Health IT in 2018 - Where are we? Where are we going? What are we missing?

Digital healthcare tools are still severely lacking in providing adequate utility to end users.

Many government programs and pieces of legislation have created a system of incentives and mandates to are driving the adoption of digital technologies aimed at increasing and improving patient engagement. Tools have traditionally been focused around patient portals and have expanded in recent times to include mHealth applications and outreach/communication tools.

However, by and large, these tools are receiving anemic adoption rates. This undercuts the ability of organizations to realize meaningful ROI outside of the ability to check the necessary boxes to comply with legislation requirements that tie a portion of their reimbursements to achieving minimal rates of "meaningful use". Nonetheless, these technologies are mainstays to the general healthcare IT environment. Not surprisingly, implementation cost becomes a bigger decision criteria when assessing patient-facing technology solutions due to the evidence suggesting that actual measurable ROI is unlikely, despite industry analyses from Accenture, Deloitte and some of the most trusted names suggesting otherwise.

But is this actually true? While patient portal adoption is in the vicinity of 30% across the industry, does this mean that the technologies are innately unable to bring real value to organizations? Or is the issue actually the lack of value these technologies currently provide to patients and the benefits patients find in using them? With tools for pricing transparency and appointment self-scheduling still largely left unimplemented, it is difficult to say. The lack of implementation of features that have been shown to align with the self-directed, empowered consumer of today in other industries does raise an interesting and significant possibility: healthcare organizations are creating a self-fulfilling prophecy where initial evidence of low adoption and non-quantifiable business value has led to low prioritization and minimal capital deployment to do just the minimal amount necessary to "check the box", thus perpetuating the trend of low-adoption and business value.

Clinical technology innovation is outpacing patient-facing tools and improvements.

The 21st Century Cures Act went a long way to moving forward the initiative of precision medicine. This has spawned a significant boom to the certain sub-sectors of the health IT industry focused on clinical technology. While these technologies are no doubt a testament to scientific endeavor and human ingenuity, the significant time and capital deployment necessary to treat these conditions seems both in-step and out-of-step with the aim of value-based care and the "triple aim" of healthcare reform.

On the one hand, These technologies provide new paths forward to significantly improve the outcomes of care for many diseases. Over the long-run, the value they will provide in providing a methodical, standardized process to identifying the most effective treatment for each patient and improving early detection of potentially deteriorating conditions will increase the quality of care and outcomes at a lower total cost, far outweighing the impressive investment necessary to make them a reality. However, deploying these technologies at scale is still several years away from being a feasible reality from the sheer production capability level and even longer when considering the dynamics at play in care delivery in general.

There is an argument to be made for a comparative long-term value, lower capital expenditure requirement and faster implementation time for cultural improvements to healthcare organizations, standardized processes and protocols, improved communication among providers and between patients and providers, and involvement in communities to foment the behavioral changes necessary to focus on promoting health within populations as a way to reduce the cost of treating illness. While not as attractive and captivating as disruptive technologies, perhaps this low-tech focus preserves the intent and spirit of healthcare reform and the responsibilities and relationships between patients and providers.

The case for the value that technological improvements can make to the quality of care and bottom line for healthcare organizations has been clearly made and recognized. However, without achieving this same level of buy-in from healthcare executives regarding the value of patient-facing technologies and their ability to empower patients and connect them more closely with their providers and care, the ability to make a significant long-term impact in the health of the US population will be limited. Perhaps the key issue at hand is that clinical technologies and improvements can be clearly tied to revenue, profitability and quality while patient-facing technologies can only be indirectly tied to reimbursements through meaningful use requirements. It's possible that the next advancement in healthcare reform comes from new billing codes tied to patient-facing technologies. If that happens, patient-facing technologies will likely see a significant increase in capital expenditures and prioritization.

Only the most prestigious health systems are prioritizing digital touchpoints with patients.

There are a few standout organizations that have incorporated a "patient first" culture across their entire organization and aligned IT as a conduit to further and empower the organization to be more patient focused. Cleveland Clinic is an excellent example of aligning a reputation for clinical innovation with putting patients at the forefront of an organization's strategic objectives. They have addressed problems in the patient experience to allow patients more access to care and control over their experience of care including coordinating transportation to appointments via Uber, facilitating telemedicine consultations and providing direct scheduling features for patients.

Kaiser Permanente has made significant efforts to provide an end-to-end experience for patients to provide them increased access to information to be able to manage their care. While it is clear that, in healthcare, patients have always been a focus. Kaiser Permanente has made a deliberate decision to address the consumer expectations of today's world in order to provide patients with convenient access to information and services to allow them to manage their health more effectively. According to Richard Daniels, CIO at Kaiser, consumer expectations and needs are a primary consideration for everything Kaiser does. There is an organizational focus on bringing design and technology together to improve their patients' in-person and digital experience of care.

Prestigious, well-funded institutions are leading the industry in their dedication to delivering high-quality patient-facing technologies as part of an organizational alignment and culture centered around improving not only the quality of care through clinical innovation but the experience patients have across all touchpoints of the system - both in-person and online. They are reaping the rewards of aligning design and technology with patient engagement and the patient experience as part of a strategic organizational initiative.

What should we expect in 2018?

If history has shown us anything in this market, it is that the rate of change is very deliberate. With this in mind, we can expect clinical innovation to continue to outpace patient-facing technologies. Healthcare analytics will also continue to grow in adoption as their ability to consolidate and present financial, operational and clinical data enables leaders to make more informed and timely decisions. Population health and the social determinants of health will likely also see greater adoption and prioritization if social media conversations between healthcare leaders are any indication of how the industry is unfolding.

But patient-facing technologies will likely still be under-valued and under-prioritized. This represents a significant opportunity for healthcare organizations to gain a significant competitive advantage in the marketplace. It's unlikely that many organizations will fully capitalize on this opportunity until a more direct link to revenue and organizational performance can be established.

Michael Scranton is Director of Business Development at Medical Web Experts and is dedicated to helping health care organizations improve quality of care and patient outcomes while reducing health costs through the improved use of information and technology.