By any measure, this has been a momentous year for healthcare information technology. Hospitals and physician practices continued rolling out and replacing electronic health systems. Policymakers in Washington kept the rule-makings coming. Providers worked in earnest to draw insights from their data and put it to work toward safer, more effective and efficient care.

Meanwhile, cybercriminals locked their sights on healthcare and set about targeting patient records with a scope and severity unlike in any years prior. And the election in November of Donald Trump left the industry in a state of suspense, as stakeholders tried to augur just what this unprecedented presidential candidate will mean for healthcare going forward.

All the while, big innovations – from cognitive computing and machine learning to the continuing evolution of telehealth – kept coming, setting the stage for evolution in 2017 and beyond.

Here are some of the most popular stories of the past year – and some that were especially emblematic of the trends that shaped it.

1. Donald Trump elected: His 7 point plan for healthcare
It wasn't the result most pollsters, pundits and prognosticators predicted (and it certainly wasn't the "landslide" the president-elect would later claim) but the real estate magnate will take the Oath of Office on January 20 – ushering in a new and unpredictable era for most facets of American life, not least for healthcare. We've written about Trump quite a bit since November, of course, polling our nervous readers about the win and reading the tea leaves about his plans for change. But this story was by far the most popular on our website in 2016, as readers looked for clues about how he – and his picks for HHS and CMS leadership – will shift health policy in the months and years ahead.

2. Meaningful use will likely end in 2016, CMS chief Andy Slavitt says
In January, speaking at the J.P. Morgan Healthcare Conference in San Francisco, Slavitt made waves when he suggested the guiding regulatory framework for health IT implementation since 2009 would soon go the way of the dodo. As he explained in a subsequent tweet, meaningful use, "as it has existed – with MACRA – will now be effectively over and replaced with something better." That statement was soon slightly walked back, since the situation wasn't quite so clear-cut, but the arrival of the Medicare Access and CHIP Reathorization Act, with its focus on the Merit-Based Incentive Payment System and advanced Alternative Payment Models, signaled a significant new policy approach to technology-enabled, value-based care for Medicare physicians.

3. Commentary: Big data and analytics to propel population health at HIMSS16
As 45,000 health IT industry stakeholders headed to Las Vegas for the 2016 HIMSS Annual Conference & Exhibition in February, contributor Brian Ahier penned this widely-read piece, offering his thoughts on how an industry "awash in information" – from EHRs, HIEs, wearable devices and more – could better bring actionable analytics to bear on it all, toward the lofty goal of pop health management. We all know about the ever-increasing volume, velocity and variety of healthcare data, said Ahier – but making the most of it also requires mastering its "variability and veracity."

4. Denver Health CIO, COO quit, blame pricey Epic EHR installation and Exec quits over patient safety concerns weeks before Epic go-live; hospital fires back that EHR will be safe
These two stories, one from January and one from March, show that, despite all the high-minded talk of a "post-EHR era," the down-and-dirty, elbow-grease-dependent work of electronic health records implementation is still extremely complicated, expensive and often contentious work. Nearly eight years after the federal EHR incentive program first spurred hospitals and health systems to digitize their patient records on a widespread basis, providers and vendors still face many big challenges – patient safety concerns, cost overruns – when trying to get these massive projects up and running.

5. Epic reveals R&D spending outstrips Apple, Google and its competitors
For years, the Verona, Wisconsin-based EHR behemoth – which raked in $1.77 billion in 2014 revenue, whose software contains the patient data of more than 56 percent of Americans – had felt little need or desire to talk much to the press. In the past year or so, however, that's changed somewhat. In 2016, Healthcare IT News Editor-at-Large Bernie Monegain traveled to the Badger State for a sit-down with Epic founder and CEO Judy Faulkner. She wrote a series of articles based on that visit, but among the most read was this one, which revealed that the company invests far more than even some of the flashiest Silicon Valley innovators on research and development projects.

6. Hollywood Presbyterian declares emergency after hackers cut off data, demand $3.4 million ransom 
If you weren't familiar with ransomware at the beginning of 2016, you sure knew what it was by the end of the year. (Hopefully, at least, not thanks to first-hand experience.) In a cyber threat environment with no shortage of bad actors and worse methods to hack, attack or otherwise compromise hospital IT infrastructure, this was the year where ransomware made its infamous name across healthcare. Hollywood Presbyterian was only one of the first and most high-profile victims of this data-freezing scourge in 2016. There were plenty of others throughout the year, each forced to face an unappealing choice: To pay, or not to pay?

7. Health Catalyst: Only 3 percent of hospitals meet CMS target for value-based care
The outgoing Obama administration and its landmark Affordable Care Act set some ambitious goals for accountable, high-quality healthcare delivery in the U.S. That's laudable, of course. But it's also worth asking whether the value-based benchmarks set by the Centers for Medicare and Medicaid Services might have been a mite too tall an order for hospitals grappling with long lists of other to-dos.

8. Telemedicine market to soar past $30B 
It's been a longtime and often vexing question: Why hasn't telehealth caught on to the extent many think it should? In an industry struggling with doctor shortages and concerns about cost and access, it would seem to be a no-brainer. Of course, reimbursement and regulatory challenges, physician resistance, high infrastructure costs and other technology hurdles mean the dream doesn't always match up with the reality. But the imperatives of value-based care look as if they may soon be forcing the issue.

9. Artificial intelligence, cognitive computing and machine learning are coming to healthcare: Is it time to invest? 
The future is now, Healthcare IT News Editor-in-Chief Tom Sullivan asserted in the April edition of his Innovation Pulse column. No longer the stuff of science fiction – not by a long shot – AI and machine learning and other leading-edge computing technologies are poised to transform healthcare in ways previously unimagined. Big dogs such as Google and IBM are already making big inroads with this stuff. And with some analysts estimating that nearly one-third of providers will run some sort of cognitive analytics on their patient data by the year after next, Sullivan writes, "the risk of investing too late may outweigh the risk of doing so too soon."

10. 27 hot health techs to watch in 2017 
As is customary as one year draws to a close, we look with cautious optimism to the next. In this list, compiled with our colleagues at HIMSS Analytics, we examine some of the technologies topping healthcare organizations' purchasing plans for 2017. From cloud-based storage to RTLS to lab-centered tech such as transfusion and specimen collection management systems, these are the tools hospitals are budgeting for to help them transform their processes toward better care at a lower cost.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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