frenetic. The EHR market has plateaued, the PHM market is still by and large in pilot phase, a new administration wants to repeal the ACA – the list goes on. With so much in flux, 2017 will be a lackluster year for most HIT vendors and the first sign of such will present itself in a month and a half in Orlando.
A nice analysis, however I would like to make a few points. The 21st Century Cures Act is a law passed with very strong bipartisan support – there have been no regulations put forth by federal agencies on its implementation in the waning days of the current administration. So we will have to see how the new administration chooses to implement the law, and while I agree that in future we are likely to see a much less heavy hand in the regulatory space, calling it a dead letter might give some the dangerous impression that they can just ignore the law altogether. This is the same mistake some our making now with MACRA.
In terms of blockchain I think you have it exactly correct – and I would be remiss if I didn’t express the same attitude towards AI. While it certainly won’t be widespread in the clinic in the next year AI will have a significant impact in healthcare beginning in this next year and over the next 3-5 years will change everything.
Have a happy holiday and see you next year 🙂
Thanks for the feedback and perspective Brian – always value your inputs. As to 21st Century Cures Act and interop, yes, strong bipartisan support was shown for this but our concern is is that without enforcement, its dead. We just do not see this administration making any forceful demands, via regulatory actions. As to MACRA, do not see new admin pulling back here as it is the replacement for SGR payment model, which was severely flawed. Like Cures Act, MACRA saw strong support across party lines and the broader industry.