Three developments to expect in health IT in 2018
Health IT differs from other technology markets in that the pace of development is comparatively more measured. The reasons that underlie the slower pace of innovation rests a complex array of factors, that are more appropriate for a separate discussion. The reasons for barriers to rapid innovation, notwithstanding, the need for more vigorous innovation in health IT is a recognized problem.
As the New England Journal of Medicine notes, the area with the most pressing need for health care delivery transformation is in EHRs and clinical decision support with 47% of respondents ranking this space as the area most in need of innovation. Regardless of the desire for more innovation among those in healthcare, the fact remains that the pace and scope of health IT development depends on the regulatory environment. Regulations on the books can both stymie needed development and channel development into areas in which the market may not normally enter absent regulations.
In light of the role regulation plays in health IT innovation, it’s looking like 2018 will be a year in which the regulatory environment will exert a push-pull effect on the health IT market. Here are three developments to expect in health IT in 2018:
1. Congress will address telehealth reimbursement
Telehealth technology has occupied a consistent but low-key presence in the health IT market. Outside of its use for the delivery of care in underserved areas, telehealth as a mainstream tool for care delivery has lagged behind largely due to a lack of parity in reimbursement rates between face to face and telehealth services.
In light of policy efforts to better manage patients with chronic illnesses outside of a clinically setting, and by extension reduce the cost of care for these patients, a bipartisan push has been made to bring parity between telehealth and face-to-face services. One such effort, the bipartisan Medicare Telehealth Parity Act of 2017, emerging from the recently-formed bipartisan Congressional Telehealth Caucus, would expand the number of qualifying geographic locations, and expand coverage of telehealth services incrementally through three phases. Based on legislative efforts to bring parity to telehealth services, telehealth technology may be set for more widespread adoption if the reimbursement for these services can be modernized.
2. Measured progress against data blocking
One of the main challenges to the full realization of EHR’s potential rests on barriers to data interoperability. As part of the mandate under the 21st Century Cures Act to define data blocking in the Spring of 2018, the Office of the National Coordinator for Health Information Technology will release guidance for the Office of Inspector General to crack down on information blocking.
After the release of the guidance, OIG officials have indicated that they will begin issuing fines, and reports that it has already begun looking into some complaints and referrals. Based on these more focused efforts at defining and enforcing data blocking, one can presume that health IT products will take another step closer to better interoperability, particularly among patient-facing technology such as patient portals, which have struggled in their ability to share information across care settings.
3. Political uncertainty and cost pressures
Like 2017, 2018 will be marked by efforts to dismantle the Affordable Care Act. With the repeal of the law’s individual mandate as part of the tax reform signed into law in December and cuts to advertisement and enrollment assistance and some subsidy funding, a strong probability exists that more insurance companies will exit the marketplaces established under the Affordable Care Act and cause insurance premiums to rise.
Absent efforts to counter this trend, insurance costs will rise and the rates of uninsured in the population will likely spike in 2018 and beyond. Accordingly, healthcare providers will likely see health IT development continue in areas related to cost containment such as analytics aimed at fiscal management and population health management.
With the caveat in mind that health IT development is often incremental, practices will likely notice modest changes in 2018 that will set the foundation for shifts in the health IT market in the years ahead.
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