Insight

Leaders across the healthcare industry are investing in patient-centric administrative and clinical systems as the industry transforms its business model toward patient outcomes versus the quantity of services delivered. As hospitals and clinics embrace this trend, executives are also stepping up their use of data, digital and agile service design to reimagine the registration, admissions, clinical service delivery, discharge and post-discharge patient journey.

Over the next decade, we expect more investment priority toward making the patient experience highly personalized, seamless and transparent across every physical and digital touchpoint.   

Hospitals and clinics will also invest in digital tools to help patients find a provider that meets their precise needs, make payments from any device and calculate costs not covered by insurance (in real time). As all of these trends mature, insurers will leverage their legacy databases to build digital platforms around all aspects of health and wellness, particularly in the management of chronic conditions.

Care will happen anywhere and everywhere

We believe digital transformation will enable a vastly more efficient service environment, attacking one of the industry’s leading cost issues. For example, a recent U.S. study found that healthcare travel and wait times are higher than any other service industry, resulting in $89 billion in lost opportunity costs. Long wait times are encouraging all consumers, especially millennials and the elderly, to place more value on convenience as they become comfortable using alternate service types such as telemedicine, in-store medical services and on-premises health clinics provided by their employers.

Over the next decade, we expect hospitals and clinics will increase their investment in these alternate service types while insurers expand their support of such offerings. As this trend accelerates, we believe more preventive and minor acute care will be delivered virtually “at home,” outside of the regular workday, by what is likely to be a larger and more diverse set of providers (e.g., pharmacists, nurse extenders, etc.).

Emerging technologies will advance patient-centricity, convenience and improved outcomes

We are also tracking the deployment trends of a wide variety of technologies--from major Silicon Valley players and health care professionals--to life sciences organizations and governments. According to Dow Jones VentureWire, “venture-capital funding in U.S. healthcare companies rose to a record $16.10 billion last year, a 34% jump from 2014.” Several exciting investment trends are making a big difference in advancing better healthcare outcomes, for example:

Simple speech will deliver faster, more accurate diagnosis

Over the next few years, we believe physicians will routinely add speech analysis to their diagnostic toolbox since the tone and words a patient uses is proving to be a reliable means for detecting potential issues such as depression, PTSD, mental illness, dementia—and even heart disease.

Innovation in the use of digital speech to augment clinical diagnosis is especially active in the startup community where technologists are finding less invasive ways to detect abnormalities sooner, thanks to advances in artificial intelligence (AI) and machine learning. Speech pattern analysis (from patient audio samples) can augment, or even replace, labor-intensive diagnostic processes that require highly educated medical professionals. Such decreases in the reliance on highly trained experts and difficult-to-locate clinicians will also lead to earlier diagnosis, which would reduce both costs and the stress of long, arduous patient treatment regimens.

We believe patients will increasingly rely on speech-enabled chatbots to help them efficiently navigate disparate health systems. As these systems begin to incorporate AI-supported “deep learning” capabilities, it’s only a matter of time before these chatbots provide preliminary diagnosis and present data-based treatment options that are physician-approved and made available to a patient in real time.

AI and analytics will continue to enable healthcare breakthroughs

We are also monitoring increased deployments of AI-enabled analytics. In a recent survey, 82 percent of healthcare decision-makers said they’re “experiencing clinical benefits (improved patient care) through data analytics.”

Advancements in AI, data science and smart machines, particularly their contribution to algorithmic medicine, will radically improve clinical care as important decisions are made faster and with greater physician confidence. Of particular promise is the ability of AI-enabled algorithms to reduce, even eliminate, human clinical involvement in care that is highly routine. For example, over the next decade, millions of ER visits will be reduced or even eliminated thanks to early detection from AI-enhanced virtual care. Such savings will give physicians more time to study complex situations and focus on health outcomes and patient satisfaction.

For example, in a 2018 Nielsen survey of digital healthcare, analysis of U.S. federal health data shows that $7 billion of physician’s time could be eliminated each year by shifting office visits to home through virtual care. We are also seeing a rise in anecdotal evidence where clinicians order tests and procedures that aren't medically necessary (usually in efforts to avoid malpractice or to protect themselves in other ways). Virtual care, powered by algorithmic medicine, could go a long way to dilute, even eliminate this overly cautious behavior, which is expensive and time-consuming—and doesn’t necessarily contribute to effective outcomes. AI and algorithmic medicine also promises to reduce waste and eliminate duplicate tests through best-practice standardization.

Healthcare platforms will be more connected, collaborative and integrated

We believe Healthcare-as-a-platform (HaaP) will be vital to personalization as sensors and apps, embedded in internet of things (IoT) health devices, collect data and alert patients and providers to precursors of disease. These advancements will enable earlier detection. New platforms will also alert patients to changes in vital signs and body chemistry that may be leading indicators of more acute disorders. Hence, patients will immediately be provided with information, recommendations and options for preventing the onset of disease before it occurs.

As innovations such as IoT mature, we believe healthcare platforms will evolve to help physicians and their teams get in front of illness faster and with greater confidence—to the benefit of all. This trend, which is happening much faster than expected, is fueling the move to replace fee-for-service (where providers are paid for the amount of service delivered) to a value-based model, which pays providers based on outcomes.

To be successful, value-based care (VBC) requires a holistic approach to treating a patient. This will lead to connected care teams, supported by interoperable electronic health records (EHRs) that share patient data to better coordinate care between care providers, pharmacies and payors. Take chronic disease, which is both costly and time-consuming for patients. Only 56 percent of such patients receive recommended preventive healthcare services to treat conditions such as arthritis, cancer, diabetes, depression and heart disease. That could dramatically change under a VBC system designed around a team’s ability to achieve measurable improvements from a more comprehensive approach.

How can you harness game-changing ideas and technology to compete in a transformed, outcomes-based industry? To prepare for the future, we recommend several priority actions:   

Invest in cultural reform

As the migration from a fee-for-service to a fee-for-value system evolves, we advise executives place priority investment on helping their organizations change and adapt. VBC has been enthusiastically embraced by the medical community as an effective way to reduce costs while increasing the quality and outcomes of healthcare. Hence, we predict acceleration in VBC implementation as it proves to help people lead healthier lives.

However, a value-based model won’t succeed if healthcare executives don’t reform cultures that improperly value service quantity and revenue—over prevention. For example, by engaging patients early and recognizing the precursors of chronic disease (e.g, pre-diabetes), interventions can be developed that prevent the disease or slow it's progression.

The benefits of prevention can be acclerated with the creation of more cross-functional, cross-discipline teams staffed with para-professionals. Smaller hospitals (because they tend to be more agile than larger organizations) and highly empowered, multidiscipline teams will also advance the trend toward outcomes-based care.

Use alliances to advance innovation

Healthcare executives should pay particular attention to the trend toward more vertical integration between retail, payers and providers as it gains momentum. Mergers and other collaborations that bring together firms in vertically adjacent industries, for example, CVS/Aetna and Express Scripts/Cigna, will continue. While health systems are just beginning to experiment with offering their own integrated insurance products, we expect to see significant progress will be made over the next 10 years, potentially leading to a merger between one or more large health insurance company and large regional or national health system by 2030. 

We also believe half of all healthcare delivery organizations will ally with Google, Apple and Amazon in their clinical diagnostic and treatment processes over the next decade. Will these digital giants become partners, collaborators or competitors? While the answer to this question is still evolving, we advise healthcare executives take the trend seriously as these new entrants will surely impact the ways we access and pay for healthcare services.

Monitor the big, transformative trends

While organizations across the entire industry are exploring and investing in hundreds of technologies and trends to advance value-based healthcare, we believe the following will prove particularly transformative:

• Precision medicine. This trend will go a long way toward delivering on the promise of personalization as it embraces the patient’s genealogy, physiology and real-world lifestyle behavioral data (RWD) into treatment and prevention. Precision medicine has been growing steadily, first from the 2015 Precision Medicine Initiative in the U.S. followed by the 21st Century Cures Act. By adding RWD elements to the patient’s genomic sequencing, skin, respiratory and intestinal attributes, physician’s will diagnosis and prescribe treatment faster and with higher accuracy. RWD insights will also include data from mobile health and fitness apps, wearables and remote monitoring devices. While many of these technologies are in use today, it will likely be 10 years before these attributes become a routine medical practice.


• 3D printing of functional human tissues. 3D bioprinted organ transplants are another exciting development. This technology, which will have transformative impact on the entire ecosystem, got a boost in 2016 when Jennifer Lewis (Sc.D. of the Harvard Wyss Institute) announced it was developing and integrating multiple functional materials within printed devices.
  
  Lewis’ researchers have developed six different inks to integrate soft strain sensors within tissue microarchitectures, which it has printed onto a cardiac micro-physiological device (essentially creating a heart on a chip). The Wyss team has also developed organ chips that mimic the microarchitecture and functions of muscle, tongue, lung, intestine, kidney and bone marrow.
  
  We believe 3D bioprinted organ transplants represent one of the ultimate transformative breakthroughs in digital healthcare.


• Blockchain. While the business case for blockchain in healthcare is still an active debate, its benefits are clear in its potential to streamline transactions and facilitate information sharing among all healthcare value chain participants (from contracting, credentialing and claims payment, to health data aggregation and analysis, and population health management). Solutions are already being developed to collect and manage provider data and credentials. As these efforts mature, we expect the technology will be extended to other administrative activities and transactions before clinical uses are addressed.


• Legislation and regulation. One wild card looming over the entire industry is the volatility of the current legislative and regulatory environment. If significant legislative policy changes occur, we predict many of these technologies and trends will mature even faster as the reshaped market will drive demand for data, integration and experiences—and ultimately produce outcomes that are more personalized, efficient and effective.