HIMSS 2019 Healthcare Trends: Digital Health, Consumerism, Demographic Challenges, and Data Governance

There is a famous American proverb: “May you live in interesting times.” Regardless of the true meaning behind this adage, many believe that the healthcare industry is currently experiencing its own “interesting times.”

The Health Information and Management Systems Society (hereinafter referred to as HIMSS), a non-profit organization dedicated to advancing healthcare, believes that the healthcare industry is currently undergoing an unprecedented period of transformation in both scope and scale.

February 11–15, the 2019 HIMSS Global Conference & Exhibition was held in Orlando, Florida, USA. As the world’s leading health information technology event, it brought together 45,000 professionals, clinicians, administrators, and vendors from over 90 countries.

On the eve of the conference, HIMSS, incorporating insights from the leadership of Healthbox, Health 2.0, and PCHAlliance, released“2019 Healthcare Trend Forecast: The Beginning of Consumer-Driven Reform”white paper report, aimed at helping healthcare industry practitioners understand industry changes and explore the prospects and potential of information and technology.

This report elaborates on the following four major trends:The impact and applications of digital health, consumer influence, financial and demographic challenges, and issues related to data governance and policy.VCBeat (WeChat ID: vcbeat) reporters have compiled and translated the contents of this report for our readers.

Currently, several factors are fundamentally disrupting the business models of the healthcare industry. These factors include: the shift toward value-based care, rising healthcare costs, consolidation of healthcare systems, the impending “silver tsunami” (accelerating population aging), regulatory pressures, consumption upgrades, the entry of major technology players into the market, and the expanding potential of digital health tools.

Traditional healthcare institutions operate in a passive mode. Emerging enterprises have found that the healthcare industry is not as easily disrupted as the retail sector.

“Today, consumer pressure is driving disruptive change in the healthcare sector. Digital health technologies are beginning to deliver on their promise by helping healthcare providers understand individual consumer preferences and deliver personalized care, thereby effectively coordinating care across the entire health ecosystem. By fully harnessing the potential of information and technology, we can create a global community of innovators, care providers, and patients that is increasingly informed and empowered,” said Hal Wolf, President and CEO of HIMSS.

In recent years, digital health tools have been a focal point of healthcare innovation, but 2019 will be the year when digital health innovators are held accountable for delivering tangible results. Pressure from consumer demand and the policy and regulatory environment will become the primary drivers strengthening accountability. With the FDA’s Pre-Cert pilot program and the CMS Innovation Center opening their doors, government-imposed barriers to digital health innovation are expected to continue declining.

Meanwhile, policymakers will more actively explore policy changes to accelerate product time-to-market, thereby enhancing patient access, improving healthcare efficiency, alleviating provider burden, and creating new pathways for non-hospital-based medical services.

In this context, digital health innovators will need to demonstrate how their technologies enhance access to healthcare services and narrow gaps in care and coverage, rather than merely launching a gadget to market.

Pressure on standardized advanced interoperability systems will continue to intensify, as they are required to accomplish their mission—helping to improve the ways information is shared and care is managed—more rapidly than ever before. In 2019, new tools and technologies will move more quickly from the testing phase to the market stage to meet growing consumer expectations and mounting pressure from policymakers.

As the digital health industry matures, we will see more concrete applications of digital health technologies in the real world, such as:

1.Artificial Intelligence (AI) and machine learning willWidely adopted in population health, thereby enhancing the identification of high-risk groups and enabling personalized (precision) treatment.

2. Virtual Reality/Augmented Reality (VR/AR) will serve as a standard treatment for postoperative pain control, and even as an adjunctive therapy for chronic pain management.

3. Wearable devices and implantable medical devices can enable more routine monitoring of chronic diseases and their treatment efficacy.

4.As the use and impact of digital therapeutics continue to grow, it will serve asalternatives to traditional treatment approaches (such as the Diabetes Prevention Program and other models related to preventing or mitigating the impact of chronic diseases) orAssistMethods(e.g., enhancing medication adherence)。

5. Speech recognition and intelligent assistants will be widely used to alleviate the burden on clinicians.

6. Amid extensive media coverage, blockchain, as a complementary technology for interoperability, is expected to gain greater prominence in 2019.

Blockchain/Distributed Ledger Technology (DLT) will be leveraged as part of a broader interoperability “toolkit” to eliminate redundancies and friction points currently present in the system (i.e., claims adjudication, benefits realization, provider credentialing, etc.). DLT is not a “panacea”; it is essentially middleware designed with transparency as a core principle. Although it will be used to facilitate dialogue with stakeholders and explore new business opportunities, these stakeholders are currently unable to “communicate” with one another due to misaligned incentives and technical infrastructure.

In 2019, external market disruptors entering the healthcare sector, such as Amazon, Google, and Walmart, will continue to leverage their understanding of consumer demand and machine learning tools to meet and exceed customer needs in ways that the traditional healthcare market cannot yet achieve.

Although these companies have a profound understanding of consumer needs and expectations, they lack awareness of the depth and complexity of healthcare services. Meanwhile, as consumers shift their attention to care services that offer convenience, choice, and cost transparency, they will increasingly demand patient-centered, personalized services.

Healthcare systems are not known for their flexibility; the challenge they face is to develop solutions that attract and retain healthcare consumers, while delivering a superior consumer experience that is as easy to use as online banking and retail interactions.

Unless healthcare systems rapidly evolve and transform to keep pace with new disruptors entering the market, they will find themselves ill-equipped to attract new consumer segments in the competitive landscape.

As healthcare institutions gradually adapt to these consumer pressures, healthcare will continue to shift toward a value-based model, with greater emphasis on patient-centered care. This evolution will be reflected in the following specific areas:

1. Healthcare providers will see influence from payers (such as Amazon, JPMorgan Chase, and Berkshire Hathaway) as they seek to manage costs across the entire healthcare value chain.

2. Healthcare organizations will continue to integrate various healthcare solutions to support value-based care, placing greater emphasis on investing in infrastructure to securely and scalably support these initiatives (e.g.,Telemedicine, Precision Medicine, and Other Consumer-Facing Technologies）。

3. The widespread adoption of integrated clinical supply chain capabilities will help healthcare organizations gain deeper insights into consumption patterns, as well as downstream traceability and trackability under clinical influence, thereby improving financial and clinical outcomes.

4. 2018 was a pivotal year for specialized, high-touch, technology-enabled, and value-driven primary care practices serving Medicare and Medicaid populations, including Iora Health, Oak Street, VillageMD, and the launch of Devoted Health. In 2019, the industry may see some large-scale acquisitions or consolidation activities.

Veteran player 23andMe (a genomic diagnostics company) raised substantial capital in early 2019, Helix acquired genomics assets, Nebula Genomics, and its blockchain platform through its “app store,” and GRAIL was also poised for an initial public offering (IPO).

For more than a decade, the industry has been striving to move DNA sequencing technology out of expensive, expert-controlled settings. HIMSS predicts that by 2019, DNA sequencing will become mainstream and increasingly direct-to-consumer.

Financial pressures on healthcare providers will continue to mount as medical organizations strive to do more with fewer resources, delivering higher-quality and safer care while reducing costs. These pressures will be further exacerbated by the “silver tsunami,” with approximately 11,000 Americans turning 65 every day.

This growing patient population, many of whom have complex health issues, will be coupled with consumers’ strong demand for cost transparency—specifically, how increased healthcare spending translates into high-quality, efficient, and accessible medical services.

To meet these demands, healthcare systems, payers, and providers will be compelled to advance value-based healthcare services, keeping costs for the industry and consumers at a low level.

We will see the healthcare industry’s efforts to achieve this goal, such as further advancing value-based care by, to some extent, managing the growth of Medicaid and Medicare Advantage.

Furthermore, demographic challenges will drive the development of healthcare services, as the medical industry works to address health disparities among patients in low-income areas—including both rural and urban regions—where access to care remains limited. Therefore, we can expect:

1. New digital health tools and technologies are being used to bridge geographical gaps, providing 24/7 care services regardless of where patients are located.

2. Population and public health analytics are increasingly used to identify high-risk groups and develop personalized solutions based on social determinants of health, such as genetics, geography, gender, income, and occupation.

3.Leverage powerful tools and technologies such as virtual care, telemedicine, electronic health records (EHRs), intelligent technologies, and AI-driven automated clinical decision support to extend healthcare services beyond the hospital setting.

In 2018, it became clear that traditional healthcare alone could not bend the cost curve, and that the social determinants of health must be at the forefront of healthcare.

In 2019, companies focusing on the social determinants of health and how to integrate healthcare services will play a greater role in triage, data-driven care, continuous care, and personalized action plans. New applications of health information and technology will improve the delivery of healthcare services, break down information barriers, and enhance the health status of individuals worldwide.

Policymakers focused on health information and technology will pay attention to potential policy changes, driven by two motivations:Privacy and Security. Safeguarding cybersecurity will become the top priority for healthcare decision-makers, as malicious actors view the healthcare sector as an industry where they can create uncertainty or generate profit.

Due to the actions of malicious actors, healthcare organizations worldwide are striving to deliver accurate patient information to formal medical institutions in a secure and timely manner. In 2019, policymakers will look to private enterprises and their policy-making counterparts in other countries to determine what policy changes need to be implemented to safeguard information sharing.

In 2019, consumer privacy will also garner significant attention. As companies adjust their privacy protection measures in compliance with the General Data Protection Regulation (GDPR), policymakers will place greater emphasis on safeguarding consumer data privacy at varying levels.

In the near future, healthcare will be incorporated into discussions and analyses as policymakers begin to explore how policies can enhance consumer confidence in the security of medical data transmission.

For example, in the United States, the Trump administration is expected to seek public comment on modernizing the HIPAA regulations. The U.S. Congress and state legislatures may begin discussing this matter in 2019.

HIMSS stated that in 2019, digital and connected health technologies were poised to replace traditional healthcare models and move toward widespread adoption. Early experience has shown digital health practitioners that opportunities for innovation emerge at the intersection of healthcare systems, providers’ workflows, and patients’ living environments.

Digital health practitioners integrate these key factors into medical tools, healthcare services, electronic health records (EHRs), improved user interfaces, and flexible behavioral response mechanisms. Healthcare providers are seeking optimal pathways to integrate emerging technologies such as artificial intelligence, virtual reality, and digital therapeutics, thereby delivering high-quality healthcare services to patients at their location whenever needed. Moreover, consumers are placing higher demands on healthcare providers, requiring them to offer round-the-clock medical services.

Finally, HIMSS recommends that all stakeholders across the entire healthcare ecosystem adopt this comprehensive development model in 2019 to drive the healthcare industry toward better progress.

Editor’s Note: The content of this article is adapted from the white paper “2019 Healthcare Trend Forecast: The Beginning of Consumer-Driven Reform,” recently released by HIMSS.

(Compiled by Cheng Xiaoqin)