Predicting the future: What to look for in 2016

The role of a prognosticator is to accurately predict the future. Although many have tried to predict the trend of the stock market, an imminent earthquake, or even the end of the world, soothsayers rarely get their predictions correct.

That said, they are very grateful that most people only remember the correct predictions and rarely if ever called to task for their incorrect ones. In this spirit, below are my predictions for 2016.

Internet of Things (IoT) Continues to Gain Interest but Not Much More – With large technology companies investing huge sums of money in sensor development and promotion, IoT will continue to be a buzz word in healthcare as well as other industries. Such concepts as Smart Cities, where sensors are used to manage traffic, parking, and energy use, are starting to come together in the real world. In healthcare, the use of sensors is making inroads – personal activity device (e.g., FitBit) – but clinicians struggle to understand how to use the data. As this information does not easily fit into the structure of a typical medical record, many electronic medical record (EMR) systems do not provide a place to store the data for useful interpretation. Until we figure out how to use the data from IoT devices and ensure that the data is reliable, IoT will remain a curiosity rather than a mainstream technology in patient care.

Politics Influences the Healthcare Conversation but the Industry Continues its Current Course – With just less than 10 months to Election Day, the politics driven cacophony addressing healthcare will continue. Earlier this month the Congress finally passed a bill repealing the Affordable Care Act in spite of its promised veto by the President, something he did two days after its passage. Without enough votes to override the veto, the legislation was doomed to defeat even before it was passed. Such "table tennis" back and forth between the political parties will continue through Election Day with no substantive changes taking place. Unless you enjoy the political banter, it is best you ignore the political pundits and go forward knowing that the rules you play by today will be in full force in 2017.

Provider Organizations Set the Stage to Effectively Leverage their EMRs to Enhance Clinical Care – With the Federal government spending more than $30 billion on EMR implementation and the industry spending multiple times that amount, the focus is now on how to get true value from that huge investment. CMIOs and other clinical professionals now greatly influence HIT in provider organizations, something that has grown with the expansion of EMRs. During the next year, more and more best practices will emerge describing how both patient and providers can benefit from EMRs delivering improvements in both clinical and financial outcomes.

CHIME's Voice and Influence on Healthcare Policy Grows – Once a small healthcare CIO organization focused on professional development and member networking, CHIME has shown a strong interest in broadening its mission and influence over the last year. This is evidenced by its expansion of the criteria for membership and membership categories, alliance with the Association of Medical Directors Information Systems (AMDIS), and tackling of important subjects such as unique patient ID and interoperability. CHIME recently announced a challenge to the HIT community to develop a methodology that can substitute for a government mandated unique patient ID, something unlikely from government considering the significant opposition by many members of Congress. I expect more bold initiatives by CHIME in 2016.

Provider Industry Consolidation Continues but at a Slower Pace – With many of the obvious mergers and acquisitions already completed, and increased scrutiny by government antitrust watchdogs, future consolidation will be driven by revision of current market strategy, unexpected opportunities, and economic forces. As organizations learn more about their current risk contracting, their success in managing their Accountable Care Organizations, and the impact of the Affordable Care Act on utilization of healthcare services, they will identify consolidation targets that best fit their needs. This will be a slow and methodical process,

HL7s Proposed FHIR Standard Opens the Floodgates for Healthcare App Development - HL7's release of the proposed FHIR standard attempts to unlock the data within EMRs and make it available for other applications to utilize. The current CCD and CCD-A data standards lack the richness and flexibility inherent in FHIR, and therefore represent only a first step in making data interoperable and useful in other systems. The richness of our personal interactions with technology—e.g., easy-to-use and intuitive apps for smartphones and tablets—essentially does not exist in healthcare. FHIR opens the door to an infinite number of useful applications that will completely change our use of healthcare information technology by unlocking that data from monolithic data structures and storage systems. These tools will improve clinical workflow, patient-clinician interactions, and patient use of healthcare applications. Watch for firestorm of FHIR apps starting sometime in 2016.

Drug Costs Take Center Stage as the Obstacle Preventing the Slowing of Healthcare Spending – There was a time that the release of blockbuster drugs drove revenue for pharmaceutical companies. With the demand for blockbuster drugs declining – many of the current medications available to treat common chronic diseases work just fine – pharmaceutical companies face a difficult marketplace in which to introduce new drugs. With our understanding of genomics driving the demand for personalized (precision) therapeutics, stratifying the population into smaller and smaller segments means a smaller number of patients who could potentially benefit from a new drug. This leads to a smaller potential revenue stream, and therefore lower profits. In lieu of developing new therapeutics, several pharmaceutical companies have significantly increased drug prices to drive profits. Some firms, realizing they held a manufacturing monopoly on some generic drugs, simply increased prices as much as ten-fold to drive profits. With the Federal government (e.g., Medicare and Medicaid) and patients on fixed-incomes bearing the burden of these increased costs, this problem will soon become a political issue. In the meantime, these unprecedented increases in drug costs will put upward pressure on healthcare spending.

When December rolls around, it will be time to see what I got right. Until then, have a great and successful 2016!

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