Suggestions about how the market for healthcare information technology will fare in the next year, or two, or 10, can vary from one person to the next. At HIMSS17, you’re likely to get 40,000 different prognostications.

Solid answers, based on certain reasoning, is difficult to find. That’s because the healthcare landscape, and direction of healthcare, appears mostly cloudy under the emerging new White House administration and Republican-controlled Congress.

While there’s no shortage of posturing and chest-thumping over what folks want to do with healthcare policy, the actual execution of philosophy will be the proverbial devil in the vast ocean of details that direct the healthcare industry.

So we all approach HIMSS wondering about how, and when, previous health policies will be unwound, and what will rise in their place. In the past, the healthcare industry has trended conservative when uncertainty lies ahead. And that’s the dog that wags the tail that is healthcare IT.

So what to expect with the industry, leading into a conference that offers a vast convention hall of new and emerging products?

A survey of about 120 members of the College for Healthcare Information Management Executives gives one perspective, suggesting that top healthcare IT executives will be looking for ways to optimize the use of records systems to gain more benefits and look for applications that can be used in tandem with them to meet current needs for provider organizations—things like accountable care and/or population health management technology (mentioned by 21 percent); consumer, clinical and operational analytics (16 percent) and virtual telehealth technology (13 percent).

From a budget perspective, most responding CIOs expect flat or declining budgets in the years ahead for their departments. The ability to add new technology will be directly related to their ability to optimize the use of existing technology to achieve savings that can be poured back into tech purchases.

Also See: CIOs look to optimize EHRs, but face budget realities

A rosier picture emerges from Vertess, an international merger and acquisition firm that’s focused on healthcare. The firm believes that, while most sectors within the healthcare industry struggle to determine what “TrumpCare” will eventually mean for them, “there is one sector which is guaranteed to grow like gangbusters under a Trump administration.”

Vertess bases its prediction on expected increases in government spending on healthcare IT, and it expects the final form of the nation’s healthcare system will include an increased emphasis on cost control and outcomes. Care management will also grow importance, especially as patient encounters are viewed more broadly, and the importance of post-acute care settings in patient outcomes and readmissions. Translation? A rapidly growing market for healthcare IT firms to supply needed tools.

Contrast this all with the dour suggestion of Joel Selanikio, MD, speaking at the CHIME CIO Forum Sunday in advance of the HIMSS conference, who teased out a recent prediction by Eric Topol, MD, saying that “I don’t see Epic, Allscripts or Cerner in existence in another decade.” Selanikio sees institutional healthcare potentially overwhelmed by consumer use of technology to enhance health, as the emphasis of care becomes the domain of the consumer in the years ahead.

Also See: EHRs, and companies that make them, are at risk for disruptive change

So, there you have it. Pick your favorite future scenario.

I’m not sure anyone in Orlando at HIMSS17 really knows the definite answer to this. I remain cautiously optimistic, although many of the machinations in Washington in other policy arenas gives me pause for concern.

Recent HIMSS conferences increasingly have seen technology solutions gravitate toward solving real-world healthcare problems, such as population health and value-based care, through applications that meet real-world needs, such as population health management and value-based care. Rather than looking at gee-whiz technology offered by vendors and wondering if it will stick, healthcare organizations are now able to consider IT that meets real needs.

It’s unclear what the “replace” will be for the Affordable Care Act that Republicans seem hell-bent on repealing. It’s unlikely that whatever new health system emerges will give provider organizations more money to work with from reimbursements; rather, providers and patients will increasingly hold the responsibility to manage care and care costs, and that will push providers to become even more efficient and rely on IT.

It seems reasonable to assume that executives of provider organizations will expect IT to deliver on its promises, after the massive run-up in investments over the past decade. IT executives, and the vendors that support their departments, will be under rising pressure to achieve a return on investment, particularly on technology that’s bolted onto electronic health records systems.

I tend to side with the muted expectations of the CHIME executives, but stay tuned for developments out of Washington—radical changes appear more likely than ever, and IT executives will need to stay nimble to anticipate, and shift with, any changes in direction.

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