Unlike last year’s list of predictions, I’m only focusing on a few broad trends for 2017.
Legislative and Regulatory Uncertainty
A new administration in Washington brings a whole new set of appointees to lead the various departments of the executive branch. Organizations like CMS, FDA, ONC and many others will experience changes in leadership and budget that will impact healthcare reform.
The biggest changes will come from repealing and replacing the Affordable Care Act. Right now the magnitude of the impact is unclear because exactly how to replace ACA is still in flux. The ACA affects nearly every aspect of healthcare, increasing the potential for disruption; however, it seems likely that many of the current elements of the ACA will stay in place with moderate updates. Healthcare information technology may see less upheaval than other parts of the healthcare system.
Another legislative change comes from the 21stCentury Cures Act, a $4.8 billion package of healthcare spending laws that was passed by the outgoing Congress and President. As part of the act, President Obama’s Precision Medicine Initiative and Vice President Biden’s Cancer Moonshot will receive further funding. There are also provisions related to telehealth, opioid abuse prevention and mental health.
Perhaps the biggest regulatory change included in Cures relates to the FDA. There are several provisions related to how the FDA regulates clinical trials with an eye toward speeding up approvals. Real world evidence will be permissible in place of a full clinical trial for new indications of already-approved therapies. Many types of healthcare-related software will be exempt from FDA regulation.
Security is always a top concern in healthcare IT, but the problem got worse – not better – in 2016. The risks associated with cybersecurity are now receiving board-level attention at many organizations, and improving best practices will be a primary focus in 2017.
Cloud-based technologies could stand to benefit from increased attention to cybersecurity. Using the cloud means ceding at least some control over security to the cloud provider. As a result, IT leaders have been historically wary of cloud deployments. 2017 may mark a tipping point. Cloud providers are increasingly focused on high standards of security, and the benefits of cloud-grade security practices now outweighs the advantages of keeping control.
Many companies are expecting blockchain to gain momentum in 2017 as the industry looks for breakthrough technologies to combat cyber threats.
Population Health and Precision Medicine
Quality measurement programs and value-based reimbursement are long-term trends that began several years ago and will continue to rise in 2017. Population health management initiatives require software and processes, and adoption has not kept pace with business needs. This is partly because organizations have focused on EHR optimization, Meaningful Use requirements and other projects. In 2017, population health will start to get the attention it needs.
With population health taking center stage, precision medicine will continue to wait in the wings. Precision medicine is seeing some uptake in oncology and a few other specialties, but broader adoption is unlikely in 2017. The trend for 2017 will be to investigate, but not widely deploy, precision medicine technologies. The five-year trend may be that population health and precision medicine work hand in hand to radically transform healthcare as we know it.
What Does This Mean for You?
With an uncertain regulatory and legislative environment, healthcare IT budgets in 2017 may be primarily focused on concrete, low-risk projects. Cybersecurity and population health management are two areas where investment is overdue, so they are most likely to rise to prominence. When the industry catches up in these areas and the regulatory environment becomes more certain, attention will turn in the coming years toward other initiatives.