Friday, January 5, 2018

Health IT Headlines for 2018

As promised, I'm following up on my easy predictions with some more difficult ones.  I'm sort of spoofing on the ending of Wait, Wait don't Tell Me, with Onion style headlines, because this is more of a wish list than a set of predictions.  Here goes:

Block Chain Finally has a Reason to be Used in Healthcare

I think this is possible in 2018, though possibly unlikely.  Most likely area of utilization will be in inventory management.  Block chain is pretty good at maintaining a ledger of things that need to be counted.  If we'd had "block chain" back in HITSP days when looking at situational awareness for Immunziations, someone would have been likely have tried to apply it, to which someone else would have said: "But block chain isn't a standard." [For what it's worth, it still isn't].  Where I see some possibilities is in dealing with accounting for stuff that needs to be managed, and immunizations might be a good place to start with that.

HIE of One actually Does Something

Here, I think we are in do or die time for HIE of One.  I see two possibilities:
  1. It adapts to FHIR and vice versa, and patients can finally access their own data in one app all together and easily.
  2. It starts to shrivel up and die.
This is one of those initiatives for which the hype is good, and the reality sucks.  The problem of the HIE of one today is NOT technology, there's plenty of technology that can make this work.  The real problem is creating a business model for it that can dis-intermediate the entrenched players, where the developers of it can still make an honest living providing a valuable service.  Some I've heard talk about it speak quite fondly of open source.  But the reality of Open Source is that someone is paying most developers to write the code.  There's an income stream funding the effort, even though the "software is free", and the effort is "donated by volunteers".  And Open Source won't pay for the essential infrastructure that will be needed to manage this. 

I don't expect I'll be able to adopt some sort of HIE of One product to access data from my current and past providers in 2018, but I expect to see some capabilities developed that will allow me to start down that path being released towards the end of the year.  I expect I'll be looking.  I had a doctor's visit today, and he and I had to sit through the painful process of me logging in, requesting my username via e-mail (which I forgot because my id was assigned to me instead of self-chosen), and finding my immunization history.  Yes, in fact, I did have a TDAP in the last 10 years, and am not due for another one till 2021.

Direct to Consumer Care Bundles

It will start with something simple, but I expect that care providers will start putting together price fixe care bundles for certain conditions, and offering them DTC just like pharmaceuticals are pushing medications. 

Do you have ___? Are you satisfied with your current treatment? Tired of having to go to three different places for all of the care you need? Come to ___, and for just $$$, we'll put you in our guaranteed treatment plan.Lots of really small print to scroll on the right hand side of the screen while the advertisement is playing regarding limitations and et cetera.

Advanced Visualization in the EHR

It's happening today, but it's mostly in demo-ware, and physicians don't understand it, and hate it or love it, and most really haven't gone anywhere.  But I'm praying that someone will finally figure out a user experience to give a physician an overview of the patient on one screen, with the ability to easily navigate to the details THEY think are pertinent or relevant.

What I kind of envision here is that someone teams up with ILM or similar and gets them to design something like we see in various Sci Fi movies, which actually gets built.

And if any of these things actually happen in 2018, remember that you heard it here first.



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