12 Healthcare IT Predictions for 2014

In early 2013, I made 13 predictions for the year in healthcare IT. Many were admittedly general, if not obvious, if for no other reason than to avoid looking foolish at year’s end. (And yet I still missed the mark on a few predictions.)

In 2014, I’m aiming to be a bit more specific — and a bit more bold. Another year of watching the industry has given me a confidence boost. No more Telehealth will take off or Security will be important. So here are 12 things I expect to happen in the world of healthcare IT in 2014. Let me know what you think.

The Healthcare.gov launch failed miserably; would-be applicants couldn’t access the site, couldn’t view information about insurance policies without creating profiles and couldn’t get guarantees that their passwords would be safe. The fixes promised for Jan. 1 were met with mixed results; even well-prepared states such as Connecticut had problems. If the site still isn’t working properly by the March 31 enrollment deadline, expect lawsuits from those who tried — and failed — to use the site to get coverage. Even if those suits aren’t filed, expect CGI, QSSI and other Department of Health and Human Services subcontractors to get hauled into court.

Consumer mobile health apps are all the rage, especially among venture capitalists. It’s not surprising: The computing power of smartphones and, increasingly, wearable technology makes them excellent resources for tracking diet, exercise and vital signs. There’s one problem, though, and it’s a doozy: Many mHealth apps are insecure.

The FDA regulates mobile medical applications that turn a smartphone into a medical device (using, say, a sensor or electrode) and would harm patient safety if they malfunction. Most mHealth apps post no such safety risk and aren’t FDA regulated. Fair enough. But they store personal health information, so they pose a security risk — and a major data breach in such an unregulated, largely uncertified market is unfortunately inevitable.

In July 2013, amid rumors of an imminent iWatch release, Apple hired many medical sensor and fitness experts, and paired them with hardware and software engineers. Last month, Apple received two patents; one is for a heart rate monitor, embedded in iOS devices, which Apple has been developing for four years. It’s hard to say what exactly Apple will do, and smartphones may not cut it as diagnostic tools, but last year’s events suggest that Apple may make a major medical device announcement in 2014.

EHR implementations are like blockbuster professional sports contracts — several years, hundreds of millions of dollars, lots of scrutiny. That, plus the largely finite number of U.S. hospitals, makes gaining market share tough for the 6 biggest EHR vendors (based on meaningful use attestation): — Epic, Allscripts, eClinicalWorks, NextGen, GE Healthcare and Cerner.

Enter the hundreds of EHR vendors that lie beneath. Each vendor fills its own niche: Regional, cloud-based, free, made for a certain medical specialty, home-grown, mobile and so on. If one of the “Big 6” wants to grow, innovate or improve customer satisfaction, it will probably need to buy a competitor.