Yes, portals and mobile EHRs were big in 2012 - but will they continue to make headlines in 2013? And what about stuff like ICD-10 training, health information exchanges (HIEs), and telemedicine? We asked more than a dozen healthcare IT experts, including physicians, consultants, and administrators, to give us their predictions for the coming year. Here’s what we’re hearing, technology-wise:
1. Training will be a big to-do: With the first stage of CMS’ meaningful use initiative in full swing, and preparations for Stage 2 underway at practices, EHR adoption and implementation is expected to grow for another year. And with it, training of practice staff. But that’s not where training ends. As blogger Carl Natale notes, this is the year that practices need to learn more about ICD-10 codes and improve documentation (October 2014 is just around the corner!).
2. Meaningful use requirements will fuel actions: In addition to EHR training, we can expect practices will be more focused on other, meaningful-use-fueled tasks, namely partnerships. “I think what drove 2012 and will drive 2013 is meaningful use and then ACOs … and anything related to the Affordable Care Act,” said Derrick Berger, administrator of Lake Jackson, Texas-based Brazosport Urology. “We have to focus our technology needs around both of those things. I think 2013 is going to be about getting meaningful use done and anything relating to that technology-wise, such as [adopting] patient portals and information exchanges.” Charlie Jarvis, vice president for health reform and government initiatives at NextGen Healthcare, noted that insurance carriers have been looking toward embracing the “more successful” of the government-sponsored ACO models with their own incentive plans.
3. HIEs will grow: Thanks to CMS’ Stage 2 requirements for clinical data exchange for meaningful use, practices will be seeking ways to send information to healthcare partners to better coordinate care. One way to do this is by using health information exchanges, which are rapidly being built out. As Gary Hamilton, CEO at InteliChart noted, “2012 healthcare trends consisted primarily of data collection to facilitate information exchange, analyzing data to yield coordinated care, and the introduction of patient driven initiatives to both engage and inform patients. “These trends will continue over the next several years as information exchange evolves into the outcome of the exchange (coordinating patient care, identifying gaps in care, facilitating the transition of patient care, patient safety) as opposed to the literal act of acquiring/aggregating/exchanging the data which is where we are today, he added.
4. Patient portal adoption will continue to surge: Of the nearly 1,400 physicians, practice administrators, and healthcare workers who participated in our annual Technology Survey, Sponsored by AT&T, 29 percent said they owned a portal, up from about 20 percent the year prior. That’s no surprise, considering Stage 2 meaningful use requirements for physicians to "provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the [provider].” However, practices may find it challenging to get patients to use portals. “The functionality is required by the CMS for meaningful use but there is not real use case for them in the present time,” warned Berger. “The concept is a good one but I don't think people are ready for that technology or to feel like their information is exposed.”
5. Tablet craze will continue: On Jan. 2, technology vendor Epocrates reported that among 1,066 primary-care physician customers surveyed recently, more than one in four PCPs uses a tablet in practice, up from 20 percent in 2011. Among these tablet users, 79 percent use the Apple iPad and 22 percent plan to purchase the iPad Mini. Bill Ho, president of Biscom, a provider of enterprise fax and secure file-transfer technology, said he expects that mobile devices will become even more indispensable with the additional ability to digitally sign documents. “Doctors and other healthcare professionals will not only be able to access patient records, but they’ll be able to sign off on treatments and prescriptions without being tethered to their offices or the hospital,” he said.
6. Healthcare mobile apps will get better: We know healthcare apps are popular among patients and physicians, whether health reference medical apps or location services that tell consumers where to find the nearest hospital. And with technology becoming only more sophisticated in 2013, the apps will only get better. Salem, Ohio, family medicine physician Mike Sevilla said he expects to see more FDA-approved smartphone apps. “AliveCor is the trailblazer in this area,” he said. “With their success, I see other companies trying to get into this market. Everyone knows about the medical device market, but this digital/electronic device market is newer, and just as exciting.”
7, We’ll see more health IT outsourcing: Mike Detjen, vice president of service lines for Arcadia Solutions, said that as hospitals, practices, and health systems move and grow, the number of healthcare information technologies will continue to increase and “become more cumbersome” for clinicians to manage. Therefore, it makes more sense that practices, especially smaller ones, will outsource their technology needs. “The time spent with the daily upkeep of these systems has taken them away from their primary role - treating patients,” said Detjen. “This challenge is compounded with crippling shortages of people who have previously worked on EHR deployments, HIE efforts, and other technologies that are involved in the effort to digitize and secure patient data while improving individual care and reducing healthcare costs.”
8. The PHR will make a comeback: While Google Health’s demise seemed to indicate a declining interest in personal health records, the increased deployment of portals by physicians could spur a new era of patients who rely on technology to keep tabs on their health. “Google Health was ahead of its time and closed down at the beginning of 2012,” noted Sevilla. “I see another company coming out with the next generation of the PHRs that will be secure, portable, and compatible with the major EHR platforms.”
9. More practices will seek the clouds: A growing number of physician practices, especially smaller ones, decided to take to the clouds when choosing their EHR in 2012. We’ll likely see more cloud migration this year. “In 2013, more physicians will see the benefits of cloud-based EHRs, which are easier to adopt and implement than on-premise solutions,” said Todd Rothenhaus, chief medical Information officer of athenahealth, citing the Best in KLAS 2012: Software and Services report.
10. Telehealth: For many reasons, we’ll see an uptick in the practice of medicine outside of the practice setting. As medical copays increase, more corporations are encouraging employees to take advantage of telehealth services to connect with physicians easily and inexpensively. At the same time, technology is getting better: Virtual visits (via video) provide a richer experience than in years past. “We recently completed a pre-op visit with a patient in Alaska, and are seeing this as a huge opportunity for everyone, especially those who can’t travel,” Brennan Dobbins, clinical and ancillary services director for The Doctors Clinic, PC, told Physicians Practice. “The technology exists; it is just a matter of organization. Of course it is easier in aesthetics and plastic surgery, because they aren’t insurance based, but a lot of times patients are willing to pay to have that kind of convenience, especially when dealing with high deductible health plans.”