10 emerging trends in health IT for 2021

Health IT adoption skyrocketed in 2020 as hospitals, health systems and patients increasingly relied on digital health technologies for care delivery during the pandemic, setting the stage for continued growth and innovation in 2021.

Becker's health IT team has compiled 10 of the top health IT trends on CIOs' radars for next year, from telehealth to cybersecurity and big data.

1. The CIO and IT teams evolution. Health systems relied on technology to swiftly move to virtual care, remote work and more coordinated communication and data management during the pandemic. Cybersecurity was also a new priority as ransomware attackers hit hospitals and health systems. As a result, the CIO's expertise was in high demand in 2020, and that will likely continue in the new year.

"At Providence we are seeing firsthand the expansion of the CIO role and its elevated value in the health system," said B.J. Moore, executive vice president and CIO of Renton, Wash.-based Providence. "I now report to our CEO, Rod Hochman, MD, and my role has expanded to include our real estate and operations function. This is in recognition of the future of a modern digital workforce and the evolution of our facilities in the future of modern digitally enabled care delivery."

Organizations will continue accelerated digital transformation next year, and the CIO's role will evolve to look more like that of a COO's, overseeing the organization's strategy and risk management. IT teams also are evolving to include more people with clinical backgrounds, data scientists and senior security professionals.

2. A new age of cybersecurity. Hackers stepped up their efforts to attack healthcare providers in 2020 to go beyond phishing attacks and stealing information to sell on the dark web. Ransomware attacks, especially during the second half of the year, shut down IT systems and slowed operations at hospitals and healthcare facilities across the U.S. As a preemptive measure, even organizations that didn't have a security incident cut off external emails and increased screening of incoming emails in October after hackers hit six hospitals with ransomware in 24 hours.

The attacks emphasized the importance of strong cybersecurity and investment in secure data storage. IT teams will need to effectively communicate good cyber hygiene to staff members to prevent attacks and troubleshoot vulnerabilities as more work goes permanently remote. In 2021, it won't be surprising to see more health systems investing in cybersecurity technology and talent as a top priority and planning for cyberattacks as a "when" and not "if" scenario.

3. Telehealth and remote care expansion. While CMS and big payers relaxed regulations on telehealth to help providers continue safely offering care during the pandemic, hospitals and health systems will continue addressing how to incorporate virtual care as part of their long-term care strategy after the public health emergency ends.

The pandemic also has accelerated advances in remote managed care both for patients with chronic conditions as well as those who have COVID-19 but don't need to be hospitalized. These developments have signaled a shift to a hybrid care model, which will replace mostly in-person visits with a combination of both telehealth and in-person visits for services ranging from follow-ups to urgent care.

4. EHRs evolving with new capabilities. As digital voice assistants like Amazon Alexa and Google Home have secured a place in consumers' living rooms, hospitals and health systems are inviting similar technologies into patient rooms. With tech developments increasingly focused on natural language processing and ambient listening capabilities, EHR vendors Epic and Cerner both inked deals to integrate Nuance's virtual assistant in their software this year, and Epic is working on its own ambient voice tech called Hey Epic!

AI startup Saykara launched a new voice assistant this year that operates both ambiently and autonomously, so it can listen to and understand the context of a patient-physician conversation without being prompted by voice commands. The company counts New York City-based NewYork-Presbyterian's innovation arm as an investor, and Seattle-based Swedish Medical Group is a customer. 

5. Blossoming of artificial intelligence and machine learning in healthcare. AI is not new in healthcare. Organizations have used artificial intelligence and machine learning in hospital administration and operations for years, specifically in the revenue cycle process. Before the pandemic, researchers began testing AI models to read medical images, yielding mixed results and leaving some wondering whether AI and machine learning would live up to the hype.

But in the last year AI became crucial in developing predictive models for COVID-19 cases spreading across the country. Academic institutions and health systems, including New York City-based Mount Sinai; Baltimore-based Johns Hopkins; Rochester, Minn.-based Mayo Clinic; and University of California-Irvine developed predictive tools and models to track the virus and estimate the risk of COVID-19 patients developing severe symptoms. The field will continue to evolve and become more integrated with clinical care in the coming years.

"A combination of wearables and other biomedical devices, combined with machine learning and artificial intelligence will continue to transform clinical research, treatment protocols and increase the virtual care capabilities of health providers," Eric Yablanka, CIO and associate dean of technology and digital solutions at Stanford Health Care and School of Medicine in Palo Alto, Calif., told Becker's in a September interview. "This will challenge traditional healthcare organizations to compete with emerging retail and virtual providers in ways we have not experienced before. It will also enable healthcare delivery science and bring data scientists to the forefront of improving patient care outcomes."

6. Big data management becomes a need. The digital transformation among health systems was well underway when 2020 began, and the pandemic underscored the need for centralized and efficient data management. Data-gathering and reporting efforts sped up during the pandemic, and even small organizations are eyeing cloud implementations to securely store and coordinate data. Microsoft, Amazon and Google all have healthcare-specific clouds.

For academic medical centers, the stakes are higher, as secure research becomes a larger priority.

"I really think investment in our cloud-based research platforms around high performance computing, artificial intelligence and the machine learning toolkits and integrating them back into our EHR is really key," said Michael Pfeffer, MD, assistant vice chancellor and CIO of UCLA Health during an interview on the Becker's Healthcare Podcast. "We are continuing to invest heavily in that, from a cost and resource standpoint. We are incorporating our EHR data with genomics data and other kinds of data, such as real-time wait forms and radiological images.

"All of these things are so critical to our research mission and improving patient care — that translational aspect of taking research-derived algorithms or other type of technologies and applying that into the operations and patient care-delivery aspects of what we do — that is a real area of investment for 2021."

7. Predictive analytics moves to the forefront. The accelerated digital transformation in 2020 means more health systems now have the technical capabilities to practice precision medicine and inch closer to predictive analytics. Mount Sinai Health System in New York City created machine learning-powered models to identify high risk and likelihood of mortality among COVID-19 patients for more efficient patient management.

Pittsburgh-based UPMC has been on the forefront of using data analytics with its clinical data warehouse that provides insights to clinicians and patients. The health system continuously improves upon their system by layering on new tools, such as artificial intelligence and machine learning, bringing them closer to predictive analytics.

"The use of analytical insights in the healthcare industry is very reactive," said Ed McCallister, senior vice president and CIO of UPMC in an interview with Becker's. "In the future, we envision that the analytic insights will evolve to be used at the bedside during the point of care. We also envision that analytics will enable us to proactively manage care and our patient population to keep them out of the hospital and healthy. We are already doing this today in some parts of UPMC and hope to expand this to all clinical departments and service lines."

8. EHR advances: Interoperability, standardization and the cloud. This year helped pave the way for advancements in EHR interoperability and standardization, with HHS' finalization of its interoperability rules to innovations spurred by the need for record sharing during the pandemic. With the federal government's new regulations, which aim to help patients gain better control of their health data via smartphone apps, interoperability is expected to increase between providers, payers and health tech developers.

In November, Google launched its new healthcare interoperability readiness program to help healthcare organizations navigate and prepare for the new changes, and EHR giant Epic reported a sharp uptick in the number of patient records transferred between providers using its Care Everywhere interoperability platform; more than 221 million patient records were shared in November — a 40 percent increase year over year. More hospitals and health systems are also making the transition to cloud platforms and partnering with big tech giants, including Microsoft, Amazon and Google, to host their EHRs and information systems to offer real-time data insights and more storage solutions.

9. Digital front door and the digitization of the consumer experience. The pandemic ushered in a newfound era of social distancing, which has forced healthcare organizations to ramp up their digital presence and capabilities to stay connected to patients. With the "digital front door," serving as the first impression potential patients have of a health system, online experience has become a critical component of their overall reputation.

As hospitals and health systems look to the future, many, such as Greensboro, N.C.-based Cone Health and SCL Health in Broomfield, Colo., are investing in a digital front door, which includes the organization's website and mobile apps that host the online patient portal, scheduling, telehealth visits and educational resources.

10. Clinical IT advancements. Augmented reality, wearable technologies and IoT devices in clinical care are steadily advancing within the hospital's four walls. With COVID-19 limiting direct contact, health systems have turned to robotics for tasks from facilitating video chat communications for patients to virtual reality headsets that display a clinician's first-person point of view from inside patient rooms remotely to the rest of the care team.

Robotic surgery developments are expected to continue across the healthcare system, in areas including spine, cardiology and oncology. In October, a surgical team at St. Elizabeth Edgewood (Ky.) Hospital became the first hospital in the U.S. to implant a Bluetooth-connected cardiac defibrillator, which can wirelessly pair with a smartphone app for patients to control. By 2025, the global medical robots market is expected to reach $12.7 billion, up from about $5.9 billion in 2020.


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