– NRC Health today released its 2021 Healthcare Consumer
Trends Report, which surveyed 2 million healthcare consumers against the
backdrop of the ongoing coronavirus pandemic.
– The latest report highlights the major trends that came to light last year, and how they will continue to impact the healthcare industry in 2021 and beyond – from declining brand loyalty, increased care deferment, the fast adoption of telehealth, a rise in wearable tech, and a broader focus on social media marketing.
– Hospital leaders will also find value in learning how
to recapture patient volumes lost in 2020 and how to bring more human
understanding into the care experience.
NRC Health, a provider of in-depth
customer intelligence in healthcare, today released its 2021 Healthcare Consumer Trends Report. For its
third-annual industry review, NRC Health surveyed millions of healthcare
consumers against the backdrop of the ongoing coronavirus pandemic. From
declining brand loyalty, increased care deferment, the fast adoption of
telehealth, a rise in wearable tech and a broader focus on social media
marketing, NRC Health’s latest report shines a light on consumers’ evolving
preferences and behaviors related to key healthcare trends and offers insight
into how provider organizations can recapture patient volumes in 2021.
COVID-19 Accelerated the Trajectory of Consumerism in
“It cannot be overstated just how dramatically COVID-19 has accelerated the trajectory of consumerism in healthcare,” said Helen Hrdy, Chief Growth Officer, NRC Health. “The onus falls on healthcare leaders to move the industry forward by ensuring patient safety, building consumer trust and bringing more human understanding into every care experience. Those organizations that are willing and able to evolve with the times will be best-positioned for success in the aftermath of COVID-19.”
“For years, consumers have made consistent appeals for autonomy, convenience, and freedom of choice,” said Hrdy. “As unsettling as it’s been, COVID-19 has brought some of these consumerist-driven measures to the forefront. While healthcare leaders have proven they can be nimble and adaptable, even in the face of crisis, consumers want a partnership with their providers and a care experience that exceeds their expectations moving forward. But only with the right data and the right understanding, can we ensure that healthcare is capable of adapting.”
4 Key Healthcare Consumerism Trends to Know in 2021
1. Consumers favor convenience, provider rapport over brand loyalty
Consumer loyalty is a major driver of health system
profitability, but unfortunately for hospitals and health systems, overall
brand preference among healthcare consumers continues to decline, from 31% in
2018 to 36% in 2020. More than a third of consumers expressed no particular
preference for a healthcare brand, when compared against independent
practitioners, and 62% anticipate their brand preferences to change after the
Ironically, providers themselves are in the best position to
earn back consumer trust. An analysis from NRC Health’s Real-time Feedback
database shows that consumers report an overwhelming fondness for their
providers, especially since the outbreak began. To capitalize on that goodwill
and bring patients back into the healthcare fold, all evidence points to
convenience. Almost half of consumers say a convenient location is the number
one factor in their healthcare decision-making.
2. Patient deferment rates will continue to rise
Prior to the pandemic, healthcare deferral rates were
approaching a five-year low. But with consumer anxiety at an all-time high due
to the pandemic, those rates rose significantly in 2020, up from 22.4% at the
end of March to 30.4% by the end of June. Forty percent of patients who delayed
care in 2020 cited the coronavirus as the reason, while 17.2% said they prefer
to manage their care on their own for now.
Delaying care can have a number of repercussions, from
threatening hospital revenue streams in the near term to causing far more
serious outcomes for consumers in the long term. Patients 75 and older
accounted for nearly 68% of all care delays, revealing a huge challenge for
health systems as they try to recruit this generation back into regular care.
3. Future of care delivery looks
uncertain after rapid telehealth adoption
Lagging in widespread adoption for years, the pandemic fast
tracked virtual care delivery from optional luxury to operational necessity.
Fortunately, consumers have been receptive to the shift, with an overwhelming
92% reporting positive telehealth experiences during this time. However, only
27% of consumers say they will consider telehealth as a potential alternative
for future visits, underscoring what is still an uncertain future for virtual
health and overall care delivery beyond the pandemic. Prioritizing provider
time and attentiveness, as well as financial transparency, will be key as
healthcare organizations work to cultivate effective telehealth practices long
4. Patients and providers still disconnected over digital
may have brought healthcare into consumers’ homes, but it is by no means the
only avenue to reach customers outside of the healthcare facility. By and
large, consumers are enthusiastic about digital innovations that bring them
closer to their provider — even as these innovations are underutilized by
tech, for example, has become a huge part of the average consumer’s daily
life in regards to how they manage their health and wellness from home. Yet
only 50% of providers are asking about wearable tech data during appointments,
despite the fact that 57% of consumers believe this data would be useful in
conversations with their healthcare providers.
Social media is another under-used digital venue for patient
interaction. Even though 72% of Americans have some kind of social media
profile, many health systems have not yet found an optimal strategy for
engagement. And while currently, only 23% of Internet users are actively
seeking health information on social media, that number is likely to soon rise
as 70% percent of consumers expressed interest in getting healthcare
information via social channels. Another 62% said they trust the health information
they get on social media, so long as it comes directly from their provider.
This was especially true during the worst of the pandemic, when consumers
trusted news from local healthcare organizations more than any other sources.
But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.
The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.
Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.
This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs.
To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.
Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:
1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk.
The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.
2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.
Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.
It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:
– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?
– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?
– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?
The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.
But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.
About Assaf Halevy
Assaf Halevy is the founder and CEO of 2bPrecise, LLC, leading an international team dedicated to bridging the final mile between the science of genomics and making that data useful at the point of care. He joined Allscripts as senior vice president of products and business development in 2013 when the company acquired Israel-based dbMotion. An initial inventor and co-founder of dbMotion, Halevy helped develop the leading clinical integration and population health management platforms in the industry today.
With 13 patents pending in the areas of actionable clinical integration, interoperability, and precision medicine, Halevy leverages his industry expertise by evaluating strategic alliances and partnerships for U.S. and international markets. Halevy was invited to participate in several U.S. government activities and contribute to an HHS privacy committee task force. In 2016, he was part of a small selective group of executives invited to the White House by Vice President Joe Biden to discuss the future of interoperability.
As we re-examine the healthcare system in the wake of the pandemic, we are continually identifying opportunities to rebuild parts of the system to new and improved specifications. One critical facet is digital health, where we continue to struggle with what should really be table stakes: the ability to integrate data from disparate organizations and systems into a unified view of the whole person and take action.
During the height of the pandemic, telehealth made it possible to deliver care that was personal yet socially responsible. As a direct benefit, the use of digital health tools on both the clinical and consumer side picked up a tremendous and timely head of steam. But what will become of these innovations once we make our eventual return to normal?
Today, many healthcare consumers can talk to a therapist or a counselor through text, monitor glucose levels through a diabetes app and meet with their primary care provider over videoconference. The challenge is that a lot of this patient data is still landlocked in electronic medical record (EMR) systems that do not communicate or coordinate with one another or with payer systems or consumer apps.
The sustainability and applicability of digital health tools are still often questioned despite reports that investors had poured a staggering $5.4 billion into the digital health industry just by June of this year (Rock Health). The key to success is to seamlessly connect these tools with legacy systems and siloed access points to create a truly integrated healthcare continuum. Jumping between systems, each holding only its own limited slice of patient data, and then trying to take action on this data, is neither scalable nor sustainable.
Healthcare consumers have long looked at the seamless nature of apps in other areas of life and asked for a similar level of accessibility and on-demand, high-quality information from the healthcare system. Accenture found in its 2020 Digital Health Consumer Survey that although consumers are interested in virtual services, a cumbersome digital experience turns them off. Additionally, the survey found that concerns over privacy, security, and trust remain, along with difficulty integrating new tools and services into day-to-day clinical workflows.
The good news is that the Office of the National Coordinator (ONC) has made several major data exchange rulings this year that will push providers and payer organizations to update legacy systems to make consumer health data more assessable and sharable across all parties, all for the benefit of the patient.
The Stage is Set: Healthcare Leaders Must Act, Now
The incredible investments in the industry, increasing consumer demand, and data sharing regulation show that healthcare connectivity and interoperability have never been more essential. To ensure that the digital health transformation and remote healthcare delivery models progress optimally beyond the current environment, we must support healthcare organizations in evolving their infrastructure and software capabilities to support this kind of strategy. This is where health tech has a critical role to play in building flexible pipes to connect the full spectrum of repositories and players, including doctors, specialists, nurses, care managers, health coaches, caregivers, and, of course, the healthcare consumer.
What does this look like in practice? Imagine if an unusually high heart rate warning was triggered by a patient’s smartwatch, which then alerted the patient’s care manager to check-in. With a comprehensive view of that patient, the care manager calls the patient to assess if they are okay and learns the patient ran out of their prescription which helps lower the heart rate. Knowing that patient does not have access to a car and is afraid to take public transportation due to COVID-19, the care manager then sets up a prescription delivery straight to that patient’s doorstep.
Through this process, digital health tools, patient data, and social determinants of health all came together to equip that care manager to deliver personalized care to the patient. Sound like sci-fi? This innovative approach can actually be a reality for organizations that manage large populations. The key is educating more healthcare leaders about the benefits of a comprehensive healthcare platform that improves health outcomes, lowers costs and increases member satisfaction.
This all starts with a platform that coordinates and aggregates the siloes of data and tools (clinical and digital) into a central hub. that allows providers to oversee the access points, plans, and processes in a patient’s healthcare journey without the task of building or maintaining the system themselves. This can be a game-changer in the way we assess and treat patients and help the industry to fully realize the dream of truly comprehensive, coordinated care.
About Adam Sabloff
Adam Sabloff is the founder and CEO of VirtualHealth, provider of HELIOS, the leading SaaS care management platform, serving more than 9 million members across the U.S. Prior to VirtualHealth, Sabloff served as VP of Development and Chief Marketing Officer for Midtown Equities, a $7 billion real estate, media and aviation conglomerate, where he also oversaw its technology subsidiary, Midtown Technologies.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
Healthcare leaders attempting to regain some of the revenue lost during the COVID-19 shutdowns now face a formidable challenge. The American Hospital Association estimates that U.S. hospitals and health systems lost $202.6 billion in just the four months from March 1 through June 30—roughly $50.7 billion per month.
Many variables feed into the overall financial impact for individual healthcare organizations, of course—including geographic location, local ordinances, specialty designations, and speed of service resumption. Regardless, every health system has experienced revenue shortfalls caused by disruptions to their service pipeline. The question now is how to generate enough additional revenue to cover some of those losses without incurring additional operating expenses.
We may be able to take practical inspiration from an unlikely source: the hospitality industry. By solving for something one healthcare organization calls “the motel problem,” health systems can increase workflow efficiency, staff satisfaction, clinic volume, and revenue.
The Motel Problem
Accurately assigning exam rooms with enough flexibility to accommodate continuously changing provider and patient schedules remains a perennial challenge for health systems. In fact, during a recent Porter Research study of 100 executive leaders, roughly two-thirds indicated their health systems lack visibility into exam room utilization.
The leaders of one academic medical center’s 65-physician neurology clinic began referring to this capacity challenge as “the motel problem.” How do motels consistently keep their rooms full of paying customers?. In contrast, their own exam rooms often appeared full on the scheduling spreadsheet but actually sat empty. Staff afraid of accidentally double-booking the space would then let those rooms sit idle.
Despite increasing the administrative time devoted to room management, underutilization in the neurology clinic caused rising patient wait times, lowered physician satisfaction, and decreased revenue. If the Porter Research survey is any indication, this situation is not unique. Approximately 72 percent of the survey’s respondents felt their room utilization rates were significantly subpar. Most said their organizations ran at about 20 points below the 80-89 percent utilization level they deemed optimal.
As the neurology department leadership mused about “the motel problem,” they looked at the similarities between motel and healthcare room management needs. Motels must match each guest to a room with the right accommodations (e.g., two doubles versus one king-sized bed) on the right dates. Health systems must take that same workflow one step further by matching the right patient and the right provider to a properly equipped exam room at the right time. In both cases, empty rooms mean lost revenue. Utilization is key.
Consequently, they came to believe that they needed a system that optimized room capacity with much of the same visibility and flexibility as a hotel or motel reservation system. That would require bringing together data about room availability, room attributes, provider schedules and patient needs—and making the resulting intelligence accessible through real-time displays.
A meaningful solution
When it comes to capacity management within a health system, the real complexity lies with provider and patient schedules. The physical space is always there; it’s the “people” part of the equation that’s fluid. What happens when Dr. Johnson suddenly falls ill, for example? Or Dr. Smith needs to attend a last-minute meeting? Or when patient Mrs. Brown reschedules her appointment?
Clinics typically rely on relatively static spreadsheets or siloed software to track room utilization. But these tools aren’t designed to make such real-time adjustments, especially at the enterprise level—which means the exam rooms assigned to an absent Dr. Johnson or Dr. Smith likely remain empty even as patients wait to be seen by other providers.
On the other hand, an organization’s scheduling system is aware when a provider calls in sick, heads to a meeting, or arrives at the clinic early. With a cloud-based scheduling platform, organizations can achieve near real-time visibility into provider availability across the enterprise.
Consider, then, what can happen when room management software is layered on top of an enterprise scheduling platform. Providers’ movements are then connected to exam room status. The entire organization gains transparency into how providers’ availability affects room availability. That allows staff to quickly and easily move providers into unused rooms and call patients in for appointments faster. Plus, by “tagging” various room attributes—like whether it’s equipped with oxygen or an ENT chair, for instance—such platforms ensure that the proper clinical accommodations are available when providers and patients need them.
Such real-time visualization of room availability can have a substantial impact on health system revenue. One regional health system, for example, calculated that underutilization in its orthopedic clinic costs at least $2,000 per provider per day in lost revenue.
Another large health system quantified the effect from a different perspective. It contemplated how maximizing capacity would enable increased patient throughput without investing in additional space or staff. With that in mind, the organization determined that every one percent increase in utilization results in an annual operational savings of $140,000.
At the neurology clinic, solving “the motel problem” by implementing a solution to standardize capacity generated both revenue growth and increased provider satisfaction. The organization has captured revenue previously missed through underutilization and has recognized that revenue scales directly proportional to volume.
To that end, gaining visibility into capacity has helped the clinic achieve a 7.4 percent increase in patient visits and a 4.7 percent increase in-clinic session volume. As important, providers now trust that the right exam rooms will be ready for them when needed—just like a reservation at a high-end hotel.
About Rich Miller
Rich Miller is the Chief Strategy Officer of QGenda, a healthcare workforce management provider, enabling organizations to optimize capacity across the enterprise. Leading physician groups, hospitals, academic medical centers, and enterprise health systems use QGenda to optimize their workforce which allows them to provide the best possible patient care.
The importance of handwashing has never been more obvious than in recent months, but as experts continue to share information on the spread of the virus, there’s a need to disinfect more than just our hands. In healthcare settings where the spread of infectious diseases is not just a possibility, but a likelihood on any given day, healthcare leaders are examining the best methods to clean devices, such as mobile computers.
According to a recent study by the Healthcare Infection Society, almost all (99.2%) hospital staff smartphones were contaminated with potential pathogens and thought to pose an infection risk. As mobile devices become even more prominent in everyday care settings, this number shows just how crucial it is for facilities to implement device cleaning protocols. Without a policy in place, the chance of disease spreading in healthcare environments is exponentially higher, putting both patients and providers at risk. In some instances, nurses have been known to have as many as 10 patients in one shift, showing just how many points of contact there are during each nurse’s workday.
Where to Start
As healthcare facilities look to implement their own device cleaning policy, one of the most important factors to remember is that not every device is the same, and as such, not every device will have the same cleaning regimen. The best way for organizations to determine which cleaning agents are safe to use is to refer to the device user guide from the manufacturer. These guidelines typically include the purity or formulation levels for each ingredient, including the types of cleaning agents to avoid. Failure to follow these protocols could result in device damage if the wrong cleaning agents or ingredients are used to wipe it down.
To ensure an optimal cleaning policy and disinfection schedule, it will also be important to consider the environment in which the devices will be used. Devices that are used in patient rooms will need to be disinfected more frequently compared to other locations within a hospital. Determining the number of patients being helped by each practitioner and the reason they are each being cared for can also help facilities develop an appropriate schedule for device disinfection.
Disinfecting Versus Cleaning
Although the terms “cleaning” and “disinfecting” are often used interchangeably in healthcare settings, the two processes are significantly different and suited for very different use cases. When cleaning a device, most facilities are referring to the steps taken to wipe the dirt and other grime from the surface of a mobile device or barcode scanner. This process helps remove visible debris from the device that can be seen by the human eye.
However, this does not remove bacteria and potential pathogens that could be sitting on the device. In order to properly remove bacteria, healthcare workers need to disinfect their devices with the correct cleaning agents. This is where a regular cleaning schedule with guidelines is necessary because routine device cleaning does not always eliminate the dangerous bacteria that can pose a risk to patients and clinicians.
Considering the Right Technologies
One of the biggest limitations holding some organizations back from implementing a proper device wipe down protocol is the durability of the devices in use. Unfortunately, not all mobile devices are purpose-built for healthcare environments and capable of withstanding the rigorous cleaning and disinfection needed to reduce the spread of infectious diseases and bacteria. This is most commonly seen when physicians are using their own consumer-grade devices during patient care. These devices can’t hold up to disinfectant procedures and the chemicals used in these solutions can lead to cracks and breaks in the material. Not only does this pose a risk for cross-contamination and the spread of bacteria from one patient to another, but providers using these devices outside of healthcare facilities can take the bacteria and pathogens home with them.
In order for mobile devices to meet a hospital’s cleaning policies, the right ingress protection (IP) sealing is needed to prevent damage from chemical cleaning solutions. For hospitals allowing physicians to use their own devices, the right sealing will need to be added to their devices to reduce the damage from cleaning agents. Many hospitals though utilize durable or rugged enterprise-class mobile devices that are purpose-built for healthcare environments and can withstand harsher cleaning protocols during their long lifecycle.
As healthcare organizations continue to evolve to meet the needs of today’s environment, having proper device wipe down protocols in place will become a priority to help reduce the spread of infectious diseases in their facilities.
About Rikki Jennings, BSN, RN, CPN
Rikki Jennings, BSN, RN, CPN is the Chief Nursing Informatics Officer (CNIO) at Zebra Technologies where she is responsible for combining her knowledge of patient care, informatics concepts, and change management to effectively address the information and knowledge needs of healthcare professionals and patients to promote safe, effective, and efficient use of IT in clinical settings. She also serves as the strategic liaison for health IT efforts representing nursing and clinician needs.