The health care industry continues to face myriad challenges to improving care delivery systems and creating economic efficiency. Technology such as health care informatics plays a role in both complicating and helping to simplify those processes, which will need to be tackled in 2012 as they were in 2011, according to an industry report by PricewaterhouseCoopers (PwC).
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Regulatory, technical, privacy and financial debates will continue to shape health care next year, the PwC Health Research Institute said in its annual report on top health industry issues.
Kelly Barnes, U.S. health industries practice leader for PwC, said in a prepared statement that "2012 will be a seminal year for the health industries as businesses wade through economic, regulatory and political uncertainty."
Barnes continued: "One of the ways the health industry is responding to these uncertainties is by connecting in new ways with each other and their consumers as they rethink existing business models and previous notions about competition, cooperation and collaboration."
The report noted some differences in how technology is being used and why. Whereas 2011 was the year of health IT adoption, data and health care informatics will be key technologies in tomorrow's hospitals.
"In 2012, data is power, and the organizations that learn how to effectively use and monetize it will gain a competitive edge," the Health Research Institute said in its report. "The practice of identifying valuable data and translating it into information to customize patient care and achieve the best possible outcomes is the domain of health informatics."
Consumers surveyed for the report said they are comfortable with increased use of health care informatics, and data sharing among providers, if the information is used to improve care coordination, real-time decision making and to support analysis of doctors' performance.
Privacy and security are still top concerns, according to the PwC report. Consumers said they would choose one hospital over another based on clear privacy and security policies, if all other factors were equal.
"Health care organizations will need to adapt old forms of patient consent and security protocols to cover new data uses or new channels of communicating and sharing data -- such as electronic health records, health information exchanges, mobile devices, and social media," the institute wrote in the report.
Top issues to watch in 2012, according to PwC
- Defining and paying for value. In light of pressure to wring costs out of the health system, health organizations must demonstrate they are delivering better value. Those that don't will be penalized.
- Higher deductibles and co-pays reducing utilization. As consumers continue to defer care because of rising out-of-pocket costs, health organizations need to counter the resulting decline in revenue.
- Population health. With the move toward population health, a further uptick in payer-provider relationships in 2012 is likely as these players team to integrate care, share information and participate in new payment models, such as the accountable care organization, with incentives for shared savings.
- Drug shortages. Sudden increases in demand for certain drugs, discontinued products, manufacturing delays and quality issues among generic drug manufacturers are creating a shortage of some drug supplies and raising concerns about patient care and safety. In 2012, there may be heightened focus by the Food and Drug Administration (FDA), hospitals and pharmaceutical companies on supply chains, real-time inventory tracking and quality-control to counteract the risk of rising counterfeit drug and gray market activity.
- Health care informatics. Before data assets can be maximized, the industry will need to address issues around data collection, quality and integration, develop scalable analytical tools, address privacy and security and overcome the shortage of skilled health care informatics professionals and trainers.
- Privacy and security. Organizations will focus more on health information privacy and security in 2012 not only because of increased risks and the threat of stiffer breach enforcement actions, but also because consumers consider privacy and security issues a differentiator.
- Health insurance exchanges. By October 2012, states are expected to begin certifying health plans for participation in the exchanges. Insurers planning to participate in state health insurance exchanges can expect new growth opportunities but also challenges as they shift from a wholesale to a retail approach, focus on population risk management and compete head-to-head for consumers' business.
- A slimmer pharmaceutical industry. Big pharma could get smaller in 2012 as pharmaceutical companies develop new strategies to deal with the decline in patented drug sales and new regulatory realities. Following two years of mega mergers and acquisitions, major players are reducing their workforce and experimenting with new approaches to R&D, sales and marketing.
- Health care social media. Organizations are experimenting with building stronger connections and communities through health care social media. The trend is expected to grow in 2012 as social media becomes part of an organization's overall strategy to improve health care and outcomes.
- The presidential election. Organizations will have to incorporate uncertainty into scenario planning, just as they did when health care was a central issue in the 2010 mid-term elections. They will need to allocate resources along multiple strategic paths and plan for contingencies that might affect strategic plans and growth assumptions.
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