2016 trends poised to transform healthcare

Changing market forces coupled with disruptive technologies that include social, mobile, analytics, cloud, robotics and the Internet of Things (IoT) are driving a radical transformation in the healthcare industry.

New innovative business models, virtualized care delivery processes, new patient engagement solutions, increased competition from new entrants and a blurring of the lines between payer and provider entities are direct consequences of this disruption.

The healthcare industry will see continuing activity in these areas as well as in technology innovation - specifically around eight key technology trends that will play a central role in influencing the industry over the next three to five years. Furthermore, non-technology factors such as organizational readiness, regulatory barriers and technology adoption will be critical in determining both the overall impact to the industry and winners and losers in the new value based healthcare economy.

1. Telemedicine: Remote consultation and monitoring through telemedicine and tele-health have gained significant acceptance driven by escalating costs, an aging population, the shortage of primary care physicians and the ubiquity of consumer mobile and computing resources. Initial use as a means of care delivery in rural areas is rapidly expanding into urban areas and private insurers like UnitedHealth, which predicts 20 million members will have access to it by 2016.

Healthcare organizations should consider implementing these tools now, as new federal and state laws mandating coverage and parity of telemedicine services - such as the Medicare Tele-health Parity Act of 2015 - will widen the definition of telemedicine. In addition, the overall cost advantage and convenience can help improve patient outcomes and improve patient satisfaction at healthcare organizations.

2. "Everything" as a service (XaaS) gains prominence: With the rapid evolution of cloud technology, healthcare players have started adopting XaaS. XaaS is evolving from "technology as a service" to "business process as a service," where integrated services and technology are available through the cloud at increasingly competitive prices. New delivery models are being adopted, from document management as a service to more complex business operations, such as clinical data management analytics. Adoption of XaaS options will accelerate in the near future to enable both cost reductions and an integrated web of consumer facing digital capabilities.

By leveraging XaaS based solutions, organizations can avoid using scarce capital dollars to purchase, deploy and manage technology, and instead use the funds to focus on other critical initiatives. Solution vendors are already offering services like claims processing, member portals, wellness applications and online shopping solutions for enrollment. Many large technology based suppliers including Microsoft, Philips, Verizon and AT&T have launched cloud based healthcare services.

3. Social media to research and make healthcare decisions: Social media is no longer just a place where people share pictures and moments – it has evolved into a place where people share personal details – including healthcare related information. A growing number of consumers from all age groups now use social media to make healthcare decisions such as finding a physician, and research preferred treatments and quality ratings on providers and hospitals. Consumers join social groups of similar patients to understand their experiences. In fact, 60 million Americans exchanged their medical experiences with each other online and almost 72 percent of patients searched for online information before or after a doctor's visit1. Though consumers have been actively using social media, many healthcare organizations are still lagging behind in adoption, even though there is recognition that it can be used to improve consumer experience and enhance an organization's brand image. Moving forward, the industry should expect to see an increase in the use of social media by payer and provider organizations.

4. Application programming interfaces (APIs) evolve as a strategic enabler: With emergence of next-generation platforms, agile delivery models and the growth of the Internet of Things (IoT), APIs and technical protocols that enable third-party software programs to interact with an application have evolved from an asset to a strategic enabler. In the last few years, APIs have recast how healthcare companies are sharing information and are reaching out to new customers and partners.

APIs will gain importance in healthcare as companies can easily implement scalable, HIPAA-compliant APIs on top of existing IT architecture for interoperability with other stakeholders.

Emerging API-powered solutions have enabled organizations to reduce costs, improve processes and enhance patient experience. Healthcare providers are using APIs to facilitate connections to external systems (i.e. outside the hospital). In addition, healthcare payers are using APIs to collect and share data across stakeholders enabling them to experiment, gain efficiencies and build innovative solutions. Payers are also leveraging APIs to monetize their data.

5. Next generation analytics and artificial intelligence (AI): Increasing adoption of smarter systems and the availability of data from CMS and electronic medical record (EMR) integration has led to more data available to help manage clinical outcomes, utilization and financial performance. Healthcare providers leverage data analytics to improve patient access, engagement and predict patient visits, readmissions, risk and even propensity to engage in disease management. Combined with enhanced patient access tools, the use of analytics will be critical at the point of care, where algorithms and other digital tools provide health insights that help in achieving the Triple AIM objectives of reduced costs, better quality of care and improved patient satisfaction. Healthcare payers are also using analytics to identify fraud and abuse, optimize value based reimbursements, drive operational improvement, improve disease management outcomes and improve member retention.

Smarter systems, such as IBM Watson and startups like Modernizing Medicine are using AI to understand genomic data to develop personalized care and medicine for patients. While these systems exist today, a majority of healthcare stakeholders have limited analytics platforms, comprehensiveness of the right data and qualified data scientists to derive actionable insights. In the future, we can see genomic data being used to further improve prevention, intervention and outcomes.

6. The explosion of the IoT: With changing consumer expectations, the IoT is emerging as a way to take connected health to the next level by reducing the cost of care and enhancing consumer engagement and patient care. Initial impacts for payers can be seen in multiple high-tech low-touch channels for providing an omni-channel experience during shopping and member management. Moreover, the introduction of ingestibles and wearables have paved new ways for technological innovation to store, exchange and analyze real-time patient data to improve the quality of care and reduce cost.

While the IoT is still in a nascent stage and there are challenges in sharing protected healthcare, we believe it will have a deep and pervasive impact due to continuing innovation.

7. Cybersecurity will evolve from protection to prediction: Data and security breaches at some of the leading healthcare players in recent years have highlighted the vulnerability of the healthcare industry and heightened the importance of protection against data and cybersecurity breaches. There is an increasing security risk due to the increasing exchange of PHI data and interoperability between payers and providers, as well as the ongoing technology advancements that simplify the way healthcare operates. In addition, 41 percent of these organizations rank today's data breach solutions as ineffective while 37 percent of organizations rank data security training and awareness as ineffective2.

In 2016, healthcare organizations will begin to re-evaluate their data privacy, security strategy and consent approaches. There will be an increased focus on data lineage, tracking data flow (external/internal) and deployment of advanced analytics models to predict cybersecurity risks. The industry could witness custom cybersecurity solutions and products from solution vendors. In the near future, organizations could start using data from different sources and deploy advanced analytics models to predict and manage PHI cyber security risks.

8. Robots and printed parts are on their way: The advent of disruptive robotic and 3D printing technologies will change the way healthcare is provided in the future. The use of such technologies varies from providing medical diagnosis to assistance to performing procedures and developing personalized medical devices.

The demand for robotics in healthcare is on the rise, especially in the field of surgical procedures and ICU telemedicine. They are also being used to provide medical assistance for day-to-day activities, such as the humanoid robot Zora developed by QBMT, a Belgian software company, to serve seniors and children.

The industry will continue to see the automation of high volume-low value, rudimentary and standardized activities which could drive both lower costs and shift the role of some providers to become more advisory. While robotics and 3D printing is still in its infancy, we expect ongoing significant innovations and far reaching future impact.

1. Wipro: Impact of Social Media on Healthcare - http://www.wipro.com/documents/resource-center/library/impact_of_social_media_in_healthcare.pdf

2. Sans Institute: New Threats Drive Improved Practices: State of Cybersecurity in Health Care Organizations - https://www.sans.org/reading-room/whitepapers/analyst/threats-drive-improved-practices-state-cybersecurity-health-care-organizations-35652

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