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Pandemic will make indelible mark on health IT

Healthcare CIOs will continue investing in digital health tools such as telehealth and patient capacity management after the COVID-19 pandemic. But they may have to do so at a cost.

The COVID-19 pandemic has become a crucible for health IT, as healthcare CIOs invested in and rolled out digital health tools to ramp up response. As a result, the health IT landscape will be forever altered, affecting the technologies healthcare CIOs will be investing in long-term, according to Forrester Research healthcare analyst Jeffrey Becker.

In a survey of frontline health IT workers, Forrester Research found that the most impactful COVID-19 technologies were patient-facing tools such as online symptom checkers, patient portals, remote patient monitoring tools and telehealth.

"What we found was that, far and away, the highest value solutions were patient-facing technologies," Becker said. "The next layer of value really could be found in solutions that are bringing some kind of analytics -- capacity analytics and overall predictive analytics."

The importance of customer experience in healthcare was alive and well before 2020, but the pandemic sharpened its focus. Digital health tools played an impactful role during its peak, and they will after the pandemic ends, as CIOs continue investing. And as CIOs shift their health IT investments, they will need a strategy to support those investments during a time when revenue is in sharp decline within healthcare systems. 

Telehealth

Shelter-in-place orders created the most critical problem for CIOs, shutting down brick-and-mortar healthcare facilities and forcing CIOs to quickly shift to remote care delivery.

Forrester analyst Jeffrey BeckerJeffrey Becker

Federal regulators helped organizations do this by relaxing telehealth restrictions to enable providers to treat patients at home and across state lines, as well as use commercial video conferencing tools like Skype and FaceTime. Regulators and insurance providers also started to address the long-standing issue of reimbursement for telehealth visits, which Becker said will help with long-term investments in telehealth tools.

"Prior to COVID-19, there was no parity between the cost of a virtual visit and the cost of an in-person visit," Becker said. "The healthcare industry at large wasn't necessarily incentivized to pivot to virtual care when that was, for many organizations, a detriment to their overall revenue. There was a financial misalignment that has been resolved in large part during COVID-19."

Gartner analyst Mandi Bishop Mandi Bishop

Health insurance provider BlueCross BlueShield of Tennessee announced in May that it would cover telehealth visits with in-network providers permanently. The Centers for Medicare & Medicaid Services (CMS) also boosted telehealth reimbursement as a result of the pandemic. Gartner analyst Mandi Bishop said changes like these will allow telehealth investments to continue.

"The ability to persist that change and the ability to rescale virtual care to be inclusive of all types of visits that have the opportunity to be successful virtually requires the support of the broader system, requires the support of a reimbursement methodology that's going to enable it," Bishop said. "We're starting to see progress in payers actively seeking ways to innovate there and embracing that model."

What we found was that, far and away, the highest value solutions were patient-facing technologies.
Jeffrey BeckerHealthcare analyst, Forrester Research

Christopher Zant, chief digital officer of Deloitte's ConvergeHealth, said as patients get used to seeing providers virtually, they will likely drive demand for such services -- a shift Zant said other industries such as retail and travel have already experienced.

Moving out of emergency response mode and into what Zant described as the "new normal," CIOs will have to figure out how to support these changes long-term, while still protecting patient data and privacy, and ensuring quality care is being delivered.

"We shop more online, we interact more online, we communicate and engage more online," he said. "But the healthcare IT infrastructure has never really kept up with that."

Clinical, operational analytics

Overcapacity within hospitals was another significant concern during the peak of the pandemic.

Becker said healthcare organizations found value in patient flow and population health analytics tools because they could forecast overcapacity and predict potential strains on resources. Indeed, Gartner's Bishop said the pandemic highlighted the need for healthcare organizations to have a patient capacity management product baked into the healthcare system's operational process. Patient capacity management helps organizations keep track of patient admissions, discharges and transfers.

Most hospitals didn't face overcapacity issues in the U.S., but Becker said the possibility convinced healthcare systems to implement capacity forecasting tools and conduct COVID-19-related forecasting on worsening symptoms. Using these tools now will open the door for CIOs to look at more advanced use cases for capacity management tools down the road within a healthcare organization, he said.

"That's clinical and operational AI being implemented, and I think that really just whets the appetite for much more compelling population health and patient flow hospital command center demand downstream," Becker said. "I don't think any of those technologies are going anywhere." 

IoT-connected hospital rooms

Another area of health IT impacted by the pandemic is in-room patient monitoring through video cameras and vital sign patches, Becker said. The pandemic pushed healthcare systems to think outside the box when monitoring patients with COVID-19 to reduce exposure and personal protective equipment use, sometimes with existing technology.

Nemours Children's Health System repurposed a video conferencing platform, video cameras and a phone system to launch a virtual rounds initiative at its two main hospitals, reducing patient-provider contact and the use of PPE. Similarly, at Jackson Health System in Miami, CIO Michael Garcia repurposed the Cerner Patient Observer tool to conduct in-room video monitoring of several COVID-19 patients at one time from a central command center.

Becker said tools like these have been helpful in managing COVID-19 patients during the pandemic and will likely push CIOs to think about how to expand the role of video monitoring tools, such as training computer vision models to look for indicators of patient health. Combined with new ways to collect vitals data such as skin patches, Becker said this could be the start of an IoT-driven healthcare experience.

"When you step back, what you see is real-time engineering of the IoT-connected hospital room," he said. "I think you'll see some emerging sort of future-of-the-hospital-room come from the hardware that is currently being pushed into the hospital room."

CIOs face long road ahead 

Healthcare organizations are still dealing with the pandemic, but Bishop said CIOs are focused on a pandemic-planning framework now to prepare for the next crisis.

Although CIOs were quick to react and roll out tools that Bishop said allowed a "true disruption of the industry," the challenge now is sustainability. These investments have disrupted IT budget cycles at a time when healthcare systems face a lack of funding due to postponement of routine appointments and elective surgeries.

Deloitte ConvergeHealth chief digital officer Christopher ZantChristopher Zant

Deloitte's Zant said CIOs are being asked to stretch budgetary dollars now more than ever to keep the lights on, enhance virtual capabilities and invest in new digital technologies, but the availability of funds to accomplish those tasks could be problematic.

Over the next few months, CIOs will be challenged to support new digital tools and operating models, and they will need to adapt to do both despite budget constraints.

"Not only are they having to be adaptive and respond to virtual care and scaling of the infrastructure to support it, and identification of new, digital tools, but they're also being told they're going to have to do a 20, 30 or more percent budget reduction across the board, while still supporting this advanced digitalization they've had to implement," Bishop said. "That is a really fine tightrope CIOs are going to have to walk."

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