I've seen it said before that year-ahead predictions are like weather reports: Everyone reads them, but almost no one looks back later to see whether they were accurate. Still, since when has that stopped anyone from indulging in this pastime as the calendar turns from December to January?

Certainly, few could have guessed, as we rang out 2019, just what 2020 would have in store for the U.S. healthcare system. But having learned some difficult lessons this pandemic year, it's worth taking stock of that hard-won wisdom – and forecasting how it might be put to work in the next 12 months as healthcare organizations chart a path forward to help a "shocked system emerge stronger" (as PwC puts it).

Here's what execs from some leading health IT vendors think about the most pressing challenges – and big opportunities – of the year ahead.

Supply chain: Machine learning insights

"One of the lessons of COVID-19 – meaningful data sharing – will continue unabated, made even more valuable as data becomes more accessible and machine learning provides deeper insights," said Michael Byczkowski, global VP and head of healthcare industry at SAP, the developer of enterprise application software.

As vaccines continue to roll out, requiring meticulous record-keeping and specialized shipping and storage conditions (and that's to say nothing of the ongoing critical need for PPE and other lifesaving equipment) nowhere are interoperability and data visibility more important than with healthcare supply chains.

Despite the challenges, machine learning is helping health systems and their suppliers to put pattern recognition to work improving supply chain management, he said, such as "tracking inventories of personal protection equipment to ensure adequate coverage and enable just-in-time provisioning of supplies."

Going forward, using AI-powered big data analytics to optimize the supply chain is going to be essential, said Byczkowski. Health systems will need to "pre-select and process data in a manner that meshes with its intended purpose and the underlying requirements for data privacy, when and where applicable."

Beyond mere supply chains, that can help optimize care in other ways: "Once a dataset has the right 'fit' and is uploaded to the cloud," he said, "AI and analytics can be applied to deliver better patient care – for example, to be used to gain visibility of total patient volumes, bed utilization, as well as workforce team assignments and workflows."

The COVID-19 crisis has been an immense challenge. But one potential bright spot is that it has "further demonstrated the predictive power of AI," said Byczkowski. And that could help position healthcare organizations to better weather similar challenges.

"By giving us the ability to see infection patterns emerge in societies in near real-time and isolate hotspots before they can spread out, AI may hold one of the keys to preventing future pandemics," he said.

"AI can also significantly help fast-track vaccine development, and with broad research and the clinical trials of mRNA-based vaccine technologies, there is a tremendous opportunity not only with regards to pandemics – but also to tackle many types of cancer."

EHRs: Automation can help

Burnout has been an ongoing scourge at hospitals for years now, and the crushing demands of the pandemic have only made it worse for physicians, nurses, telehealth managers and others. Electronic health records don't usually help, even if their impact on burnout is more complex than many realize. But there's no question that technology could do better helping solve the problem.

"Amidst the ongoing health crisis, clinicians need relief," said David Lareau, CEO of Medicomp Systems, which develops EHR optimization tools.

"Doctors and nurses are overwhelmed with surging patient loads, yet we continue to add fuel to their frustrations by forcing them to use inefficient technologies that add to their workloads and interfere with direct patient care," said Laureau. "For years we have promised them new solutions that leverage AI and machine-learning technologies to improve workflows and manage data more efficiently."

Clinicians still spend too much time combing through EHRs to relevant data when they need it, he said – and too much time meeting billing and reporting requirements when they'd rather be off the clock.

"A primary health IT focus for 2021 must be empowering clinicians with solutions that deliver relief today," said Laureau.

They need tools that "support the way clinicians think and work and make it easier for care teams to share actionable data for care coordination," he said, that can aggregate data from multiple sources and filter it logically so that clinicians have rapid access to patient- and problem-specific information at the point of care."

Workforce: 'Connected and protected'

But EHR workflows aren't the only area that need more focused attention when it comes to the wellbeing of health system staff in 2021, said Brent Lang, CEO of Vocera Communications.

As has been shown, the causes of clinician burnout are multifactorial. In recent months, there's been yet another factor: fear of infection.

"Together, nurses, doctors, policymakers, hospital executives and innovators can build a future where healthcare workers are both connected and protected," said Lang. "We must modernize PPE standards to include technologies like hands-free communication that can empower staff to do their job safely and without worry of getting contaminated."

"Before COVID-19, the level of cognitive overload and burnout among nurses and doctors was alarmingly high," he said. "With the ongoing pandemic, fatigue, depression, and now fear, among clinicians and others on the frontlines are causing many to leave the profession. A brighter future of caring will require collaboration between legislators, hospitals, and technology companies to ensure care teams have the right tools, enough PPE and the capacity to care for patients safely, effectively and with compassion."

In 2021, "it will be critical for hospitals and health systems to put policies and resources in place that make the safety and well-being of frontline workers a top priority," said Lang. "It will also be important for local, state and federal governments to assist hospitals and health systems in their efforts to safeguard the physical, mental and emotional wellbeing of those who care for their communities."

Meanwhile, he said, "innovators and technology companies must continue listening to frontline workers to understand their challenges and create new solutions to ease their burden and protect their livelihood. While we can manufacture more masks and ventilators, we cannot do the same with nurses and doctors, and the country cannot afford to lose these essential workers."

Telehealth: Now what?

One of the biggest storylines since the early days of the pandemic, of course, was telehealth – finally capitalizing on its potential as it was thrust into the spotlight as a necessary modality of care delivery.

Now the question is, what's next? One exec says the basic concept of the doc-patient video visit is not enough.

"Telehealth's growth trajectory has moved forward by a decade during the past several months," said Kuldeep Singh Rajput, founder and CEO of Biofourmis, developer of digital therapeutics and virtual care tools.

"However, for that momentum to continue, technologies such as wearables, remote patient monitoring and artificial intelligence will need to augment telehealth. This approach will expand the use cases for telehealth and will continue to make the case for parity with in-person visits."

Telehealth served as a vital lifeline during the early days of the pandemic, when in-person visits weren't feasible. But for all its benefits, it's not enough to simply have screen-mediated virtual consults.

"Clinicians can’t make optimal clinical decisions remotely unless they are armed with actionable data," said Rajput. "As we continue to battle this virus and in a post-coronavirus world, telemedicine won’t be used in isolation, but rather in tandem with these complementary technologies.

"For example, AI-based analysis of the data obtained from remote monitoring can be leveraged to flag a decline in a patient's health, so clinicians can intervene early and prevent a medical crisis," he added. "There will be a huge shift in virtual care that moves from typical phone and video chats to these types of software-based therapeutic interventions that are fueled by AI-driven data."

That will encourage providers and patients to use telemedicine even more widely, he said – boosting outcomes, decreasing hospitalizations and ED visits and lowering costs. 

"The future state of telemedicine is a world in which care delivered by phone or video will become predictive and personalized, rather than reactive," he said.

Providers & payers: Communication is key

In addition to ongoing questions around the reimbursement of telehealth and remote monitoring, one of the other challenges highlighted this past year was the still-suboptimal communication among providers and payers, especially early on.

Soon, however, there were signs that COVID-19 has helped push forward some information exchange improvements that could be long-lasting.

"It's no secret that many providers and payers relied heavily on the use of fax machines and printed documentation," said Paul Joiner, chief operating officer of health information network Availity.

But as the pandemic "disrupted operations for payers and providers, with many employees and staff members working from home, the willingness to collaborate advanced significantly," he said. "The old way of sending transactions, clinical documentation and policy changes transformed overnight."

That quicker communication and more robust collaboration has been "indispensable" during the pandemic response – and will only become more beneficial as it's built upon in the year ahead, said Joiner.

The ability to send claims information electronically – rather than spending "countless hours finding, printing and faxing medical records to payers for prior authorization requests" – will be hugely useful for provider efficiency and patient experience going forward, he said.

"The pandemic brought about new challenges for our healthcare system, but it also helped us to overcome many of the barriers that stood between payers and providers," he added. "It has propelled the transition to better and faster communications, and even helped build trust along the way. In 2021, we predict the shift to electronic communications and improved collaboration across the system will have staying power. There’s no going back."

Value-based care: New impetus for change

On the topic of healthcare reimbursement, some have wondered what the COVID-19 pandemic might mean for the momentum of accountable care efforts, given the unprecedented disruption of the past 10 months – never mind the fact that many provider organizations are still unsure about the ROI of their value-based investments over the past decade.

Michael Gleeson, chief strategy and innovation officer at population health company Arcadia, sees some interesting trends on that front for 2021 and beyond.

"Health systems and hospitals in the U.S. have been under unparalleled financial strain as a result of the pandemic," said Gleason. "We've noticed that those organizations that have been aggressive in taking on downside risk have been partially buffered against this impact."

In 2021, he said, "we expect these organizations will continue to expand their risk profile. When combined with their expertise in managing populations and the investments in data connectivity and analytics, these organizations will use the fallout from the pandemic to expand their market share and acquire their way into new markets."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.