'The home is the next frontier': 9 CIOs predict what health IT will look like in 5 years

The health IT field changes at a rapid pace as new technologies emerge and patient preferences evolve. Below, nine CIOs from health systems across the country weigh in on how they think the field will change and grow in the next five years.

Editor's note: Responses have been edited for clarity and length.

Bruce Darrow, MD, PhD. Deputy CIO and Chief Medical Information Officer at Mount Sinai Health System (New York City): I expect that health IT will become less obtrusive and more coordinated. Integration of voice options, both for our patients and our clinicians, has the promise of reducing the current clunkiness of many of our user interfaces. And with the development of robust standards and requirements for interoperability, coordination of information across IT systems — both within and across organizations — will be simpler.

Zafar Chaudry, MD. CIO at Seattle Children's: Heath IT evolution over the next five years will lead to a shift in the EHR to the web, some new startups in the marketplace; predictive analytics will become mainstream; the security and access of patient data across systems will become the de facto standard; artificial intelligence will continue to mature spurred by a new generation of data scientists; both virtual and augmented reality will continue to advance; wearables will become mainstream; and nanotechnologies, robotics and 3D-printing will continue to upsurge.

Andy Lehman. CIO at Kettering (Ohio) Health: As macro forces in the healthcare industry continue to drive the delivery of care to environments outside the hospital, the delivery of care inside the home will continue to surge. The COVID-19 pandemic has begun a tectonic shift in the purpose of our homes. The concept of "transcend but include" applies.  

The home will always be the physical manifestation of our families. However, the home is now a classroom, doctor's office and place of business. As healthcare evolves, it will also become a hospital, which will drive significant changes in health IT. Although not all care can be moved outside of the hospital, there are studies indicating an improvement in outcomes when care is delivered in the home for appropriate episodes. 

Healthcare networks have designed IT infrastructure to support care in the hospital, physician offices and peripheral locations. The home is the next frontier. 

Michael Elley. CIO at Baptist Health (Little Rock, Ark.): Many organizations have long been attempting to drive virtual care and patient portal adoption, and with COVID-19 ... those platforms have proven to be effective in impacting positive care outcomes. Now, I think the attention will shift to remote patient care, providing care outside the walls of our hospitals. It has many names: remote patient care, care at home, care anywhere. 

We are, in essence, meeting patients where they are, not only in the physical location sense, but in the digital sense as well. The comfortability with apps and our digital world has expanded to a broad range of demographics and our patients or consumers of healthcare will be able to be treated, monitored and managed differently, based upon their expectations — not ours.

R. Hal Baker, MD. Chief Digital and Information Officer at WellSpan Health (York, Pa.): Healthcare IT is moving at an unprecedented pace. Where we are today is vastly different than where we were five years ago. Looking ahead, I believe the biggest change in healthcare IT over the next five years will be the slow but steady transfer of service and connections from in-person meetings in medical offices to web-based connections through patient portals. Conditions like hypertension and diabetes can be managed more effectively with a monthly five-minute asynchronous electronic connection between the doctor, patient and measurement device than in three or four office visits a year. 

As the payment model shifts to outcomes over visits, the opportunity to find a better way to provide care through more frequent and less costly connections will improve both the ease and cost of care, as well as its effectiveness. Our work to connect companies, like Livongo, through EHRs, like Epic, allows our care team to build on the success of healthcare innovators through connecting them to the medical home. We feel this will be the largest change in healthcare IT in the coming years, but this is just the beginning.

Sunil Dadlani. CIO at Atlantic Health System (Morristown, N.J.): The biggest challenge will be posed with 5G coming into the mainstream. That will lead to billions of artificial intelligence/machine learning-enabled medical Internet of Things, wearables, sensors and remote patient monitoring devices exchanging sensitive protected health information over the networks, resulting in unprecedented cybersecurity and patient safety issues and challenges.

Scott MacLean. CIO at MedStar Health (Columbia, Md.): I think the biggest changes in health IT five years from now will be:

  • EHR acceptance by clinicians and consumers with ambient speech recognition to enhance the patient/clinician interaction.

  • Payment system reform that will incentivize patients as well as providers to make rational decisions on care expenses. We will need intuitive, mobile IT systems to support this consumer engagement.

  • Effective use of data. We will have much more specific guidance for clinical decision support of personalized medicine. This is dependent on appropriate organization and use of human subject data along with the promise of artificial intelligence.

  • Security and privacy will be not only expected, but feasible. New technologies and operational approaches will help patients and providers interact in ways that are secure and private.

  • There will be a demand for effective, frictionless technology in support of the continued move to ambulatory, home and digital care.

Ray Gensinger, MD. CIO at Hospital Sisters Health System (Springfield, Ill.): I believe we need to steel ourselves for the largest transition in healthcare and healthcare-related information technology. The much maligned transition to EHRs (avoiding the debate related to any inefficiencies and disruptions) have generated a treasure trove of data that is allowing us to remake the entire healthcare industry.

Five years from now, I would estimate that 50 percent of primary care, preventive health and low-acuity office visits are going to be managed in a fully artificial way. Patients will interact with an FDA-approved series of silicon services that enhance the availability, patience, depth, breadth and accuracy of a health experience. Appropriate prescribing and follow-up testing will be scripted. The part I'm uncertain of is whether this can all be done absent any human clinical review. I'd say there's a 50-50 chance that the final step of these silicon services will be the review and approval by nurse practitioners. This will likely be driven by payer expectations more so than any true diagnostic validation.

I suspect this will be a bit frightening to some peers in the field, but I think this is not only going to provide better and more efficient care, but it will also provide the stress relief needed by the shortage of our caregivers so that they can focus on the more complicated needs of presenting patients that fail the silicon pathways as well those that need our expertise in specialty, traumatic and procedural care.

Tom Barnett. Vice President and Chief Information and Digital Officer of Baptist Memorial Health Care (Memphis, Tenn.): The biggest change that I see in healthcare IT in the next five years will be the growing and expanding availability and accessibility of health data.

Greater availability of patients' data is a very exciting advancement, but we need to be careful that we don't lose sight of the source and accuracy of that data. As health data becomes increasingly mobile and is consumed by a host of data aggregators, third-party applications and interested organizations, it could lead to an overall data quality issue as incomplete, non-normalized, "enriched" or otherwise modified data all begin to commingle in "the wild" and we slowly start to lose the original integrity and inherent trust that the data once had.

As health data becomes more portable, legal issues would likely become trickier. What constitutes a breach and what qualifies as information-blocking could become more challenging to define. To address those concerns, there would predictably be new rounds of rules and legislation proposed presumably to improve the situation but which in reality would aggravate the underlying issue.

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