Fellow foresight 2024: Looking back at 2023 to make sense of what lies ahead
These ongoing insights from fellows of the American College of Health Data Management presage trends that will impact the industry in the New Year.
At Health Data Management, we rely heavily on the experiences, stories and insights from those leaders who are in the trenches, on the frontlines of health and care.
The Fellows of the American College of Health Data Management represent those tenured leaders who day in and day out are working with their teams to realize the Quintuple Aim of improving patient experience, care team experience, driving toward better outcomes for all populations, reducing the cost and burden of care, and striving to create equity of access to care for all.
We asked our Fellows what 2024 might look like. We will continue to update this article as fellow responses come in. We hope you find insight, direction and enlightenment from these incredible leaders.
Coming out of 2023, several emerging trends are transforming the landscape. Value-based care will increasingly become the solution to create 'win-win-win' economic models of care with the strategic precision needed to build cohesion between payers and providers. Capitation will become ever more prominent in 2024, as we have learned how to more effectively design payment models that mitigate the risks of financial arbitrage that result in limited access, accountability, and poor outcomes.
With the advancements in technology platforms and transparent information on managing the total cost of care, organizations will position solidly in 2024 for a more sustainable market position that leverages the totality of clinical, quality, experience, and financial outcomes that are most satisfying for consumers, employers, and government stakeholders.
Lastly, I predict that Generative AI and LLMs (Large Language Models) will gain more traction in the clinical domain, improving diagnostic accuracy and treatment outcomes. Providers will first focus on back-office applications, but 2024 will bring novel applications like automated triage, population outreach, engagement, and personalized shared plans of health.
My prediction is that we will see increased utilization of programs that provide healthcare to vulnerable populations outside the traditional healthcare facilities (i.e., hospital-at-home, telemedicine). There will be more training for medical professionals on the use of artificial intelligence and machine learning. I foresee greater use and education surrounding digital and precision medicine. We will see more workforce development and training to prepare for changes in processes due to healthcare policy and emerging technologies.
In 2024, the trajectory of healthcare is anticipated to witness an increased integration of artificial intelligence, enhancing diagnostic and treatment capabilities. However, a parallel emphasis on establishing robust ethical frameworks will be imperative to address concerns related to privacy, bias, and accountability in the application of AI within healthcare settings.
Healthcare organizations will devote more time and resources to technology rationalization. Most organizations are a decade plus into their EHR journey. They’ve refined their applications, they’ve supplemented/integrated with other tools (ex: LIS, reporting platforms), and as they look at their technology landscape, they are more likely to say, 'I’d like to optimize, clean-up, and simplify,' than they are to say, 'I need lots of new tools.' The exception to that is AI tools, but even then, addressing 'what existing tools and technology can I sunset with the adoption of new AI tools' will be a key question in selection and implementation.
In 2024, vendors and developers will draw more scrutiny when presenting/pitching new AI-enabled technologies. Buyers (mostly providers) will want to know details about the system/model being considered and how it was trained and validated. The AMA recently published a memo titled, 'AMA Principles for Augmented Intelligence Development, Deployment, and Use,' and they recommend for AI tools that, 'Transparency and explainability regarding the design, development, and deployment processes should be mandated by law where possible…' While I don’t think we’ll see expanded regulation any time soon, we should expect buyers to have developed a list of standard disclosures they expect from AI developers and this could maybe translate into a standard across the industry. The excitement of AI in healthcare will pass, and providers especially will start considering the risks and how best to mitigate them (especially from a physician liability perspective!!!).
Providers are going to increasingly invest in technologies that alleviate burden on their employees (doctors, nurses, patient relations). Technologies such as virtual health, automation in principle should reduce some of the repetitive tasks, make users more efficient and drive cost reduction and revenue improvement opportunities for the health system.
As we approach 2024, the healthcare landscape continues to rapidly evolve with technological advancements, particularly in Artificial Intelligence (AI) and generative AI. Formally trained physician informaticians holding the role of Chief Medical Information Officers (CMIOs), are poised to play an increasingly significant role. Their expertise will be instrumental in blending cutting-edge technology with compassionate patient care. This expanded insight explores the expectations from CMIOs in 2024, focusing on the integration and governance of AI technologies to advance healthcare.
The Core Focus of CMIOs in 2024: CMIOs, equipped with both clinical experience and informatics training, are uniquely positioned to bridge the gap between advanced technology and patient-centered care. In 2024, their role will be crucial in navigating the complexities of integrating AI into healthcare systems.
1- AI and Generative AI Integration: Depth of Integration: CMIOs will be tasked with the comprehensive integration of AI and generative AI into clinical practice. This involves understanding the depth of AI applications in diagnostics, treatment planning, and patient engagement. Ethical Application: They will ensure that AI tools are used ethically, aligning with patient care standards while navigating the complexities of data privacy and algorithmic transparency alongside Chief Security Officers. Real-World Application: Real-world applications could include using AI for predictive analytics in chronic disease management or implementing AI-driven diagnostic tools that offer faster and more accurate diagnoses.
2- Data Analytics and Patient Care: Enhancing Personalized Care: Utilizing data analytics, CMIOs will drive the personalization of patient care. This involves leveraging patient data to tailor treatment plans, monitor health outcomes, and predict health risks. Optimizing Health Outcomes: They will play a crucial role in interpreting complex health data to optimize patient outcomes and streamline clinical workflows, thereby enhancing the quality of care.
3- Ethical Considerations and Compliance: Navigating Ethical Challenges: CMIOs will be at the forefront of addressing ethical challenges posed by AI, including concerns around bias and patient confidentiality. Regulatory Compliance: They will ensure adherence to evolving regulations around AI in healthcare, safeguarding patient rights while fostering an environment of innovation alongside legal counsels and the Chief Compliance Officer.
4- Advancing Telemedicine and Virtual Care: Expanding Access: CMIOs will explore how AI can enhance telemedicine and virtual care, expanding access to healthcare services, especially in underserved areas. Improving Patient Engagement: They will focus on improving patient engagement and satisfaction through virtual health solutions, ensuring that remote care is as effective as in-person visits.
5- Collaboration with Other Healthcare Leaders: Strategic Alliances: The CMIOs' collaboration with CIOs, CMOs, CFOs, and other healthcare executives will be more strategic, aligning AI initiatives with the organization’s overall mission. Interdepartmental Synergy: They will foster interdepartmental synergy, ensuring that technology adoption is coherent with clinical objectives and overall patient care goals.
6- Educating and Training Healthcare Professionals: Cultivating AI Literacy: CMIOs will focus on educating healthcare staff on AI and its applications, enhancing AI literacy across the organization. Training Programs: They will develop and implement training programs to ensure healthcare professionals are equipped to leverage AI tools effectively, fostering a culture of technological adaptability.
In 2024, the role of CMIOs, as physician informaticians, will be crucial in guiding healthcare towards an AI-enhanced future. Their involvement as part of the senior leadership team is critical, offering valuable insights to the CIOs, CMOs, CFOs, and other key executives including CEOs. With their unique combination of medical knowledge and technical acumen, CMIOs will play a pivotal role in steering the ethical and effective application of AI in healthcare. Their expertise will be instrumental in ensuring that technological advancements complement rather than replace the essential human element in patient care.
As we venture into this new era, CMIOs will play a collaborative yet pivotal role in ensuring that technological advancements are seamlessly integrated within healthcare systems. Their key focus will be to align these technological innovations with the fundamental mission of healthcare – providing compassionate and effective care to each patient. By working in concert with other senior leaders, CMIOs will not only guide but also actively shape the way technology enriches the patient care experience, ensuring that it remains rooted in empathy and efficacy.
Health and Human Services will finally release the long-awaited changes to the HIPAA Privacy Rule. And because there are so many states adopting their own consumer data privacy law, Congress will discuss the need for a national law. However, in 2024, no such law will be passed because of special interests and the money at stake.
As health information technology continues to advance, there will be increased attention on ethical considerations and data privacy in healthcare. Striking the right balance between utilizing data for medical advancements and protecting individuals' privacy rights will be an ongoing challenge.
Reflecting on 2023 and the enlightenment of empowering healthcare with artificial intelligence (AI) in 2024 will be challenging and exciting for healthcare executives at health systems and universities.
However, many stand-alone facilities might find AI intimidating and start considering merging to stay competitive for their communities in the era of AI as it progresses to copy human cognition in the analysis, presentation and understanding of data at a speed that is greater than human capabilities with new ways to promote preventive care, diagnose, treat or prevent disease.
AI will also make personnel unsure and afraid of job security, fearing that the newest technology will be interpreted as a human replacement.
As 2024 approaches, healthcare organizations (HCOs) will look to technology solutions to improve patient engagement and staff experiences. Retail giants like Walmart, CVS and Amazon continue to offer healthcare services, forcing HCOs to compete to retain and attract patients. This will require technology solutions and strategies centered around patient engagement and digital access. HCOs will deploy digital and mobile technologies to manage appointments, communicate with care providers, offer virtual visits, and provide patients convenient access to and control over their care.
Artificial intelligence will further augment patient engagement technology solutions to improve the overall consumer experience. AI will enable a personalized consumer appointment scheduling experience by compiling past patient preferences, provider specialty applicability, appointment availability, and geographic data, positively impacting care delivery.
The adoption of generative AI (GenAI) and ambient clinical intelligence (ACI) will continue to make advancements in improving clinician and staff experiences. Significant use cases include leveraging GenAI to summarize components of the patient's medical record and ACI tools to automate encounter documentation by leveraging natural conversation between the clinician and the patient.
HCOs and health IT suppliers will also be focused on responding to government legislation and policies. Relevant regulations include the Trusted Exchange Framework and Common Agreement (TEFCA), information blocking and HTI-1. In the interoperability space, there has been a lot of conversation and speculation around TEFCA. The first designated Qualified Health Information Networks (QHINs) have been announced. This and information-blocking disincentives for providers are reasons for HCOs to focus on data exchange strategies.
Although treatment will remain the primary TEFCA exchange purpose most HCOs are focused on, payment and healthcare operations use cases will be more broadly discussed. This is because of the efforts of QHINs to leverage these exchange purposes as a source of revenue to offset network infrastructure costs. HCOs will look at these use cases as an opportunity to digitize their request of information processes. QHINs will attempt to differentiate themselves through value-added services like data presentation tools and attractive business terms to HCOs. Undoubtedly, HCOs will lean on their EHR vendors and digital health providers to enable seamless connectivity to these networks and for guidance on how TEFCA exchange purposes help them meet their data exchange needs.
Healthcare is continuously changing, and HCOs that adopt a solid and forward-looking technology strategy will be well-positioned to leverage the opportunities presented to them in 2024.
Between dealing with the repercussions of a global pandemic, supply chain issues, staffing shortages, rising costs and ongoing digital transformation needs, it's been a whirlwind year for those of us in the healthcare industry.
As we look toward 2024 and beyond, data-driven innovations will continue to push boundaries like never before. Data analytics have revolutionized how healthcare professionals analyze patient data by identifying patterns, predicting outcomes, and monitoring patients more reliably and efficiently.
Leveraging data analytics will continue to be increasingly important, and as a result, healthcare professionals will provide improved outcomes, better insights and more personalized care in the year ahead.
The landscape of healthcare is undergoing rapid transformation, with hospitals positioned at the forefront of this evolution. Looking ahead to 2024, it becomes imperative to discern the primary focal points shaping the future of healthcare delivery. Healthcare leaders are facing a pivotal moment concerning digital strategy, contending with challenges such as escalating cyber threats, the need for electronic health record (EHR) system modernization and the growing demand for digital care.
A confluence of factors, including technological advancements, evolving patient demographics and dynamic healthcare policies, has forced hospitals to adapt and innovate. The conventional healthcare delivery model is being vigorously challenged, prompting hospitals to embrace novel strategies aimed at elevating patient outcomes, optimizing operational efficiencies and enhancing overall healthcare quality.
Health organizations, characterized by multiple locations and sizable workforces, find themselves tasked with the dual responsibility of swiftly responding to public health emergencies while maintaining a comprehensive awareness of community health issues, some of which may take years to manifest. Simultaneously, they require an integrated view of their expansive operations, spanning finance, planning, human resources, supply chain and other facets. This comprehensive perspective is crucial for managing the returns on investments in technology, capital, facilities, research and personnel.
A few of the areas healthcare leaders will focus their efforts on in 2024 and beyond include:
Transforming patient experience through integrated care. In the swiftly evolving landscape of healthcare, the integration of physical, digital, and automated care is redefining the patient experience. Once considered a luxury, telehealth is now an integral part of healthcare delivery. Hybrid care, weaving together in-person, digital and automated elements, transcends conventional boundaries. It represents a radical transformation that not only changes where care happens but also redefines how payers and providers engage with patients. Healthcare leaders are proactively preparing for this shift, recognizing that a “wait-and-see" approach risks marginalization in the industry.
Addressing the nursing crisis. With approximately 1 million registered nurses in the U.S. older than 50, the healthcare workforce is on the brink of a significant generational shift. Budget constraints and resource shortages in nursing schools compound the issue, resulting in a potential shortfall of as many as 450,000 nurses by 2025. Nurse burnout, increased caseloads and poor work-life balance contribute to a concerning trend. Virtual nursing emerges as a lifeline, supporting admissions, discharges, remote rounding and medication reconciliation. By leveraging technology, healthcare leaders aim to alleviate burnout, invigorate the pipeline of future nurses, and ensure the satisfaction of this vital care team member.
Embracing virtual primary care as the future. The focus on virtual primary care dominates the agenda of healthcare leaders as non-traditional entrants blur the lines of healthcare delivery. Legacy providers must adapt by acknowledging that patient care transcends in-person assessments. Balancing traditional primary care with virtual options becomes essential for patient attraction and retention. Looking beyond 2024, the aging population and increasing healthcare demand pave the way for virtual specialty care, emphasizing the evolving nature of healthcare services.
Harnessing technology to address behavioral health challenges. The worsening shortage of behavioral health specialists and the growing demand for mental health services underscore a crisis in mental healthcare. More than 60 percent of Americans lack a mental health professional in their county, and 40 percent of behavioral health professionals plan to retire in the next decade. Recognizing the power of technology, payers and employers are leveraging interactive tools, videos, virtual coaching and live support to bridge gaps in mental healthcare access. In 2024, societal stigmas surrounding mental health are further being dismantled as technology continues to break down barriers to behavioral health care access and support.
Elevating cybersecurity measures. In an era where cyberattacks and breaches pose increasing threats, cybersecurity remains a top priority for healthcare organizations. The imperative for effective Electronic Health Record (EHR) integration and modernization makes these systems prime targets for cybercriminals. Additional investments in cybersecurity aim to mitigate the risk of data breaches, safeguarding against legal and financial repercussions, and protecting brand reputation.
Patient and provider-centric digital transformation. Healthcare leaders, recognizing the inevitability of change, prioritize the intersection of technology and care for the benefit of patients and providers alike. Digital agendas for 2024 may vary, but the common cause is clear: leveraging technology to support patients in between visits, during follow-ups and post-discharge. For providers, technology serves as a crucial support system, stepping in when the demands of the job become overwhelming, whether physically or mentally. The commitment to this shared cause drives the ongoing digital transformation in healthcare.
In a survey conducted by the American College of Healthcare Executives in 2022, workforce challenges were the No. 1 concern of health system CEOs. The light is shining brighter on the role the health systems play in clinician burnout, and conversations and solutions regarding clinician burnout will continue to grow.
There are growing bodies of evidence regarding the role that technology, particularly the EHR, plays in the acuity of burnout and increase in turnover across organizations. Health executives will have to consider how the governance, training and support of technology help or hinder how clinicians deliver care. If it isn't helping, it is probably hurting.
If clinicians feel that an EHR training strategy is a waste of time, it is a contributing factor to their experience of burnout. If they feel their training is specific to their role, delivered at the time of need and always up to date, they see that their organization prioritizes their needs, leaving them feeling supported and that their organization cares about great patient care as much as they do. It will become impossible to ignore the need for exceptional IT education.
Healthcare data security stands as a paramount concern. In an era of rapid digitization, hospitals and health systems are leveraging cutting-edge technologies such as blockchain to fortify the protection of patient information.
Decentralized and secure, blockchain ensures the integrity and confidentiality of health records, mitigating the risk of cyber events that could compromise sensitive data.
As the healthcare industry evolves, robust cybersecurity measures are imperative to safeguard patient privacy and maintain the trust that is essential in delivering effective and secure healthcare services.
The percentage of the population older than 65 increases yearly. The last of the Baby Boomers approach Medicare as the workforce transitions to those whose generations were defined by falling birthrates. In recent years, we have seen the impact of staffing and resource deficits on healthcare delivery. Extrapolate what healthcare will look like as fewer practitioners are available and demand shows exponential growth... untenable.
In 2024, there will have to be further innovation into how technology can be leveraged to ease cognitive burden and take on more of the repetitive aspects of healthcare.
Additionally, the support roles that aid in ensuring patients have the means to succeed in optimizing their health, whether it be care management, social work or community-based outreach, will have to be funded and lifted up. Planning to provide chronic care in the future rather than food and housing today is not a wise investment, and based on population shifts, it will be a losing battle.
With the delaminating of public interests in vaccination protocols worldwide, there could be another crisis in communicating airborne diseases. On the other hand, with every single episodic social healthcare-related disaster, there would be a chance to reconcile current protocols and change them appropriately, while innovation would be enhanced simultaneously.
Dr. Christine (Emerson) Pirillo
Looking back at 2023, many healthcare delivery systems are still recovering from the impact of COVID-related disruptions and economic headwinds. There has been a strong need to address labor shortages and health inequities across the U.S. Care delivery models will likely show greater dependency on automation and artificial intelligence to address labor and quality challenges.
We can also see heightened awareness of waste reduction and efficiency. Newly implemented standards in the realm of health inequity will highlight a strategic need to address prominent social determinants of health to close gaps and boost health equity in underserved communities across the United States.
Medicine 3.0 will continue to reshape the patient-caregiver model to a proactive and inclusive relationship where education and two-way communication are critical success factors.
The health and care arena is in the midst of a transformation that will render historical norms obsolete or void. Change will be the most predictable theme in health and care in 2024.
Precision medicine: It involves formulating individualized treatment plans for patients. A key area of application is in genomics, where artificial intelligence and machine learning examine individual genetic profiles. This enables precise diagnosis and treatment of diseases and the creation of medicines tailored to the unique genetic composition of individual patients. It is expected to become increasingly significant in addressing future healthcare challenges, moving away from a generic treatment approach to one that is customized to each patient's specific genetic and health profile.
IoT-enabled virtual care: It involves the use of connected devices (wearables) for remote patient monitoring and establishing communication channels between healthcare providers and patients. It extends beyond just offering remote consultations. It represents a comprehensive approach to providing remote patient care and treatment.
Technology partnership of artificial intelligence and blockchain: Ensuring the security and privacy of healthcare data is a growing concern, especially with the increasing adoption of digital health technologies. Artificial intelligence and blockchain are poised to overhaul clinical trial methodologies, improve public health crisis prevention strategies and revolutionize how healthcare data is managed, shared and secured.