A new year is upon us, and it's time to look ahead to the new year in IT. Here's my read for 2007 in health care IT:
Bet on health IT legislation within two years. So close, and yet so far in 2006! One result of the November congressional election saw Rep. Nancy Johnson (R-Conn.), one of the most stalwart supporters of health care IT on Capitol Hill, lose her seat. Nonetheless, we should still see health IT featured among top legislative priorities in the next two years. While Republicans and Democrats could not harmonize the two bills in the House and Senate this year, there continues to be support in the new Congress. Sticking points include tight funding with new "pay-as-you-go" rules for new projects.
There will be a plethora of private sector PHRs. The private sector isn't waiting around for Congress to pass health IT legislation. In the fourth quarter of 2006, we witnessed several private-sector announcements around personal health records that will come to fruition in 2007. From the BlueCross and BlueShield Association and America's Health Insurance Plans to the Dossia project, there is a lot of talk about introducing PHRs to the market. However, how many consumers will begin to adopt these tools remains a cloudy question.
A few engaged consumers will actually use PHRs in 2007. A PriceWaterhouseCoopers poll found that 42% of people didn't know whether personal health records would impact their health care. Only one-third of people believe PHRs would improve their quality of health care, and 24% don't believe PHRs would improve quality. The lack of consumer understanding about the value of PHRs remains a key issue for the industry to prioritize in public relations and education efforts in 2007. As Ed Fotsch, CEO of Medem, has said, PHRs "need to solve a problem people think they have."
Outsourcing will drive EHR adoption. Privacy issues aside, we've witnessed the start of the growth curve of EHR adoption driven through outsourcing. This will enable smaller practices, especially, to acquire EHRs and will continue to be a positive force for market penetration in 2007. We will see hospitals, physician associations and vendors maintaining software on behalf of physicians, who pay ongoing service fees -- just as they do for Internet connections and wireless communications.
M will stand for "mobile." The 2006 report from Spyglass Consulting, "Healthcare Without Bounds," explained that "clinicians are mobile warriors who are constantly on the go as they travel between their offices, exam rooms and the corridors of affiliated hospitals." Continued efforts to improve patient safety, the drive to contain health care costs and chronic labor shortages will compel adoption of mobile communications, particularly in hospital environments in 2007. However, as Spyglass points out, there will be no consensus on a single ideal mobile communications device. So clinicians, grab your tool belts -- you're going to be saddled with phone, beeper(s), electronic prescribing device and tape recorder for some time.
The struggle toward transparency will continue. The marketplace for consumer-directed health is enabled through information transparency -- even President Bush has made this a talking point of his administration in the past year. But information transparency in health care is easier said than done. We'll see some of the efforts that began in 2006 come to fruition in 2007.
An example of these information transparency efforts is the launch of Consumer Reports Best Buy Drugs, which polled physician consultants on branded and generic offerings for many common conditions and offered the "Best Buy" designation to some of them. Consumers can access this information online at no cost.
Social health networks will emerge. Time magazine named its person of the year... "You." That would be you. Yes, you. Health care has met social media, and it's a powerful force. The recent First Health Care Blogging Summit in Washington, D.C., brought together a diverse group of bloggers, public relations gurus, health care opinion leaders and patients -- a great mix of opinion leaders who are at the forefront of shaping health information online.
Word-of-mouth grows virally online, and health care is no exception. Blog tracker Technorati calculates that thousands of blogs discuss health care every day. 2007 will see substantial growth in health care blogging, which will impact the way consumers interact with the health system and stakeholders.
Unintended consequences of consumer-directed health will emerge. Lawsuits stemming from misinformation is an emerging trend. In New York state, Attorney General Eliot Spitzer (D) found that UnitedHealthcare gave misleading information to policyholders. UnitedHealthcare had an inaccurate list of participating providers, which led to consumers paying claims for out-of-network services. UnitedHealthcare attributed this inaccurate list to computer programming problems between 2000 and 2005. It would be nice for providers and plans to sort out such issues before going to press and Web site.
The primacy of privacy concerns will rule. With all the excitement around PHRs, EHRs, transparency and social media, the topic of privacy is at the top of U.S. citizens' minds. According to the Ponemon Institute, in 2005, 23 million U.S. citizens were notified that their personal information had been compromised in a data security breach of a corporate, not-for-profit or government database. These leaked data included birth dates, Social Security numbers and credit card information.
There were thousands of health care data breaches in 2006. In 2007, a privacy battle could heat up between consumer privacy advocates and the health IT industry. While these two stakeholders' interests aren't mutually exclusive, hysteria and hyperbole could derail understanding among consumers. This forecast is based on a recent statement from Rep. Edward Markey (D-Mass.), who said, "There is going to be much more emphasis placed upon privacy protections in the next two years than we have seen in the last 12 years."
Privacy concerns will be hyped based on the private sector PHR efforts, particularly those among employers such as Wal-Mart (think: "Big Retail") and BP America (think: "Big Oil"). Privacy advocates could conjure up scenarios where "Big" employers, especially those with lagging reputations, could have access to personal health information. If privacy lobbyists protest the involvement of these employers, you could have enough sparks ignite for a health privacy battle in the media.
More on the Web:
Consumer Reports Best Buy Drugs
iHB coverage of Dossia
Spyglass Consulting Group
About the Author:
Jane Sarasohn-Kahn is a health economist who advises organizations at the nexus of health care and technology. She leads Think-Health, a health consultancy, and works with stakeholders throughout the health care industry. Sarasohn-Kahn can be contacted at jane@think-health.net
The views expressed in this column are those of the author and do not represent the views of the California HealthCare Foundation or the Advisory Board Company.