A Sardonic View of What’s Ahead Frank Cutitta, ICD Senior Advisor
As we close out what might arguably be a somewhat normalized year as compared to the world of 2020-21, we find that there is still no shortage of challenges, cynicism, and opportunity leading into 2023.
For our inaugural Healthcare Predictions blog, Frank Cutitta presents this pundit’s views on where COVID has taken us for good and for bad, and some of the obstacles that healthcare practitioners and vendors will face in the new year and forward. As with any predictions we welcome you calling us out on the ones you disagree with, or echoing the ones with which you concur. Fasten your seat belts here we go!
Clinical burnout will mutate into a number of new variants in much the same way we saw with COVID. Ranging from the trendy Quiet Quitting to debilitating PTSD and more subtle Moral Harm, burnout can no longer be viewed as one size fits all.
Despite diversity, equity, and inclusion being on the top of the list for healthcare (and virtually every other industry) empirical examples of innovation for curing it will remain sparse. The fact is that technology can only do so much and many of the groundbreaking solutions are more subtle community-based issues that don’t stand out like breakthroughs in genomics or AI. In 2023 we will be vigilant in finding equity innovations that result in the “Oh Wow” response.
Skeptics of AI
The infatuation notwithstanding, Artificial Intelligence will continue to face a generational skepticism maturity model. What with the love affair for the new ChatGBT algorithm and technology that starts to get emotional, the fact is that there is still a great deal of skepticism in the “do no harm’ world, especially in the “Marcus Welby” demographic. We will continue to attend conferences where most speakers will say “in five years from now you’ll see what this can do”. Much like what we heard five years ago!
Robotic Process Automation (RPA)
Despite the caution and skepticism of AI in general one of the most compelling use cases will be in the area of RPA coupled with natural language programming (NPL). Mundane tasks related to billing and record keeping will increasingly be performed using (low code driven) robots, theoretically enabling healthcare workers and administrators to spend more time with the patient and family-facing priorities.
The ability to capture unstructured and conversational data that arguably makes up 80% of the most important healthcare insights will remain challenging despite voice recognition reliability. Some of the most important data will simply evaporate for lack of ability to capture it and derive insight from it. Yes, ambient technology is improving, but it is far from ubiquitous technology that picks up conversations that aren’t between normal clinical characters.
Patients will become increasingly participatory in their care which will fuel demands for a much greater ability to access and capture their unabridged healthcare records. As a 100-day COVID in-patient I can attest to this personally. Even the meek started asserting more authority over their care over the past three years and that momentum will carry on, especially in the portability of health records and even questions about the ethics and privacy aspects of AI.
Healthcare technology vendors will continue to have increasing difficulty verbalizing their products’ competitive advantages in the softer sides of the business-like burnout, equity, literacy, and even patient experience. Technology vendors are great at explaining speeds and feeds where quantification is relatively simple. But after producing conferences on these topics, they’re not so great in quantifying the qualitative. In fact, in many of these more emotional segments of the market, finding healthcare leaders who even talk to technology vendors for equity and burnout solutions can be very difficult.
Despite advances in cybersecurity technology, more and more healthcare enterprises will employ “hostage negotiators” as part of their ransomware and breach response strategies. Think about going to a provider or payer CFO and asking for funding for a go-between with the dark state! Unfortunately, this is a new reality and one that most healthcare enterprises don’t really like to talk about for obvious reasons.
Hospital at Home
Hospital at Home will continue to gain traction but will face challenges with reimbursement, workforce, and especially CFOs and Transformation Officers who have to justify the ‘buy-in’ for an acute @Home Strategy. The inclusion of H@H funding in the recent omnibus bill is a very positive sign in much the same way telemedicine was in 2020. The CMS Waiver during the pandemic provided a jump-start for early adopting healthcare systems that now have best practices to share. Many health systems will be looking to integrate this into their strategy in the coming year to address patient demand, especially the aging population.
Digital Divide Widens
The digital divide is actually widening as more and more wearables will become a key element in remote care and monitoring. I’ll never forget hearing about how families in low-income multigenerational housing were pooling together their phone card credits to get their grandmother enough time for a telemedicine call. Think about how few people who need it the most are wearing an Apple Watch. Not to mention the “last 100 yards” for connectivity in many rural remote areas.
Digital Mental Health
The convergence of mental health and digital transformation will move from the Peak of Inflated Expectations to the Trough of Disillusionment as a result realization that nudging and artificial bot conversations are inadequate. As a user of some of these technologies, as with AI and bots, the first few layers of digital interaction seem helpful but as the conditions become more complex, it becomes apparent that empathic technologies are still in their embryonic stages.
Implicit bias will continue to grow as more and more processes will be relegated to emotionless technology with limited human controls due to workforce considerations. In a world where facial recognition technology confuses a blueberry muffin with a chihuahua (google it!) is there any surprise that algorithms designed by people with a different ethnic or gender dimension would result in an unfair depiction of that patient or healthcare worker? Ironically, the technology that has embedded biases is now being used to unearth the bias in other technology platforms.
Expanded telemedicine investment will be scrutinized as more and more patients wish to have face-to-face appointments and more and more clinicians become frustrated with the technology. Spoiler alert! Patients really like telemedicine and doctors don’t really think it’s that great! Why patients only have one bad experience with a telemedicine technology a month, whereas doctors could have dozens a day. Telemedicine is far from going away, but there is a return to patients' desire for in-person visits, and on the tech side there’s actually an increase in demand for texting in various segments.
Medical students and doctors will increasingly feel that their education was inadequate in some of the most important aspects of digital transformation patient experience, wellness, and health equity. Doctors are the first to admit that they’re trained to heal people but not necessarily themselves. Burnout is a perfect example of an area where docs (and healthcare leaders) tell us that there are huge gaps in education on stress management and delivering equitable healthcare.
Loneliness will reach pandemic proportions globally despite advances in technology to reduce the effects of isolation. When nations literally appoint a Minister of Loneliness there is reason to watch this trend in 2023. Needless to say, COVID isolation magnified loneliness at the patient level, but my personal experiences tell me how profoundly lonely many clinicians and doctors have become. Voice-enabled technology will arguably help with the elderly, but yet again the technology has not been able to advance as quickly on empathic recognition as it has on basic speech recognition.
I challenge you to join us in person at a conference or on the ICD Healthcare Network to track the accuracy of my prognostications and to engage with the digital content curated on our site to fill in the gaps between the in-person conferences,
Wishing you a Happy & Healthy 2023!
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