2016 predictions for health IT

2016 predictions for health IT

No, Watson will not replace clinicians

As the year ends and we archive the accomplishments and challenges of 2015, it’s time to think about the year ahead. Will innovative products and services be social, mobile, analytics, and cloud (SMAC)? Will wearables take off? Will clinicians be replaced by Watson? Here are my predictions:

1.  Population health will finally be defined and implemented. Recently I asked a number of clinicians to define population health. Although no one could define it, they were sure that their current EHR did not provide the desired functionality. To me, population health tools in 2016 will automatically aggregate data from multiple provider, payer and patient sources then create lists of patients with care gaps to be closed. This article in Harvard Business Review illustrates some of the functionality we’ve built at BIDMC in anticipation of 2016 needs.

2.  Security threats will increase. Two weeks ago, the Attorney General for National Security from the Department of Justice visited Boston to meet with a group of CIOs and CISOs, describing the escalating number and sophistication of cybersecurity attacks. He concluded that if a device is internet connected, it will be compromised. At BIDMC, we will continue to invest millions in security technology, rewrite many of our policies and invest in continuous security education for all our staff. Despite our best efforts, I cannot promise a breach-free year in 2016.

3.  The workflow of EHRs will be re-defined. In 12 minutes, can a clinician enter 200 structured data elements, manage 140 quality measures, be empathic, never commit malpractice and make eye contact with the patient? Nope, it’s impossible. This Wall Street Journal piece illustrates the problem. The EHR must evolve from a fraud-prevention tool in a fee for service world to a team-based wellness tool supporting alternative payment models. I’ve told CMS that the ideal EHR will be a combination of Wikipedia (group authored notes) and Facebook (you’ll have a wall of health related events).

4.  Email will gradually be replaced by groupware. Managing daily email is a burden with minimal rewards. Facebook has announced Facebook for Work to provide enhanced communication among teams, supported by enterprise grade security. I receive over 1500 emails a day and might declare email amnesty in 2016 (an out of office message declaring email to be an ineffective communication medium and suggesting that I will never respond).

5.  Market forces will be more potent than regulation. Meaningful use has accomplished its goals. MU is dead, long live MU. We need to move away from prescriptive regulations so complex that no one understands them. Instead, we need pay for performance based on outcomes, giving providers and industry the freedom to achieve these outcomes using whatever technology they feel appropriate.

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