January 23, 2020

Health IT Predictions for 2020

Dave Levin, MD

Chief Medical Officer

It’s January and that means it is time to make some predictions about health IT trends for 2020. This year, I am sticking with the categories of predictions based on patterns observed over the years. So, without further ado, here are my predictions by category for the year 2020.

Promises Fulfilled

*What previously promising technology will begin to fulfill its potential in 2020? *

This category is for health IT efforts that have been brewing for a while but have yet to consistently deliver measurable value (ROI or VOI) through practical use cases.

Dave’s Pick(s): Telemedicine holds enormous promise to reduce time and location as obstacles to care. Widespread deployment of telehealth solutions has faced numerous barriers including provider licensure requirements, tech-heavy approaches, lack of reimbursement, and provider acceptance. There’s been significant progress the last few years in simplifying provider licensure and the widespread use of videoconferencing in other settings is easing discomfort with using this technology in healthcare. The recognition that many types of telemedicine do not require high-definition, two-way video, coupled with advances in general videoconference tech have paved the way for simpler and easier to deploy technology that is suitable for many applications, and at a lower cost. Perhaps most importantly, reimbursement for telemedicine services is improving, making the business case more appealing to the typical provider organization.

Reality Strikes

*What technology, that has been riding high on the hype cycle, will be viewed more realistically in 2020? *

Most health IT goes through a predicable “hype cycle.” This category is for health IT activities that are the deemed the “next big thing” and currently riding a wave of unrealistic expectations that will subside in 2020 as reality asserts itself.

Example Hype Cycle from Gartner

Dave’s Pick(s): The excitement around social determinates of health (SODH) will collide with political, economic, and social reality. Primary care providers (like me) who trained in programs with a bio-psycho-social framework can tell you we have long recognized the impact of phycological and social factors on health. Advanced analytics surely has something to offer in terms of even better recognition of these factors. And it’s terrific that the impact of social factors is getting more attention.

The challenge is what comes next? For example, if the root of the problem are economic (homelessness, food insecurity, and the like), what does the typical provider or health system offer that is effective and economically sustainable? Expect to see more discussion about this “So what?” challenge as the limits of the traditional healthcare system to deal with larger public health and social problems are further exposed.

Megatrends

What major health IT trends will accelerate in 2020?

Trends come in all sizes. This category is devoted to calling out the biggest trends that may take years to play out but will gather momentum in 2020.

Dave’s Pick(s): The pendulum began to swing away from monolithic electronic health records (EHRs) and back towards best-of-breed applications in 2018 as part of the emerging next-generation health IT ecosystem. The entrance of big players like Apple, Amazon, and the rise of EHR-based App stores will continue, fueled by large venture investments. Advances in interoperability and cloud-based computing will, as they have in other industries, continue to chip-away at technical barriers. Since I think it’s inevitable, expect to see more applications designed from the ground up using public-cloud services like AWS.

In 2019, I predicted that this move back towards best-of-breed will benefit from the growing backlash of end-users fed up with awkward workflows and the lack of usability with the current generation of EHRs. When you see editorials co-authored by doctors and nurses in the NY Times on this topic, it’s easy to believe the momentum will continue to build as more providers speak up publicly and more studies demonstrate impact on safety, workforce productivity, and provider burnout.

Sleepers

*What “under the radar” health IT issues will come to the forefront in 2020? *

This category is all about surprises and focuses on opportunities or issues that will burst onto the scene in 2020.

Dave’s Pick(s): Behavioral health IT.I picked this as a sleeper in 2019 and while it didn’t “blow up” in 2019, momentum continues to build. The opioid abuse crisis, decreasing life expectancy largely due to “deaths of despair,” provides the impetus and opening to leverage the funding parity and requirements of the 21st Century Cures Act as well as the synergy with SODH to pursue behavioral health IT.

The battles over interoperability and information blocking will become hotter in 2020 as the proposed rules from ONC and CMS become final. The rules provide a broad framework and guidance, but they are not cookie cutter. Substantial incumbent corporate interests and money is in play. Past behavior is often a good predictor of future behavior, so I expect entrenched interests to engage in foot-dragging, a search for loopholes, and many arguments over the exact meaning and application of these rules. It will take years for this to all play out before we see the actual impact of these rules.

2019 Reflection Looking back at my seven predictions from 2019, I’d argue I was mostly right on four, partially right on two, and completely wrong on one. As I’ve written before, it’s humbling and a good reminder that predicting the future requires a bit of hutzpah and some recklessness! It’s also an essential ingredient in imagining a better future and making it come to pass.

Do you have predictions of your own or thoughts on mine? Drop me a note. I’d love to hear them!


Dave Levin, MD is a co-founder and Chief Medical Officer for Datica where he focuses on bringing healthcare to the cloud. Dave is a nationally recognized speaker, author and the former CMIO for the Cleveland Clinic. He has served in a variety of leadership and advisory roles for health IT companies, health systems and investors. You can follow him @DaveLevinMD or email Dave.Levin@Datica.com

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