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The Year of the Patient in HIT

By Betty Rabinowitz, MD, FACP

As we move forward into the new year, it’s natural to try to predict what HIT trends will have the greatest impact in 2019. Many experts have singled out artificial intelligence (AI), machine learning, blockchain technology, and voice applications. I wholeheartedly agree that these health technologies and applications are garnering significant investment and industry focus. It is indeed exciting to think about applying AI to generate actionable insights and predictions using health care Big Data or applying machine learning to error-prone tasks in the physician’s workflow to increase patient safety.

This year, as in years past, I wonder how many of these predicted innovations will materially impact the day-to-day lives of practicing physicians across the country. I have a strong sense that, in reality, most practicing physicians will not feel the impact of these technologies for some time. I do, however, think there are HIT trends and themes that will impact practicing physicians in meaningful ways in 2019.

My central prediction for 2019 is that many HIT systems and platforms will be challenged to shift their focus from physician and health care team workflows to the patient. I say this because there are mounting regulatory requirements and incentives that now truly place engaged patients at the center of the clinical endeavor.

Take, for example, the recent requirement for hospitals to provide patients full access to the pricing of their care and the now-prevalent expectation that patients should be able to access their actual care notes and charts on demand—these are going to challenge health care organizations and their HIT systems to the core.

This call for transparency clearly exposes the complexities and idiosyncrasies of health care billing and pricing and the lack of clear industry standards. In reality, few systems natively produce information understandable to the average patient. I predict this requirement will generate tectonic shifts in the way pricing and costs are set, documented, and shared with patients.

2019 will also be the year many HIT platforms have to meaningfully collect and incorporate information pertaining to patient’s social determinants of health. Population health management platforms will likely be challenged to include these data elements in advanced risk and predictive algorithms, and, most importantly, population health management platforms and EHRs will need to interoperate with community resources to generate actionable referrals to nonclinical entities, such as food pantries and homeless shelters.

Patient ease of access and convenience will continue to be central themes. As a result, enabling technologies will thrive and proliferate. It will be interesting to see whether incorporating these capabilities into more primary care offices in 2019 will stem the rise of the freestanding telemedicine companies, which proliferated in the absence of these capabilities in traditional primary care practices.

Patient engagement is going to attract increasing focus in 2019. Algorithms to predict “impactability” will further evolve, along with more sophisticated risk stratification and predictive models that will allow practices to identify, engage, and impact patients with the greatest needs.

In summary, I predict 2019 is the year in which the HIT industry shifts from a physician-centric view to a view in which the focus is (and includes) the patient. In this regard, I think 2019 is going to be a great year.

— Betty Rabinowitz, MD, FACP, is chief medical officer of NextGen Healthcare.