Photo courtesy of Sebastian Seiguer
The COVID-19 pandemic has highlighted the importance of all kinds of healthcare information technology, from telehealth to artificial intelligence. As a result, the opportunities that exist for health IT companies are massive.
Crunchbase estimates that healthcare technology companies have raised a record-breaking $36.6 billion globally from 2020 through October 2021. That sizable mountain of cash offers myriad opportunities for innovation in 2022 and beyond.
To get an idea of what this future may hold, Healthcare IT News interviewed Sebastian Seiguer, CEO of the Johns Hopkins-backed health IT company emocha Health. Sebastian discusses how the pandemic has reinforced the need for AI and machine learning technology to help improve patient and clinical outcomes, how health IT can help address the challenges facing the U.S. healthcare system and help mitigate revenue loss, and the top innovation opportunities that exist for health IT companies.
Q. How has the COVID-19 pandemic reinforced the need for artificial intelligence and machine learning technology, moving into 2022, with the goal of improving patient and clinical outcomes?
A. While advanced AI applications hold great promise for healthcare, we currently lack the giant datasets and the granularity of data to go beyond fairly simple algorithms and truly improve outcomes.
At the simplest level, AI refers to training machines to act like humans, automating routine tasks such as coding claims or scheduling appointments. Today, AI in healthcare is most commonly used to automate tasks such as call center routing or appointment scheduling.
AI-powered chatbots are a perfect example – these are glorified decision-tree frameworks in a chat window, in content not much different than the automated computer-voice decision tree we experience when calling into large companies or government agencies.
There are at least two reasons why we lack the needed data sets to fulfill the promise of AI in healthcare. First, much of our healthcare data is siloed between providers’ offices, health insurers, laboratories and other locations. Each locale collects patient data, but the data sets don’t talk to each other.
And second, so much of what influences health takes place outside of healthcare settings, where patients live, work and play. Today there’s a huge push to integrate social determinants of health data into these larger datasets, but we remain in a situation where that data is either not collected or too general to be useful. This is not an adequate basis for meaningful machine learning.
We know, for example, that half of patients don’t take their medications as prescribed. This leads to death and preventable hospitalizations, among other terrible outcomes.
Yet we don’t employ the data systems and technologies to track the exact causes and cadences of medication non-adherence. Until we can pinpoint the reasons behind non-adherence on a dose-by-dose basis, we won’t be able to create predictive algorithms to help us intervene effectively.
The good news, though, is that activity in this area is exploding. COVID-19 pushed us to digitize healthcare interactions and federal rules are requiring that datasets adhere to standards that allow for integration. These trends point to exponential growth in both the size and granularity of our datasets, allowing healthcare data scientists to begin to train the models needed to truly realize the potential for AI to impact clinical outcomes.
Q. There are some predictions that health systems may suffer revenue loss in 2022. How can health IT help mitigate such loss?
A. Health systems are at a crossroads. During the early days of the pandemic, they rapidly adopted virtual care models – telehealth and e-consults – and patients adapted. Now, with increasing vaccination, some patients are coming back to in-person visits, but the volume is far less than pre-pandemic levels – and is likely to remain low through 2022.
The solution is for health systems to adapt to and further extend virtual care models. More types of virtual care are now reimbursable thanks to new rules created by CMS.
For instance, by recently approving a new set of reimbursement codes for remote therapeutic monitoring (RTM), CMS has made it possible for health systems to get paid for a wide range of virtual therapeutic encounters. By embracing a hybrid model of in-person and remote care, health systems with employed providers may be able to make up some of their projected lost revenue.
Q. What are a couple of the top innovation opportunities for health IT in 2022?
A. This is a huge question, as health IT touches all parts of the U.S. healthcare ecosystem: payers, providers, researchers, life sciences, etc.
My company is mainly concerned with one dynamic in particular: how relevant healthcare technologies can be combined with human engagement and scaled so virtual care can also improve clinical care and complete the consumer experience.
The first wave of innovation in that space involved allowing providers to communicate with patients via chat, video, photo-uploads and texting. Those abilities have now become standard fare – patients expect them, and all providers will have to offer them.
The next wave is the dawn of digital-first clinics with a primary care focus, while offering certain specialties – such as physical therapy, cardiology, maternity or behavioral health. These providers are interacting with patients in a mix of bricks-and-mortar and virtual care models.
Another emerging opportunity lies in RTM. Built into the 2022 Medicare Physician Fee Schedule, RTM codes encompass a broad set of virtual patient care services, including the digital collection and monitoring of medication adherence and “therapy response” data as well as the delivery of “treatment management services.”
RTM also provides reimbursement mechanisms for digital programs that help patients follow “doctor’s orders” in between appointments – including taking medication properly.
Q. What will the next wave of health IT-fueled consumer innovation look like in 2022 and beyond?
A. COVID-19 showed us that providers and patients alike are capable of embracing new digital modalities. Now these interaction formats are becoming normalized and commoditized. Into 2022 and beyond, the implementation, adoption and integration of digital and virtual care across different populations and use-cases will keep expanding.
As healthcare delivery becomes more location-agnostic, consumers will likely expect their healthcare experiences to look and feel more like other online experiences but with greater privacy, and the opportunity for personal connection.
As healthcare leaders, our challenge will be to assure that we integrate in-person and virtual care without sacrificing healthcare outcomes and while continuing to improve patient engagement.
Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.
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