If HIMSS09 was abuzz with talk of meaningful use and the scramble for ARRA funding and HIMSS10 was "all about HIEs and continuing to beat the drums for EHRs," said Chilmark Research analyst John Moore, this year's hot topic will be "payment reform – moving toward the patient centered medical home and accountable care organizations."

In short, he said, "2011 is going to be about ACO enablement." And for vendors in a position to do that, it should be a great year indeed. Because this is the moment, analysts say, where the promises of health IT should really start to bear fruit.

"I think we're seeing a market now that I think is finally trying to translate meaningful use into a set of executable actions," said Scott Lundstrom, group vice president at IDC Insights. "The net result of that is going to be a pretty good year for the healthcare IT community."

Conversations with industry watchers show an array of trends, challenges and opportunities in the year ahead. Among them:

Networks, networks, networks. "Certainly for forward-looking organizations there is at this point a real understanding that healthcare is becoming a network-based business," said Lundstrom. "And I think especially when you begin to look at the requirements of PCMH, ACOs, post-discharge patient management, when we look at patient engagement under meaningful use, when we look at the very clear and strong economic advantages of telemedicine and remote health, the investment in being a more dynamic, workflow driven, network-based business is really an imperative from a survival perspective."

HIEs. Ingenix's purchase of Axolotl, followed by Aetna's Medicity buy, made waves in 2010. Likewise, "some of the stronger HIE players making an enterprise play ought to do well," said Moore. But "it really is a big question mark as to how providers will view companies owned by payers. I think they're going to have to do some very careful messaging to the market, and demonstrate very clear Chinese walls between one part of a payer org and the software part, which is dealing with clinical data. There's a lot of distrust in the market as to payers' intentions."

M&As. As vendors better understand what they must do to deliver on the promise of meaningful use, "we certainly expect to see a continuation of the mergers, acquisitions and consolidations that have become so prevalent in this market," said Lundstrom. What's more, "on the end-user side, we continue to see consolidations and extensions of integrated health systems that in effect co-join payers and providers – the economic advantages have really been increased under stimulus by putting those two together."

"Always on." Consumer adoption of digital technologies has led to a big shift in expectations, with patients expecting health information at their fingertips 24/7. With patient engagement a pillar of health reform, payers and providers will have to leverage IT to be "always on and always accessible," said Preetham Peter, a director in PricewaterhouseCoopers' Health Industries Advisory Practice. "It's really forcing organizations to take a hard look at how they represent themselves externally. It becomes very much of a buyer's market. Which means you have to provide a lot of consumer purchasing features that are much more in line with, say, Amazon.com than with traditional health insurance purchasing."

Mobile health. "I think this will be a year of significant movement in the mobile space," said Peter. "We're seeing a lot of movement on the technology vendor side – phone and device manufacturers and so on – but also, very importantly, the real muscle is on the payer side." Moreover, increased EHR adoption has brought the promise of mobile tech to the fore. Smartphones are mobile and always connected and can relay information in real time. But until recently, "there really wasn't a place for it all to go,” Peter added. “Now the data has a place to go. Once it's there it can be analyzed and reviewed."

Data storage. "The data center remains front and center as an area of focus, both from a cost reduction and an enhanced capabilities perspective," said Lundstrom. "Warehousing, storage and virtualization are areas that can expect to see "strong, significant ongoing investment," he added. "Those are all clear winners.”

Surprises? "I think the big unexpected surprise is what's going to happen with healthcare reform with the new Congress," said Moore. "If they are able to vote through any changes to the law, what will those changes be and how will they impact the healthcare sector? That's anyone's guess. In saying that, I still think that there are certain things that have already left the station. Meaningful use is already headed down the tracks. You have HIEs going into place. And you have organizations that are looking to operate more efficiently, and using IT to do that."