Sunday marked the start of National Hospital Week, a celebration dating to 1921. Originated to honor nurses and their impact on the field, hospital week has evolved to not only honor employee achievements, but also educate communities about the latest trends in the health care industry. This year's theme is "A Guiding Light for Changing Times," and I figured that makes for a decent excuse to ponder these times that are a-changin'.
I've spent the last few weeks in a few different time zones hearing some of the brightest in the business pontificate about what's next for the hospital field. Futuristic movies were always an obsession of mine growing up — my family's VHS tapes of the Back to the Future series are practically dust from getting played so many times over the years. So why not hop into a virtual DeLorean and ponder what health care might look like in 10 or 15 years?
Let's start with the impact of the technology revolution and consumer choice. Remember Blockbuster? Those yellow and blue signs were once as ubiquitous as the Starbucks logo is now. During its heyday, the video store had nearly 9,000 bricks-and-mortar locations. Assaulted by cheaper options like Netflix and Redbox, Blockbuster has dwindled to around 500 and the franchise would appear to be on the brink of disappearing altogether.
Will bricks-and-mortar hospitals go a similar route? Probably not, but thanks to continuing advancements in telehealth and telemedicine, much of the more routine care is migrating away from the four walls of the hospital, John Sena, an author and Ohio State University professor, said at last week's Siemens Health Executives Forum, where several speakers drew parallels to Blockbuster's limping legacy. Baby boomers are dealing with multiple chronic conditions; primary care docs can be hard to come by, particularly in isolated rural areas; and technology keeps evolving, all making telehealth ripe for wider use.
Sena gave numerous examples of forward-thinkers in the health care industry who are using technology to transform care delivery. WellPoint has developed a wireless cuff for heart patients that can transmit data to nurses. The University of Arkansas created sensors that can be placed in patients' bras or underwear to track blood pressure, respiration and temperature and send data to a smartphone. The University of Nebraska is using telehealth to connect psychiatrists with patients at rural hospitals to help battle a shortage of mental health professionals in the state.
There are still barriers to wider adoption of these types of innovation, including state licensure laws, reimbursement and privacy, but Sena believes telehealth will keep growing as a game changer.
"It really is the brave new world of health care," he said. "If there's any new technology that's going to save our bacon, it's going to be telehealth. Whatever you're doing in this, believe me, it's just the tip of the iceberg."
Health care futurist and regular H&HN contributor Ian Morrison, appearing at the same meeting, discussed the growing importance of transparency and the patient as a consumer. Some employers are putting money into transparency tools that tell health plan members exactly where they are in their deductible, prices for different providers and out-of-pocket costs. Consumers react to that kind of information, he said.
According to a recent survey by Harris Interactive that was released at the forum, some 52 percent of patients are "very" or "extremely" interested in having a portal to see their information, even though only about 15 percent said such a service is available. Roughly 44 percent of those surveyed said they're interested in online appointment scheduling, while only 14 percent said they have access to such a service.
"How we interact with health care is obviously very different from the way we do everything else," said Debra Richman, a senior vice president with Harris. "We do a lot of things electronically, but we do not do that in health care. So it is inevitable that there will be this merge. I think there's an expectation that that consumer experience will align with other things I do in my life, and I actually think it's a major opportunity."
Retail clinics were also cited as a continuing force in the industry. About 21 percent of those surveyed by Harris said they had used some sort of retail clinic, up from 7 percent in 2008. Sena said he expects clinics to see a "major boost" as the uninsured grab plans of the exchanges next year, and hospitals and health systems will increasingly try their hand at retail, or find ways to partner with the existing ones.
Just as these somewhat external forces are colliding, hospital leaders are wrestling with the realities of shrinking payments and new payment models. This was a hot topic at the AHA's annual meeting. In one report from the meeting, my colleague Bill Santamour examined how three health systems have taken very different approaches to adopting bundled payment. I had the chance to speak with James Skogsbergh, who has implemented some innovative contracting practices at Advocate Health Care in Illinois. You can view that interview at the end of Bill's blog.
Among technology, consumerism, payment reforms, the quality agenda, and so on, what do you think the health care industry is going to look like when we're celebrating National Hospital Week in 2023? Share your visions in the comment section below.