Ongoing market dynamics and trends will affect the acquisition, implementation, and use of connected health technology by U.S. health care providers, payers, and consumers in the year ahead and beyond. Increased understanding of these forthcoming changes will help health care organizations and I.T. vendors optimize their strategic planning and investments. Overarching themes that run through IDC Health Insights' top 10 connected health predictions include mobile, social, “big data," cloud, and analytics. Health reform and market pressures to reduce costs and improve the quality of care will play a major role in shaping the following 10 themes and predictions.
 
1. Legal and political challenges to health reform will not derail the fundamentals of ACO development.  Despite the uncertainty of the final form of health reform created by numerous constitutional challenges to the Affordable Care Act of 2010 and 2012 being an election year, it is clear that a fundamental shift in business models is currently under way. To deliver care under the new business model of accountable care, providers will leverage investments in meaningful use technologies. They will invest in technologies that include analytics, clinical decision support and consumer engagement tools.

2. Successful accountable care organizations will emerge from private or public-private initiatives.  Federal legislation is not required to move forward the principles of accountable care and the patient-centered medical home. Some of the most innovative and successful programs have been developed by commercial payers and in private-public relationships.  Expect to see more experimentation with new reimbursement and care delivery models from the private sector and fewer-than-expected health care organizations applying to CMS-sponsored payment pilot programs.

3. Vendor solutions will converge to support health information exchange, care management, and analytics.  In 2010 and early 2011, HIE vendors were focused on helping their customers demonstrate meaningful use. Since then, the focus has expanded to encompass supporting not only meaningful use but also the needs of emerging accountable care and patient-centered medical home initiatives.  The HIE market experienced marked consolidation as larger health care I.T. vendors, as well as health care organizations, acquired smaller companies with solid solutions to expand their existing product and service offerings. The same was true for vendors of care management and analytics solutions that also added complementary products and services through internal and external efforts. Expect more of the same in 2012 as vendors vie to offer "accountable care in a box" type offerings and remain competitive.

4. The success of accountable care will depend on connecting consumers. Consumer engagement is recognized as key to successful disease and health management, which along with care coordination will be required for successful patient-centered medical home and ACO initiatives. Health policy experts have identified that engaged consumers have a vital role to play in the improvement of health care quality. The resurgence of investment in consumer engagement tools is now focused on mobile technologies that provide consumers access to health information and applications that enable consumer decision making from their personal mobile device.  The winning consumer engagement strategy will be a balance of technology and personal touch.

5. Health and Wellness Programs Will Become Social and Mobile to Engage Consumers.  Health and wellness continue to be an important trend in 2012 for not only payers and employers but also providers, as the industry focus shifts from treating chronic conditions that have become serious (often in acute care settings) to preventing them from happening in the first place or, when they do, actively managing the conditions to reduce the need for emergency and acute care.  In 2012, successful programs will employ social gaming and mobile technology to keep consumers engaged in health and wellness programs.
6. The next generation of consumer engagement will leverage consumers' social graphs.   There is a growing body of research that suggests that consumers' health status — both positive and negative — is influenced by not only the company they keep but their friends' friends as well.  Online social networking sites, such as Facebook with its 800 million users, exponentially extend the impact of real-world social networks by creating social graphs, which are defined as connections through which people communicate and share information.  In 2012, new entrants will enter the field of social health as vendors, health care organizations, and employers look to tap consumers' social graph to affect positive health behaviors. Consumer engagement solutions will be increasingly mobile and connected to social networking platforms like Facebook.

7. Innovative health care organizations will explore virtual caregivers.  Labor costs represent the lion's share of health care organizations' budgets. To remain financially viable, many organizations are trying to do more with fewer staff. These combined factors are driving innovative health care organizations to explore using virtual staffing clinicians — to augment, not necessarily replace, current clinician staffing levels — using computerized staff and robots.  In the next five years, forward-thinking health care organizations will conduct the necessary research to demonstrate the efficacy and cost-effectiveness of using virtual patient advocates and health coaches, telepresence robotics, and other connected health technologies to extend human clinicians. These technologies will help reconnect patients with their health care providers and care givers.

8. The HIE-enabled, highly functional provider portal will supplant PHR efforts.  Consumer adoption of PHRs has stalled, as evidenced by two IDC Health Insights surveys conducted in 2006 and 2011. In both surveys, only seven percent of respondents reported ever using a PHR and approximately half of them abandoned using their PHR, in part because they didn't see the value in PHRs or want to spend the time updating them. Meaningful use requirements to provide consumers access to their electronic medical records are driving providers (and EHR vendors) to invest in portal technology. These tethered PHRs reduce the need for patients to manually enter their health information and keep it up to date.  In 2012, patient portals will include PHR-like capabilities, such as health and wellness applications, chronic condition management tools, and mobile device access.

9. Bring your own mobile device will gain popularity, but security risks abound for clinical mobility.  Increasingly, clinicians want to use their own mobile devices. This trend creates additional security concerns because personal devices are harder to manage and security controls are typically not as robust as those found on corporate-provided devices.  CIOs will be pressed to develop policies about who should be allowed to use their own device and should these devices be connected to the network. A bring your own device (BYOD) strategy will require health care organizations to be device agnostic.  The mobile device itself represents the tip of the proverbial clinical mobility iceberg. Over the next three years, the top infrastructure categories for investment will be interoperability, client/desktop virtualization, mobile application software distribution, and application servers for clinical mobility.

10.  Proliferating self-service technology will result in big data explosion.  The corporate drive to reduce costs by reducing labor costs has led to a "do it yourself" generation.  Increasingly, health care is moving along a similar path. A wide range of devices are available to enable consumers to monitor their vital signs and activities of daily living.  These devices include personal health and fitness devices, medical kiosks, home and body sensors, and mobile devices.  Consumer use of these self-service technologies is just beginning to get traction but will grow as consumers are compelled to take a more role in managing their health and reimbursement models encouraging their use evolve. Ultimately, self-service data collection will result in massive data sets, which will create a market opportunity for cloud computing, data storage, and analytics.
Over the next five years, the industry will make significant investments in health care I.T. including EMR, HIE, and analytics, as well as social and mobile technologies, which are all key enablers to connected health. When effectively deployed, connected health services and technology will enable the transformation of how health care is delivered today from traditional office- and facility-based care settings to the consumer's home or anywhere on the planet via the consumer's mobile device. This will be vital to achieving the objectives of health reform — greater access to health care, reduced health care costs, and improved outcomes.

 Lynne A. Dunbrack is program director, connected  health I.T. strategies, IDC Health Insights. She contributes to Health Data Management, a SourceMedia publication.

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