You reap what you sow. The idea is the push behind countless movie plots and rock songs but it's also a central theme to PricewaterhouseCooper's (PwC) Health Research Institute's (HRI) new report on healthcare trends to watch out for in 2017. The seeds for next year were planted in 2007, according to the new report.
There will be certain uncertainty over the fate of the Affordable Care Act next year. However, many of the trends that should be on top-of-mind for hospital administrators next year will relate to value-based care, Trine Tsouderos, PwC's Health Research Institute director, told Healthcare Dive. "If you think about the political changes as the waves on the surface of the ocean, there's a very strong current underneath that is the shift to value-based care," she said. "We do not see that changing. We see the shift continuing industry-wide despite any changes in Washington, DC."
For example, only 90 or so retail clinics were in operation and about one in 10 consumers had been to one in 2006. Today, more than 3,000 such clinics have been propped up across the U.S. with one in three consumers having visited one. This drift highlights the continued move to more convenience in healthcare access as well as price transparency for patients.
Sticking with the nautical theme, Tsouderos likened the healthcare industry to a battleship in explaining why ideas from 10 years ago are now coming to fruition. It takes a long time to change the course of such a large and complex ship. "You can't turn [the industry] on a dime," she said.
What emerging trends administrators should know for 2017
There are a fair number of the usual suspects on the PwC's "watch list" for 2017. Retail clinics, high drug prices, deductible prices as well as health data security concerns make their assumed appearances on what HRI believes will be the top issues in 2017. However, the report notes a couple of topics that caught Healthcare Dive's eye:
In 2007, obesity was deemed the new smoking, according to the report. Today, 35.7% of American adults are considered obese while 68.8% of American adults are overweight or obese. To matters worse, about 20 million Americans live in so-called “food deserts,” communities lacking access to nutritious foods, the report stated.
"The drive toward value-based care is prompting established health organizations and new entrants to focus on nutrition as a way to prevent costly medical problems and improve the overall health of the populations they serve," the report stated. "This growing industry awareness of diet as a key driver of healthcare costs for many Americans is fueling creation of inventive programs and collaborations in 2017."
In theory, a better diet creates healthier patients and just telling patients they need to lose weight can prove ineffective without readily available access to healthy food or accountability. It's this line of thinking that led ProMedica, a nonprofit health system headquartered in Toledo, Ohio, to build a full-service grocery store in a food desert area in Toledo. The store incorporates nutrition classes as well as health and wellness education programs. "The system also operates two 'food pharmacies' that fill prescriptions, good for six months at a time, for nutritious food to patients with diet-related issues as well as their families," PwC reported. "In 18 months, the food pharmacies have served almost 10,000 people."
One of the hotter words in 2016 for healthcare was "blockchain" and how it could affect the industry. It's a distributed electronic ledger that can record and confirm transactions. In 2017, it's time for healthcare administrators and managers to learn and strategize how their organization could utilize blockchain and other emerging technologies, Tsouderos said, who added blockchain could be effective with EHR management, consumer identity management and fraud prevention.
In addition to blockchain, PwC outlined seven additional emerging technologies: Artificial intelligence, augmented reality, Internet of Things, robots, virtual reality, 3-D printing and drones.
Tsouderos stated drones could have a large impact on digitized supply chains for pharmaceutical companies but also for hospital systems as more care is being delivered in the home. Drones are a natural extension as a means to swiftly deliver healthcare goods or medications to patients or quickly deliver disaster response. Will armies of drones blot out the sky in 2017 to deliver medications and healthcare equipment replacement parts? Tsouderos says no but administrators should begin to think about such technology as they look 10 years out.
Shift in the nature of primary care
The report trends a large swath of the industry but another section that hit our alarms is the changing time and duties for primary care physicians. Looking 10 years out, 55% of physicians reported they expect to spend less time on conducting in-person care, likely pointing to the move toward on-demand and virtual care. Sixty-five percent responded they expect to spend more time on managing medically-complex patients while 85% expect to spend more time using data from apps and wearables.
As it's 10 years out, it's yet to be seen but it does provide a snapshot on where clinicians believe their profession is going operationally. In fact, this shift to value and new avenues of care delivery are partly prompting medical schools to rethink how they train young doctors, PwC added.
"Developers of continuing education programs also should recast appropriate training programs for work in a value-based world," PwC concluded. "Continuing medical education and post-graduate medical education training, including board certification requirements, should build on these newly-acquired skills and keep physicians up-to-date on industry developments, particularly as state and federal agencies continually issue new requirements and opportunities."