Weathering the Winds of Change, Prediction: Healthcare 2013

Source: Lorraine Fernandes, RHIA and Michele O’Connor, RHIA, MPA, FAHIMA Date: Jan 2, 2013 e-mail to a friend

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We're looking forward to a calmer climate in 2013 especially since 2012 has been a tempestuous year in more ways than the weather. While there is no Farmers' Almanac for healthcare, here’s how we see the 2013 forecast.

Rise of consumerism. Consumerism takes many forms and will hit all age segments of Americans, from Generation Xers who may be buying insurance for the first time, to baby boomers who seek information and insight about their health and wellness as they face retirement, to seniors and their families trying to coordinate care. Now that the dust has settled from the general election and the (first) Supreme Court ruling regarding PPACA, we need to march forward and realize that roughly 40 million Americans could acquire health insurance in the 2014-2015 timeframe. These new enrollees, as well as those already covered, will demand access to their health information, use information that will enable them to make better financial and health/wellness decisions, and expect to actively participate in health information exchange decisions. They will require convenient service through portals that provide services like scheduling, email, and phone consults, and (gasp) push the care givers beyond limits they have historically embraced. We predict that the more tech savvy consumers will create a furious storm if their personal health information (and its traceability and lineage) is not as readily available as a bank statement. Woe to the healthcare organization, payer or provider or government agency, that doesn't re-define systems, processes, and technology to address the requirements of empowered and inquisitive consumers.

Rise of a data driven healthcare organization. Controlling costs and improving quality will only happen when we use data (and we have plenty of it) to gain insight into the root causes and see data as an asset to transform the health industry. Sitting by the sidelines and waiting until analytics is "mature" is not the strategy for growth or even survival. We have created structured data for decades for some aspects of healthcare, and the volume of data will accelerate rapidly with the Meaningful Use requirements and certified EHRs. Leveraging big data solutions will give healthcare organizations the ability to process huge volumes of structured data, as well as tapping into unstructured data and streams of information from a myriad of sources. As a result, the "world of the possible" in genomics, research, and person-centered care is rapidly expanding. The rise in consumerism and analytics will also give a much-needed push to the adoption of a data governance strategy that includes people, processes and technology. These analytic and governance advances don't mean you have to approach analytics by flying into the eye of the storm. Rather it means you need to stimulate a breeze in your organization, create the processes and culture that embrace analytics in both the clinical and administrative realm, and be prepared for the rising tide of data.

We're wishful that 2013 is a little calmer in all ways that 2012, but we're not putting our umbrellas, galoshes, all-weather coats far from our reach. Cheers to 2013!!!

Lorraine Fernandes, RHIA, is Global HC Industry Ambassador for IBM, and Michele O’Connor, MPA, RHIA, FAHIMA, is Worldwide Master Data Management, Chief Privacy Officer for IBM Initiate Solutions.

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