The rate of change in health care is accelerating. There are several trends that are now apparent, and they have the potential to significantly change the way we deliver and consume health care. Here are five highlights and predictions for what’s next:
Telemedicine ascendant. Telemedicine is the use of technology to deliver health care services remotely. The concept and much of the technology are decades old, so much so that passionate advocates for telemedicine have seemed more doting than daring. We’ve heard for years that telemedicine will revolutionize how we practice, yet adoption for both providers and patients has been paltry. This year is different. The convergence of high-fidelity, affordable technology, changed consumer expectations, and now viable telemedicine business plans have created an environment for telemedicine to thrive. As payers look to reduce the costs of hospitalization and get patients home sooner and safer, the use of telemedicine video and remote monitoring has grown rapidly. According to the American Telemedicine Association, more than half of all U.S. hospitals use some form of telemedicine. Now that Medicare and other payers have opened their wallets to start reimbursing for some telemedicine services, providers are looking to capitalize. Our patients have changed as well. Patients/consumers have shown they are interested in using phone calls, photo sharing, and video conferencing as channels to get their care, particularly for common and routine medical problems. Telemedicine is as hot as social media for Silicon Valley entrepreneurs and venture capitalists. Prediction: The AAD Telemedicine Committee will someday eclipse all others in popularity.
Wearable technology. According to a PriceWaterhouseCoopers 2014 report, Americans believe in the promise of wearable wellness devices: Fifty-six percent believe that the average life expectancy will grow by 10 years because of wearable-enabled monitoring of vital signs! Today, just one in five American adults owns a wearable, but that market is expected to grow rapidly as technology improves and entry costs drop. For health care, the potential impact is huge, but the barriers are equally large. For wearables to reach their full clinical potential, they need to provide more than just data. They will have to deliver on engagement for patients and insight for physicians. Both are headed our way. Prediction: Medicine moves from helping sick people become well to helping well people become uber-healthy.
Increasing adoption of electronic medical records (EMRs). Whether you love (if one could actually love an EMR) or curse your EMR, chances are you have one. Soon we all will. Centers for Medicare and Medicaid Services stipends and promises of penalties have broken the inertia. Two studies from the U.S. Department of Health & Human Services’ Office of the National Coordinator for Health Information Technology showed that almost half (48%) of all physicians had an EMR system with advanced technologies in 2013 (double the adoption rate of 2009). Similarly, 59% of hospitals had EMRs with advanced technologies (quadrupling their 2010 rate). Although expensive, flawed, and accompanied by trade-offs in patient interaction and physician work experience, EMRs have brought benefit to health care. Soon they will be ubiquitous and later no longer an interesting topic of discussion. Prediction: Open notes (wherein patients can read their entire medical chart) are next.
The consumerization of health care. From retail health insurance stores to health care kiosks in malls, health care is moving toward consumerization; that is, health care as an industry is shifting from business-to-business (B2B) to business-to-consumer (B2C). As consumers pay more out of pocket for their services, they are experiencing health care in a different way and expect a higher value for their costs (they are more “price sensitive” as they say in economics). This has profound implications, such as more patients “shopping” for health care. Just as consumers have come to expect high-quality, customized experiences in retail and digital spaces, so too do they expect high-quality, personalized health care experiences. Prediction: Online doctor reviews will become more relevant over time.
Retail health care clinics. Walk-in retail health clinics have been around since 2000, yet only recently have they gained momentum. CVS, Walgreen’s, Target, and Walmart are all entering this space. A 2014 report by Accenture predicts that retail health clinics will double in number this year. Three trends are driving this rapid growth: 1) Increased numbers of newly insured patients (as a result of an improved economy and the Affordable Care Act) with too few primary care physicians to care for them; 2) The ability of efficient retailers such as Walmart to drive down the cost of care delivery and consequently prices for patients; 3) Clinics using price transparency, another trend that is attractive to consumers. As with telemedicine, consumers are coming to accept the idea of getting health care while at the grocery store or the mall. Prediction: Telemedicine plus retail will lead to opportunities for specialists to add value to retail settings. Buy diapers and have a remote dermatologist consult for your child’s rash all in one, low-cost visit.
Dr. Benabio is a partner physician in the department of dermatology of the Southern California Permanente Group in San Diego, and volunteer clinical assistant professor at the University of California, San Diego. Dr. Benabio is @dermdoc on Twitter.