Day 12: Drummers Drumming on 2021
We have come to the end of our 12 Days of Christmas Posts and as always we want to wish you happy holidays and new year.
I am thinking like me, few want to look back and reflect on 2020. It is all eyes ahead to 2021. With vaccines shipping and being administered, with new testing and therapies being approved, and with a new administration set to take over we are all hoping there is a light at the end of this dark tunnel.
On day 12 we have selected 12 of our radio shows and asked the hosts to help us look to the future. Here is what they have to say.
The Tate Chronicles
In 2021 we will see how well state healthcare systems can handle the COVID-19 vaccination rollout. The complexity of this project is truly immense with issues related to supply chain, prioritization of recipients, data tracking, notifications, and decisions as to the locations where the vaccine will be administered. We are about to see what challenges are ahead in the quest to vaccinate hundreds of million citizens as quickly as possible. There are bound to be challenges, but the ability to address those will be the true test. Here’s hoping and wishing that this will be a unified effort with quickly established best practices.
Host of Payment Matters
2021 will be the year where the consumer experience matters more than ever before. New price transparency rules and a growing need for safe, contactless interactions stand to alter the way consumers approach care. Healthcare organizations should prioritize the consumer experience, especially when it comes to payment.
It is unclear what impact the CMS Hospital Price Transparency Rule, which goes into effect January 1, will have on the patient experience. InstaMed’s Trends in Healthcare Payments Tenth Annual Report revealed that 91% of consumers are surprised by a medical bill. Many factors such as contracted rates, deductible balances and coinsurance percentages all impact the amount the patient ultimately owes. Transparency of pricing may clear up some confusion, but the lack of tools on payment assurance and education on health insurance terms need to be factored into the consumer experience. Healthcare organizations should look for ways to help patients and members understand and collect their payment responsibility throughout the journey. What is needed are people, process and technology changes – not just government mandates – to make this better.
The COVID-19 pandemic accelerated the adoption of technology to help minimize contact and the spread of germs. Contact-free payment transactions have become the preferred way to do business across industries, and consumers will expect the same of their healthcare experience. While healthcare has historically relied on paper and manual processes for payments, the industry now has the opportunity to surge into a digital landscape. Options like online payments, tap to pay and mobile payments should become the standard for consumer healthcare payments.
Healthcare de Jure
It is a safe bet to say that digital health and telehealth will continue to be utilized and expand within healthcare. One specific area primed for greater growth is remote patient monitoring. It is arguably a gateway to broader telehealth use cases because it can be implemented relatively easily and provides an immediate financial benefit given reimbursement that existed pre-COVID-19. Remote patient monitoring is also a gateway to value-based care delivery because it encourages and enhances collaboration and communication between patients and care teams. All of the benefits are gaining better recognition along with maturing support, which should translate to an even more prominent role in 2021.
How I Transformed This
There has been a lot of discussion about how telehealth in healthcare will continue to soar next year due to COVID. I agree that we have all become more accustom to virtual visits and there are very convenient for both the patient and the provider. I expect the trend to continue, but also expect the need for human interaction whether virtual or in-person with the really tough behavioral health issues that continue to rise. As the “digital front door” is expanded at health systems and payers, I also predict that efficiencies with transformational technology that make it easier and more productive for all of us to connect. We’ve learned this year that we can get more done without traveling across the country or across town. Being virtual allows us to touch more people and make more impact as individuals and a company.
The Scope with Dr. K.
The dark cloud of COVID-19 will pass in 2021 and the sun will shine again. Unfortunately, that light will reveal the carnage of the pandemic and will expose the structural flaws that led to the severity of its damage. In rebuilding, our goal should not be to build things back the way they were before, but rather to rebuild them fixing the infrastructure problems so that we can create a long-range solution for the future.
Looking back at 2020 – Always Look on the Bright Side of Life
While the Pandemic played havoc with many things we considered normal, decimated lives, health, industries, communities, and countries there were some bright moments to be found. So in the spirit of my glass being full (half full of whisky and half full of air) here were some stand out positives from this past year: Working from home became mainstream along with a decline in commute misery and telemedicine and telehealth came of age (finally).
For 2021 – Keeps Gettin’ Better
We will have several vaccines available and they will roll out, but the impact of COVID19 will not disappear overnight. The good news is this will provide an extra tool to the toolbox to combat the pandemic. There will be better testing options that will become a standard part of our lives but it will come with complexity in our regular lives, tracking and surety of the data but innovation and brilliance of the hive minds will overcome these problems. We will continue to suffer from the polarity in opinions and the erosion of trust in the our leading science organizations that will challenge acceptance and uptake of the above solutions. We will start to see the long tail of COVID19 that is not just confined to a long term clinical effect but will include huge brain health difficulties in all parts of our society and world and will require more kindness and compassion from everyone.
Well, it won’t be quite like 2020 that’s for sure, and may that year rapidly fade in the rear-view mirror.
So, here’s the gimme’s:
- 2021 will see a return to science-based decision making in healthcare.
- Hospitals will do nearly whatever they can to make up for the shortfalls they experienced this year, further delaying the move to value-based care and with it, even with all this talk of population health and health disparities, which reared its ugly head during the COVID Pandemic, 2021 will not see the rapid changes we need to address the underlying root causes.
- Pharmaceutical companies will ride their recent success in rapidly developing effective COVID-19 vaccines, indeed a major achievement, to mitigate government efforts to control their cost’s.
- Medicaid expansion will become further incentivized by the large number of Americans who have lost their jobs due to COVID and the new administration’s focus on the ACA.
And here’s the bold one.
CRISPR Gene editing, developed by Nobel Laureates Jennifer Doudna and Emmanuelle Charpentier will be used to cure one genetic disorder.
The macro gain?
2021 will present an opportunity to return to empirically driven and evidence based health policy anchored at the federal level via value added collaboration with both state and county health authorities.
The Biden/Harris administration will value leadership competence and a commitment to public service that is at the heart of what it means to be ‘called’ to serve the American public as healthcare professionals whether clinical, administrative or in the health tech or health IT space.
My top predictions include:
- Valued based healthcare will be at the center of the Biden/Harris administration agenda with an emphasis on ‘fixing’ the Affordable Care Act’ (ACA), i.e., Medicaid expansion, the return of a public option, restoration of essential premium subsidies and possibly the return of non-profit, community owned Co-Ops.
- Clear and consistent Federal support of health insurance exchanges whether federally facilitated or state administered.
- The continued support for service delivery innovation at the Center for Medicare and Medicaid Services bolstering primary care; and
- The nomination of Xavier Becerra, California’s current Attorney General and the lead in Texas v. United States a coalition of 20 states and the District of Columbia will return competence to the Department of Health and Human services eviscerated by weak and politically motivated leadership of Secretary Alex Azar and the Center for Disease Control (CDC) with the nomination of Dr. Rochelle Walensky, the current Chief of Infectious Diseases at Massachusetts General Hospital (@MGHMedicine) vs. the abdication of leadership by the current director Dr. Robert Redfield.
The national nightmare is almost over!
Yet, we have much work to do to get through this pandemic and right the ship of a flailing and underperforming U.S. healthcare economy (i.e., obscene costs, highly variable quality and outcomes, spotty access, health in-equites, disparities and endemic institutional racism), the net effect of which is a decade plus of restraining middle class wages while transferring household wealth to an industry model that cannot effectively manage clinical risk and thus transfers the excess cost burden to covered beneficiaries via increasing deductibles, co-pays, caps, limits and other benefit redesign (reductions).
Yet, I am optimistic we can and will deliver on the to date illusive triple aim.
This Just In
I see that virtual care will expand in every corner of this country and that we will deploy healthcare consumerism best practices at a faster clip than ever predicted before. Healthcare practices and organizations, large and small, will be implementing enhanced digital front door, telehealth, RPM and remote care management strategies to capitalize on patient demands and deliver care how and when patients require.
I also see the organizations that are thinking strategically in these patient engagement and virtual care areas increasing staff and adding to their patient panels as we have seen many smaller organizations unfortunately go out of business but those care providers and patients are being picked up by larger organizations in many cases whom are capitalizing on how this market is quickly shifting beneath us.
I also predict the fastest interoperability progression in our industry, ever. API and standards-based interoperability are being greatly enhanced through the efforts of the ONC and the Cures Act to securely ensure the right information gets in the right hands at the right time to provide optimal patient care. I have personally been working on this for over a decade and very excited and optimistic of what this increased interoperability focus will yield for patients, care providers and getting the much promised ROI out of our national healthcare investments.
Tragically, a significant level of health-related technology will be shaped by the on-going tragedy of the COVID-19 pandemic. As providers seek to manage continued COVID hospitalizations, post-COVID patients suffering from chronic conditions, vaccine advocacy and ambulatory volume normalcy, many will focus on extending and maximizing their digital health resources in several areas:
Digital Care Redesign and Experience: The pandemic has forced hospitals to accelerate their digital maturation and transformation. Much of this transformation has been reactive and will need to be fully integrated into existing care design and patient journey models. While remote health and telehealth models of care delivery increase access and patient engagement, there will likely be more research devoted to its impact on patient experience and provider/patient satisfaction. In addition, hospitals will generate increased data on the impact of increase remote care on overall patient outcomes.
Healthcare Disparities: COVID-19 has done nothing if not reinforced the racial and economic disparities in our understanding of population health and care delivery. Sadly, Black and Brown communities are at higher risk of infection and death from this virus. With the proliferation of mobile device use in all socioeconomic groups, hospitals will begin to better leverage mobile device solutions to improve monitoring and medical adherence in communities who suffer from disparities in care.
Vaccination Planning and Advocacy: An inconsistent federal response to the pandemic combined with historic controversies surrounding vaccinations, will create challenges with COVID 19 vaccine adoption. As trusted sources of healthcare in their communities, hospitals will assume of the role of chief vaccine “evangelists” by assuring safe and effective vaccinations. Public and personalized digital communications will drive effective vaccine messaging and tracking.
Harlow on Healthcare
I expect 2021 to be an exciting if confusing year for healthcare innovation. As we plan for a post-COVID-19 world, we will need to create shared expectations about the future uses of telemedicine and digital health services — there’s no getting that genie back in the bottle — and the approval, licensure and reimbursement environments for these services. The federal government has taken some initial steps via regulatory and sub-regulatory action, but some legislative fixes are needed as well, and they will require bipartisan cooperation.
1st Talk Compliance
2021 will, without question, be a far better year than 2020 has been, largely because of the superlative work of the pharmaceutical industry, which has developed highly effective vaccines, and due to the rapid expansion of telehealth, allowing people to slowly resume some of their pre-COVID lifestyles. Of course, vaccines will not eliminate COVID entirely and, like all medications, they give rise to other types of health issues, so we must continue to exercise vigilance and use common sense to protect and preserve our well-being. And every tragedy spawns those who desire to profit from it, and as HHS has warned us, 2021 will likely be rife with scam artists who may concoct COVID related schemes of every sort, like phony contact tracing, counterfeit vaccines, or other types of fraudulent miracle treatments. Finally, while COVID has demonstrated how resilient and dedicated the health care workers are, I believe 2021 will give rise to increased precautionary measures that will help mitigate future global health emergencies.
Healthcare IT Today
2021 will be a tale of two halves. The first part of the year will test our mettle as a society. How tolerant will we be when limited supplies of COVID vaccines slowly roll out? Will we rally one more time to support overworked and stressed healthcare workers as they deal with the carry-over surge in cases? Do we have enough love for each other to lift up those who have lost their jobs, homes and loved ones to this virus? The optimist in me says we will, but it won’t be easy. In the second half of the year, the world will slowly emerge from hibernation. We will travel again. See friends and family again. Enjoy live sports again. Get back to work again. Specifically for healthcare, in this second half, we will see strong momentum for care-at-home services + technologies. The pandemic has shown us that stacking elderly loved ones in a single building isn’t the best idea. 2021 will mark the beginning of the era of remote care and aging-in-place.
And we close with John’s great 12 drums of 2021!
The following are 12 topics that are getting their drum beaten as we head into 2021. Not all drums are created equal, but they all contribute in different ways. Here’s how I see the 12 drummers drumming when it comes to health IT in 2021.
- EHR is the Bass Drum. Many people think it’s not needed, but once the bass is removed they realize that it’s essential. There’s no getting around it. It’s the connective tissue for so many things.
- Telehealth is the Hi-hat. It’s always there and been obvious, but you don’t want to overdue it. The Hi-hat is very versatile, but it’s often just the start of something bigger.
- Remote Patient Monitoring is the triangle. It adds so much value when used in the right places, but most people don’t realize how valuable it is until they experience it themselves.
- Remote Work is the conga drum that everyone can play and have a good time.
- SDoH is the Tambourine. We’re not even quite sure why it’s with the drums, but we all know the value that it adds. We’re just not sure how to use it properly.
- Patient Communication is the Bangos. Many people don’t think it’s essential. Although, once they experience it, they understand the value this can bring.
- Security is the Kick Drum. Most people don’t even realize what’s happening and the importance of it.
- AI is the Cymbal. Always comes in with a bang and then kind of disappears for a while until it explodes again.
- Healthcare Analytics is the Snare Drum. It’s the basis of most drumming and is involved in pretty much everything.
- Ambient Clinical Voice is the Tenor Drum. Most of you probably don’t even know what a tenor drum is and it takes an amazing amount of coordination to make this drum sing. However, once you do, it’s one of the most amazing things to behold.
- Healthcare Consumerism is the Toy Drum. Everyone loves to play with it and talk about it, but it’s currently more of a toy that people like to play with versus a real drum.
- Interoperability is the Timpani. It’s really hard to do and takes someone with extreme expertise. However, when they’re great at it, then it’s amazing.