For more than two years Healthcare IT (HIT) has followed on a steady growth track, according to U.S. Bureau of Labor Statistics and that is likely to continue in the next few years, according to Bill Spooner, senior vice president and CIO at Sharp Healthcare. "HIT will continue to be a hot job market for the next two-three years," Spooner says.
The healthcare sector of IT walks a tightrope consisting of privacy, data security and the need to grow and update the infrastructure. HIT faces more challenges with HIPPA laws and privacy concerns then most other areas and with the convergence of mobile technologies, cloud computing, virtualization, clinical analytics and the upcoming IDC-10 (International Statistical Classification of Diseases and Related Health Problems), HIT could be the most active area within the IT sector next year. To help you hone in on where the career opportunities lie, here are eight HIT trends for 2013.
1. Mobile Healthcare
The adoption of smartphones and tablets in HIT comes as no surprise. These devices are helping doctors, nurses and other healthcare workers get their jobs done on the move.
It's easy to see the promise that mobile technology holds for the future of healthcare, but the challenges lie in security and HIPPA privacy regulations. "This is a huge topic for any organization. Whether it is a mobile cart, a tablet or a smartphone, you need to give caregivers access at their fingertips. The [other] challenge in healthcare is that it's not a one-size-fits-all initiative. Beyond just finding a solution for all you then have to worry about security and application presentation to all of these types of devices," says Joseph Hobbs, CIO at Community Hospital at Anderson located in Anderson, Indiana.
CIOs are tasked with securing data, devices and managing who can access what, while facing penalties from HIPPA for mistakes. "Real-time alerting tools are being developed to signal changes in the patient's condition or environment and allow immediate intervention," says Spooner.
2. Cloud Computing and Virtualization
Not only are CIOs faced with growing and updating infrastructure, they also have to find a way to do it while saving money and resources. Virtualization is one of the ways IT professionals in HIT is trying to achieve this goal. It has been becoming more and more common and will likely continue, making IT workers with skills in cloud and virtualization in demand in 2013. "Most organizations have already been virtualizing servers and storage, a trend that will continue," says Spooner.
Cloud computing while being adopted on nonmission critical systems is still being held back due to HIPPA privacy and security concerns, but as the cloud industry matures and security catches up, companies will likely move more and more systems to the cloud, so they can focus on their core business objectives. "Cloud computing is accelerating at a somewhat slower pace, with organizations more frequently adopting private cloud technologies as vendor offerings mature, [and] prove their security models and become more cost-effective," says Spooner.
3. Big Data/Clinical Data Analytics
"Clinical analytics are a top priority for all providers, and big data is beginning to move from research to mainstream," says Spooner. Using clinical analytics, doctors can see what the most common ailment and conditions are; look at recovery rates for different procedures; and monitor vital signs of patients remotely, in real time.
It also provides a means for hospitals to use population data to identify patients with chronic illnesses such as diabetes, asthma or high blood pressure. These patients often require repeat visits and information provided by analytics could help better identify, train and educate these patients to better treat their disease or illness reducing costly ER visits and follow-ups.
"We are seeing HIT companies begin to apply advanced analytics tools to understand population health opportunities, increasingly important as the industry advances to collaborative, accountable care models," says Spooner. The challenge-and the opportunity for IT pros with analytics skills-- lies in finding efficient ways to store and maintain all this data while keeping it secure from prying eyes.
And, of course, there is the bottom line. Big data is giving providers a way to better examine where their resources are being spent. This, in turn, allows them to see how cost effective intricate and expensive procedures are. Then a hospital or a doctor can decide to invest more time and money in a specific area because it generates more revenue. Or, to the contrary, they could drop an area because it's not making money or is even losing money.
4. ICD-10 Compliance
The International Statistical Classification of Diseases and Related Health Problems, or ICD, is a diagnostic coding system put in place by the World Health Organization and used by healthcare providers globally.
While the rest of the world uses ICD-10, the U.S is still operating on ICD-9, an outdated version of the code set. This medical classification list holds different codes for symptoms, diseases, injuries, external causes and a host of other things including billing software, which should be a good indicator of just how far it reaches into the healthcare sector.
"The transition from the ICD-9 coding structure to ICD-10 is major. ICD-10 will provide far greater coding specificity for more accurate reimbursement and research," says Spooner.
Where ICD-10 has roughly 68,000 code sets, IDC-9 has only about 13,000. That sounds daunting enough but it is even more than that. It is also a way to ensure that current and future software releases can support these codes. It's fixing drop-down menus, expanding text boxes and hounding electronic health records (EHR) vendors to make sure they are, in fact, working on it.
"The transition entails changes to every computer system containing billing codes, more than 50 applications in many organizations, and extensive training of clinicians and coders alike," says Spooner.
The date for ICD-10 compliance has been pushed back to Oct. 1, 2014, but HIT companies are still struggling due to the costs and the processes that are involved with the changeover. Some providers are hesitant to move forward with an ICD-11 release looming in 2015. For example, the AMA called on Congress earlier this year to block the mandate.
5. Meaningful Use
Meaningful Use is a federal incentive program. Healthcare providers must meet certain requirements in in an effort to make better use of EHR. There are three stages: Stage 1 is currently ongoing;Stage 2 is set to start in 2014; and Stage 3 is set for 2016. The requirements include the following:
- Improving quality, safety, efficiency and reducing health disparities
- Engaging patients and families in their health care
- Improving care coordination
- Improving population and public health
- Maintaining privacy and security
In August, the federal government released the 672-page final requirements for Meaningful Use Stage 2, which included 17 core measures to be taken. In 2013, providers will be on the lookout for potential technological stumbling blocks that would prevent them from being compliant with Stage 2. "With the portal designated as a Stage 2, Meaningful Use requirement for incentive payments under the HITECH law, strong adoption will occur over the next two years," says Spooner.
HIT faces some tough challenges here, though, surrounding health information exchange, interoperability and a patient's ability to access their records via a patient portal. These were optional in Stage 1 but in Stage 2 they become mandatory. Combine that with proprietary nature of EHR software and HIPPA privacy regulations and it becomes clear how convoluted and complicated the entire process is going to be.
6. Patient Portals
People are using technology in more ways than they even realize, why shouldn't healthcare be the same? Patient portals are browser-based gateways though which healthcare providers can engage with patients using EHRs.
According to Meaningful Use requirements, Healthcare providers are tasked with building a system that allows patients to view, download and transmit patient data about a hospital stay within 36 hours. "With the requirement of HITECH act saying that a percentage of patients must use a portal, organizations are going to have to really get on the move when it comes to patient portals," says Hobbs.
In Stage 1 this was optional and according to CMS stats 66 percent of the providers that successfully completed Stage 1 deferred in this area because it was too much to tackle. Stage 2 mandates this and also requires that a certain percentage (5 percent) of a provider's patients must use and interact with patient portals. Many providers contend that this is unfair. Providers simply can't force patients to use portals.
American Hospital Association (AHA) Vice President Rick Pollack says, "Collection requirements flies in the face of other ACA provisions designed to reduce variations in data collection or handling, such as HIPPA transaction standards and operating rules, meaningful use requirements for electronic health records, recent changes to the uniform bill, movement to ICD-10 coding, or privacy standards," in an October 2011 letter to the Centers for Medicare and Medicaid (CMS) services.
As the technology advances, more providers are adopting telemedicine. "Physicians and other clinicians are increasingly trying telemedicine in many forms, ranging from low-tech telephone consultations to video presence augmented by sophisticated medical devices. Breakout will occur as telemedicine services become reimbursable to providers and/or are shown to reduce total cost of care," says Spooner.
This year has seen a number of large organizations form relationships with telemed companies. For example, in June, American Well began a program in cooperation with the University of South Florida to bring telehealth to seniors who live in The Villages, an over-55 community located in Florida. Through the program, retirees have access to their primary care provider from the comfort and safety of their homes. Combine relationships like this with a maturing of the technology and it could be the break out year for telemedicine.
8. Data Breach Prevention
Data breaches cost companies hundreds of thousands of dollars as well as credibility and trust. Last December, Ponemon Institute released its annual Patient Privacy Study. One of the major findings was that healthcare data breaches are on the rise and that most breaches were due to employee negligence or sloppiness. Ninety-six percent of polled healthcare providers have reported a breach in the last two years.
The adoption of mobile devices is also putting patient data at risk as 81 percent of those polled said they used mobile devices to collect and store patient data. And 49 percent of respondents said that they do nothing to secure or encrypt this data. Healthcare organizations need to ensure that they are doing everything possible to reduce employee mistakes and identity theft. Security will be a top priority in 2013.
It's clear that the healthcare IT sector is fertile ground for technology professionals. If you have expertise in any of the eight areas outlined above, 2013 could be the year you make a career move. Or if you're looking to broaden your IT skillset, you now know some areas that could pay off down the road.