A Look into the Future with IDC Health Insights’ Mutaz Shegewi | David Raths, Contributing Editor | Healthcare Blogs Skip to content Skip to navigation

A Look into the Future with IDC Health Insights’ Mutaz Shegewi

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Predictions about blockchain, artificial intelligence, ambient interfaces, digital patient experience

Nils Bohr, the Nobel laureate in physics, was famously quoted as saying, "Prediction is very difficult, especially if it's about the future." Indeed, figuring out the rate at which new technologies will impact the healthcare sector is a tricky business. Yet every year at this time IDC Health Insights releases its IDC FutureScape: Worldwide Health Industry 2019 Top 10 Predictions, several of which touch on the U.S. healthcare provider experience and are quite thought-provoking.

I had a chance last week to interview Mutaz Shegewi, research director for healthcare provider IT transformation strategies at IDC Health Insights. I mentioned to him that some CIOs and CMIOs may be resource-constrained and focused more on the next year rather than five years out. He stressed that the predictions encompass both longer term trends as well as short-term, low-hanging fruit that are low-cost or low-complexity to address. One example he started with was improving the digital patient experience. The FutureScape prediction is that “driven by rising consumer expectations, 60% of healthcare providers will make optimizing the digital patient experience a top 3 strategic imperative by 2020.”

I asked Shegewi if we had surveyed health system executives about this a few years ago, what that number might have been. “For the most part, the digital patient experience wasn’t even acknowledged two or three years ago,” he said. “The conversation was around patient engagement.” The shift to the experiential conversation is being shaped by market forces involving the rise of consumerism and the promise of personalization, he explained. “In the new era of healthcare, health IT and digital transformation of organizations, the thought processes around working with patients and consumers is shifting very quickly.

I wondered whether this shift in focus meant changing responsibilities for health IT leadership or in the types of people they hire.  Shegewi said this recognition about patient experience is happening across the board within health systems. “Previously there was a siloing of roles with the implementation of EHRs and the technology that got us to this point,” he explained. There was siloing between nonclinical IT leadership such as CIOs and clinical IT such as CMIOs and CNIOs. There were further silos between IT and line of business personas — CFOs and chief medical officers. But for organizations that acknowledge the gist of their responsibilities around health IT, patient experience crosses all those roles. It is not the responsibility of any one group.

Another FutureScape prediction is that personal data stewardship practices in healthcare will triple globally by 2023 due to digitally engaged patients bringing their own data and industry- and government-led data guardian initiatives.

In an example of just such an industry-led initiative, last week the CARIN Alliance, a group of more than 60 healthcare stakeholders, released the first draft of a voluntary code of conduct that entities not covered by HIPAA can self-attest to in order to access health data on behalf of consumers.

The paradigm around patient-generated data is still evolving, Shegewi said.  “We have seen some of it come into play with trackers and wearables. We are seeing EHR systems incorporate that data to close the loop of care, but also some skepticism about the accuracy and validity of data. The prediction centers around the increasing role that the individual will play around stewardship of their data. This will be driven by industry- and government-led initiatives. It is something that is emerging as the bargaining power of the patient becomes more pronounced in the relationship with other stakeholders. For the most part in the past that relationship was paternalistic.”

While noting that artificial intelligence has been overhyped sometimes in the past, IDC Health Insights predicts that the steady progress in AI adoption will directly impact 25% of business processes by 2020.

It is still too early to say where it will have the biggest impact, but there are areas where we are seeing AI increasingly introduced and showing promise,” Shegewi said. One of those areas is radiology, where computers are able to perform certain tasks that complement the efforts of a radiologist and facilitate capabilities for a radiologist to draw upon. “Another very promising area is in the clinical documentation and work flow itself. We have seen vendors introducing algorithms for population health analytics or as a virtual assistant within the EHR. They are increasing the ability to do more voice-driven and personalized approaches to the data capture of data and work flows.”

Cybersecurity is another area being affected by AI. In fact, another FutureScape prediction is that by 2022, 40% of healthcare providers will leverage machine learning and AI- algorithm advances to improve their cybersecurity capabilities with automated threat detection to thwart ransomware. “Over the last three years the healthcare sector has come to acknowledge it has a digital trust crisis,” Shegewi said. “With the ransomware attacks came a sudden acknowledgement that we need approaches that are preventative in nature and actively monitoring as opposed to reactive. AI has a huge role to play there.”

Another prediction touches on the frustration clinicians have with EHRs – that they get in the way of clinical care and patient engagement: “By 2022, 50% of clinical apps will include ambient interfaces — speech recognition, sensors, and/or gesture — as their primary data capture model, supported by AI, enabling a 40% rise in data quality.”

“The drive toward ambient interfaces is being driven by the acknowledgment that technology has a role to play, but that it is in the way,” Shegewi explained. “Vendors are starting to slowly acknowledge that they need to find ways to have the technology sit in the background. That is where ambient comes in — speech recognition, gesture and sensors.”

Finally, IDC Health Insights predicts that blockchain use will increase eightfold across healthcare and life science ecosystems by 2022. Blockchain has received a lot of market buzz, Shegewi said. “In healthcare there is more realism being expressed. We may not know yet where the highest impact will be but there are a lot of use cases being explored and piloted. One good example is for supply chain operations and inventory management; another is for provider credentialing. “Blockchain has value as an immutable ledger, so it would make sense to use it as a record locator, giving individuals their own unique blockchain identifiers.”

Let's check back in a few years and see how many of these rang true!

 

 

 

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Investors Have Strong Interest in HIT Sector, Despite Valuation Concerns

December 13, 2018
by Heather Landi, Associate Editor
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Healthcare IT remains a hot investment sector despite concerns about these companies being overvalued, according to KPMG-Leavitt Partners 2019 Investment Outlook, a survey of health care investment professionals.

Looking ahead to 2019, more than a third of respondents (34 percent) said they were most interested in investing in health care IT, followed by care management (31 percent), home health (23 percent), retail-centric medical groups (22 percent) and primary care practices (21 percent).

New York City-based KPMG and Leavitt Partners, based in Salt Lake City, surveyed 175 respondents online from corporations, health systems, investment banks, venture capital and private equity firms between September 17, 2018 and October 21, 2018. Of those surveyed 32 percent were C-suite executives; 29 percent were principal, partner or managing director; 32 percent were vice president or director; 6 percent were analysts/associates and 2 percent held other titles.

“We are not surprised by the great deal of interest in health care IT and care delivery outside the hospital,” Governor Mike Leavitt, founder of Salt Lake City-based Leavitt Partners and former Utah Governor and U.S. Health & Human Services Secretary said in a statement. “As health care continues to march toward value, the emphasis on moving care to lower cost sites and enhanced coordination will continue, and those who can increase quality and lower cost will win.”

According to an October report from Rock Health, 2018 is already the most-funded year ever for digital health startups. Digital health funding in this past third quarter soared to $3.3 billion across 93 deals, pushing 2018 funding to $6.8 billion, already exceeding last year’s annual funding total, which was $5.7 billion, by more than a billion dollars.

Drilling down into respondents’ predictions for investment activity in 2019, in the health care and life sciences market, 96 percent of respondents see either a lot or a moderate amount of investment in health IT and data next year, while a similar percentage (90 percent) see significant or moderate investment in outpatient services. Forty-four percent forecast a lot of investment in post-acute care services, 39 percent predict significant investment in provider services and about a quarter of respondents believe there will be a lot of investment in managed public programs, payer service providers and pharmaceutical and biotech manufacturers. Eighteen percent believe there will be significant investment in medical device and diagnostics and medical equipment.

The survey results indicate there is concern that health IT is overvalued, yet investors believe there is some room to climb.

The majority of investment professionals see health care IT investments as an overvalued sector (64 percent), yet 40 percent expect the valuations to increase in 2019 while 51 percent see them staying the same. About two-thirds of respondents (62 percent) think the health IT sector will grow faster than the market in 2019, and three quarters of investment professionals see increasing competition in the health IT market. Investors also estimate that the average purchase price multiple, in terms of EBITDA, will be 12.5 for the health IT sector in 2019. Survey respondents expect ongoing demand for tools to help with consumerism will impact investment and deal making in the sector, according to the survey.

About four in ten respondents believe the healthcare market is experiencing a “moderate bubble,” while 9 percent believe the bubble will likely burst.

Care management solutions for risk-bearing providers, a highly competitive sector which helps coordinate care of the chronically ill or seriously injured, are expected to be the second highest sector for investment behind health care IT, similarly driven by trends of consumerism and increased focus on early care interventions.

Looking at potential drivers of M&A activity in the health care and life sciences sector in the coming year, 64 percent of respondents cited cost consolidation and economies of scale, while 45 percent cited accretive acquisition strategies. Forty percent of respondents see changing payment models as a driver of M&A activity, and 38 percent cited pressure from competition. Other drivers cited by respondents include expansion/divestiture of service areas (25 percent), geographic expansion/contraction (24 percent), revenue synergies (22 percent), need to deploy cash on balance sheet (17 percent), and regulations and legislation (13 percent).

“Deals are largely being driven by the need for savings, economies of scale, and improving cash flow or accretive earnings per share,” Carole Streicher, Deal Advisory leader for healthcare & life sciences at New York City-based KPMG, said in a statement. “Secondarily, there is a bit of a defensive posture motivating investments as health care organizations contend with competition and reimbursement models connected to quality and efficiency, as well as the entrance of tech firms investing in the sector.”

 

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Report: Massachusetts General Hospital Targeting Various Blockchain Use Cases

December 7, 2018
by Rajiv Leventhal, Managing Editor
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Massachusetts General Hospital (MGH) researchers are partnering with MediBloc, a Korean healthcare blockchain company, with the aim to improve patient data sharing and storing, according to an article in CoinDesk.

Per the article, the Laboratory of Medical Imaging and Computation by MGH and Harvard Medical School will be escalating research in a variety of broad areas “from medical image analysis to health information exchange by leveraging our cutting-edge technologies such as blockchain, artificial intelligence and machine learning,” according to Synho Do who is the laboratory’s director.

Do specifically told CoinDesk, “In collaboration with MediBloc, we aim to explore potentials of blockchain technology to provide secure solutions for health information exchange, integrate healthcare AI applications into the day-to-day clinical workflow, and support [a] data sharing and labeling platform for machine learning model development.”

Interestingly, MGH won’t be using any real patient data for its research, but rather simulated data, according to officials, since the various institutions that have the real patient data keep it in a way “that can’t be shared securely and often is in various incompatible formats.”

MediBloc’s CEO noted that the company is not only developing a distributed ledger for storing and sharing medical data, but also working on a tool that would convert data now held by hospitals from existing formats to a universal one, per the article.

For this initiative, MediBloc has already gotten partners across Asia, including eight healthcare organizations and 14 technology companies, officials said.

Earlier this year, a testing environment version of the blockchain was launched, and the network is expected to go live before the end of the year before becoming fully functional in the second quarter of 2019. Furthermore, there are also apps in the works that are planning to go live next year, with one of them, currently in a beta testing phase, “designed for patients to sell the information about their symptoms and the prescriptions they get to MediBloc. After that MediBloc will analyze that data and sell the analysis to pharmaceutical and insurance companies,” according to the story.

In the end, the main goal of the blockchain project will be to let patients independently decide what to do with their information.

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Medicaid Transformation Project Expands to 24 Health Systems

December 6, 2018
by Heather Landi, Associate Editor
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Seven new health systems have joined the Medicaid Transformation Project, a national effort to transform healthcare and related social needs for the nearly 75 million Americans who rely on Medicaid.

In total, the project now includes 24 health systems that comprise 342 hospitals, more than 65,000 beds, in 25 states with over $121 billion in combined annual revenue.

The Medicaid Transformation Project, which was announced August 28, was formed with the vision that healthcare organizations can work collaboratively to enable better health and outcomes for vulnerable populations, while also reducing costs, through the adoption of digitally-enabled care models. The project is led by AVIA, a network of healthcare organizations committed to digital transformation, and Andy Slavitt, former Acting Administrator of the Centers for Medicare & Medicaid Services (CMS).

The project initially began with 17 health systems, with five health systems anchoring the work—Advocate Aurora Health in Chicago and Wisconsin; Baylor Scott & White Health in Dallas; Dignity Health in San Francisco; Geisinger in Danville, Pa.; and Providence St. Joseph Health in Renton, Wash.

The project worked with health systems to target four critical challenges over the next two years to better meet the needs of vulnerable, low-income populations: behavioral health, women and infant care, substance use disorder, and coordinating community care to reduce avoidable emergency department (ED) visits.

The seven new health systems joining the Medicaid Transformation Project span distinct geographic and socioeconomic markets: BayCare Health System in Clearwater, Fla.; Boston Medical Center in Boston; Cedars-Sinai in Los Angeles; Carilion Clinic in Roanoke, Va.; Children’s Hospital Colorado in Aurora, CO; Jefferson Health in Philadelphia; and University Hospitals, in Cleveland.

According to Medicaid Transformation Project leaders, underpinning this action is an acknowledgement of the current health disparities seen in communities across the country. A leading indicator of such disparity is life expectancy, which is highly correlated with ZIP code, income, and race because care delivery varies greatly based on those factors. Insufficient healthcare access, patient engagement, and social determinants create variations in life expectancy that can be as great as 16 years between communities that are just a mile or two apart. The Medicaid Transformation Project’s commitment is to close the gap in care and outcomes in communities in need through a renewed focus on innovation and investment, leaders say.

“The current healthcare delivery system needs to be disrupted to dismantle health inequities. At Jefferson Health, we believe that collaboration and creativity will drive this necessary transformation,” Stephen Klasko, president and CEO of Jefferson Health, said in a statement. “We’re joining the Medicaid Transformation Project to learn from others across the country and to find the best innovations that improve care and outcomes for the most vulnerable among us.”

The 24 participating health systems have decided to initially focus on transforming the role of the emergency department, and leaders recently convened in Chicago to discuss how to better position EDs for sustainability and care coordination.

To do this, project participants are seeking to improve linkages from the ED to other critical parts of the delivery system, namely primary care, behavioral health, specialty care, and social services and supports. The underlying goals are reducing unnecessary ED visits, reducing avoidable ED visits, and improving patient disposition and sustainable transitions at the moment of discharge, project leaders say.

“By bringing together the nation’s leading health systems, we have a unique opportunity to improve the health of underserved populations in a way that hasn’t been done before. We’re committed to sustainable, durable solutions that improve care and outcomes for people. We must consider the best existing and new ideas and invest in the right ones,” Andy Slavitt, Medicaid Transformation Project Chair, says.

At the Action Forum, Medicaid Transformation Project participants discussed care models that had shown success—but had been previously limited by barriers in labor, cost, or technology. They viewed 10 on-site demonstrations of scalable solutions and engaged directly with company founders to explore relevant care models, ranging from community health worker (CHW) programs to virtual triage. They gathered insights from one other and from leading Medicaid experts, including Molly Coye, M.D., former Commissioner of Health for the State of New Jersey and Director of the California Department of Health Services, and Vikki Wachino, former Director of the Center for Medicaid and CHIP Services.

“The collaborative model of the Medicaid Transformation Project is providing us with a new and necessary lens to view a long-standing challenge, which is improving access and coordination to community care,” Thomas M. Priselac, president and CEO of Cedars-Sinai, said in a statement. “Our team is excited to share what we’ve learned working with our community partners, and to scale new digital solutions that lower long-standing barriers to care.”

The health systems in the Medicaid Transformation Project will next select scalable solutions to extend care models and begin early implementation. “These 24 health systems have put a stake in the ground around transforming the function of the Emergency Department in communities with heightened vulnerability. By acting locally and collaborating nationally, we can create a force-multiplier effect that will inspire ripples across the country. We’re honored to help lead this work,” AVIA President Linda Finkel said in a statement.

The Medicaid Transformation Project will launch its next body of work on behavioral health in January 2019.

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