Well, we weren’t wrong.
We predicted that the Top 5 Medical Technology Trends for 2015 would be gamification, wearables, telemedicine, mobile medicine, and 3D printing.
Gamification in medicine definitely advanced in 2015. In South Carolina a university is using $1 million from the NIH to find out whether digital reminders can improve compliance among kidney transplant patients. This year students at Imperial College Business School in the UK have proposed an app called Quit Genius that gamifies smoking cessation.
As for wearables, telemedicine, and mobile medicine, those will be huge trends in 2016, as well. Cloud computing, patient portals, big data, and security will join them.
Here are the top 5 EHR trends for 2016:
1. More EHRs are moving to the cloud
An on-premise EHR can cost $40,000 to set up. Cloud-based EHR infrastructure and maintenance costs are included in the monthly price, eliminating high startup costs.
Other benefits include:
- Access to records from outside the office, including on mobile devices
- Better continuity of care
- Easier updates and improvements to software
2. More EHRs are providing patient portals
“Patient engagement through health technology such as patient portals is rapidly increasing,” Craig Kemp, leader of innovative partnerships for Merck Vaccines, told mmm-online.com.
A 2015 survey of more than 11,000 patients, 237 physicians, nine payer organizations representing 47 million lives, and pharmaceutical marketers backed up Kemp’s claim.
Patient portal use got off to a slow start in 2013, but gained momentum in 2014 and 2015. Between 2013 and 2014, key tasks such as sending lab tests to patients using an EHR’s patient portal increased 26%, and sending patient education and disease education increased 50%. About half of physicians offer their patients portals right now. Another almost fifth plan to offer one in the next twelve months.
Educating patients on how and why to use portals will be key to getting them to use them in 2016. Almost a third of patients said they were interested in using a patient portal to engage with their physician, track their medical history, and receive educational materials and patient support. However, almost 40% said they’d never heard of a patient portal.
Payers, for their part, want portals to offer patients access to their medical records, personalized health reminders, and total health programs (such as diet, exercise and medication guidance). But they don’t want to provide the educational materials, create the adherence programs, or offer the financial support, like co-pay cards and vouchers, that would be necessary to set that up.
3. Telemedicine will blow up
We’ve come a long way from remote villagers using bicycle pedal-powered, two-way radios to communicate with the Royal Flying Doctor Service of Australia. In 2013, Transparency Market Research valued the global video telemedicine market at $559 million. They now predict it will grow to $1,624.4 million by the end of 2020.
Telemedicine offers too much value to fail to grow, particularly to a large segment of the population that’s only growing: seniors. Benefits include:
- Getting care to remote and homebound patients
- Reducing the cost of care
- Keeping seniors at home longer
- Eliminating the risk of picking up new illnesses in a clinical care setting
- Providing flexibility to providers
For instance, telemedicine is currently helping recovering stroke patients in rural Minnesota avoid hours-long (and often snowy) drives for follow-up care. Nurses at a nearby facility can check motor skills by asking patients to push, pull and squeeze with their hands and feet. A doctor on a screen can advise on care.
Walgreens, the largest U.S. drugstore chain, and telehealth provider MDLive recently expanded their virtual care collaboration to 20 more states in November, bringing the total to 25.
One big technological leap forward for telemedicine has been the mass adoption of wearables. They make store-and-forward telemedicine easy, automatically collecting valuable health data so it can be transmitted to a doctor or medical specialist at a convenient time for assessment. Watch for more EHRs learning to connect with wearables in 2016.
4. EHRs will (finally) go mobile
One thing that will blast telemedicine forward is the trend toward EHRs becoming more mobile-friendly. Clinical staff want to able to be productive in and out of the office. A 2014 Software Advice survey showed that users are desperate for mobile access to their EHR. The majority (58%) of users who can use their EHR on their tablet or smartphone reported being “very satisfied” with their software. Only 28% of users who couldn’t felt the same way. Since 89% of physicians reported using smartphones and tablets to communicate with staff in a 2013 survey by Black Book Ranking, that dissatisfaction makes sense.
Cloud-based EHR software makes mobile access possible. Yet vendors are behind. As of 2014, one-third of providers’ EHR wasn’t mobile-optimized, according to a Epocrates Mobile Trends report.
In 2016, look for more EHR vendors to start offering mobile access to schedules, patient charts, and prescribing functionality.
5. Big data will reveal more connections
While “big data” has become an overused bit of jargon, personalized medicine enabled by big data is an emerging trend in healthcare. Innovation will continue apace in 2016.
SAP Chief Medical Officer, David Delaney: “Personalized medicine focuses on analyzing a person’s genome, environmental, social, biometrical, and religious influencers, and determining a treatment for the individual based on that data.”
“It’s about moving from a one-size-fits-all approach,” Delaney said, “to instead creating micro-buckets of patients by analyzing their medical records and genome sequences, and treating patients based on the research and records of how other patients in similar situations have reacted.”
Big data is working to identify the behaviors, risk factors, and early indicators of disease so we can prevent it more effectively.
Stanford researchers are sharing health data from medical apps like MyHeart Counts to find fascinating new connections, such as that people who go to bed and get up earlier are happier than late sleepers and night owls, and South Dakota residents eat more fruits and veggies than Californians.
Big data can also help doctors predict which patients will need more help taking their meds on time. Medication adherence is a $300 billion problem and one of the leading causes for hospital readmission. Factors such as depression or limited language skills could be associated with low adherence. “The information is already there,” said SyTrue CEO Kyle Silvestro. “But we need the ability to select and use it easily, to manage our populations correctly.”
Big data isn’t just about saving lives though. It can also help save money.
Last year a new database revealed that places that spend less on Medicare do not necessarily spend less on healthcare overall. President Obama visited Grand Junction in 2009 to laud it as a model of better, cheaper health care as part of his push for the Affordable Care Act. But big data revealed that Grand Junction is actually one of the most expensive health care markets in the country for the privately insured – despite its unusually low spending on Medicare.
The new database includes nearly every claim made by private, employer-provided health plans. In 2011 UnitedHealthCare, Aetna, and Humana formed an organization to pool their data, and called it the Health Care Cost Institute. Together the three insurance companies represent about 14% of people in the United States. They shared their data with researchers who found that
Big data is only the first step. That data must be cleaned and structured so it can reveal patterns in factors that influence outcomes. “There’s six billion base pairs in human DNA,” Delaney said. “Add that to years of medical research plus a lifetime of doctors’ notes. Multiply that monstrous number by billions of patients all over the world. The product is a volume of data so immense that it’s extremely difficult to extract complete and actionable insights. It’s estimated that 30% of all existing global data is healthcare related.”
But most of the data is too poorly coded to use. According to SyTrue, the cross-industry consensus is that approximately 80% of all healthcare data remains unstructured.
Another problem is that government is halting true innovation with ham-fisted regulation. GovHealthIT warns that mining individually-identifiable health information could constitute a breach of patient privacy if the analysis falls outside of the scope of HIPAA. “It is not clear whether using patient data to improve products, as opposed to health outcomes, is allowed under this law. And an even more concerning scenario could take shape if health information were combined with other personal, non-medical data for the purposes of user profiling.”
6. Security will continue to be a major concern
We’ve moved beyond letting security concerns keep EHRs in the stone age on local servers and off our phones (thank you Based God). But security is still a major concern.
According to Healthcare Dive:
- A data breach now costs organizations an average total of $3.8 million, up 23% from 2013.
- The worldwide per capita cost of a stolen record in the healthcare industry is $363, making it the most expensive industry for a breach.
- 49% of breaches in the U.S. are the result of criminal attack, rather than human error or a system glitch.
To mediate the cost of a breach, medical teams may want to assemble an incident response team. One study indicated that it can create over $12 in per-capita savings. In addition, medical data security best practices, such as encryption, employee training, BCM involvement, a CISO appointment, board-level involvement, and insurance protection, can all make a data breach less likely.
Web-based EHR systems achieve HIPAA compliance through data centers with bank-level security and high-level encryption methods that render data unreadable — even if a security breach occurs. Client-server systems are often left unencrypted and are only as secure as the room where they are stored.
Between wearables, telemedicine, mobile medicine, cloud computing, patient portals, big data, and security, what EHR trends are you most excited about in 2016? And what trends did I miss? Let me know in the comments!