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Healthcare AI Could Generate $150B In Savings By 2025

Posted on September 27, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Is the buzz around healthcare AI solutions largely hype, or can they deliver measurable benefits? Lest you think it’s too soon to tell, check out the following.

According to a new report from market analyst firm Frost & Sullivan, AI and cognitive computing will generate $150 billion in savings for the healthcare business by 2025.  Frost researchers expect the total AI market to grow to $6.16 billion between 2018 and 2022.

The analyst firm estimates that at present, only 15% to 20% of payers, providers and pharmaceutical companies have been using AI actively to change healthcare delivery. However, its researchers seem to think that this will change rapidly over the next few years.

One of the most interesting applications for healthcare AI that Frost cites is the use of AI in precision medicine, an area which clearly has a tremendous upside potential for both patients and institutions.

In this scenario, the AI integrates a patient’s genomic, clinical, financial and behavioral data, then cross-references the data with the latest academic research evidence and regulatory guidelines. Ultimately, the AI would create personalized treatment pathways for high-risk, high-cost patient populations, according to Koustav Chatterjee, an industry analyst focused on transformational health.

In addition, researchers could use AI to expedite the process of clinical trial eligibility assessment and generate prophylaxis plans that suggest evidence-based drugs, Chatterjee suggests.

The report also lists several other AI-enabled solutions that might be worth implementing, including automated disease prediction, intuitive claims management and real-time supply chain management.

Frost predicts that the following will be particularly hot AI markets:

  • Using AI in imaging to drive differential diagnosis
  • Combining patient-generated data with academic research to generate personalized treatment possibilities
  • Performing clinical documentation improvement to reduce clinician and coder stress and reduce claims denials
  • Using AI-powered revenue cycle management platforms that auto-adjust claims content based on payer’s coding and reimbursement criteria

Now, it’s worth noting that it may be a while before any of these potential applications become practical.

As we’ve noted elsewhere, getting rolling with an AI solution is likely to be tougher than it sounds for a number of reasons.

For example, integrating AI-based functions with providers’ clinical processes could be tricky, and what’s more, clinicians certainly won’t be happy if such integration disrupts the EHR workflow already in existence.

Another problem is that you can’t deploy an AI-based solution without ”training” it on a cache of existing data. While this shouldn’t be an issue, in theory, the reality is that much of the data providers generate is still difficult to filter and mine.

Not only that, while AI might generate interesting and effective solutions to clinical problems, it may not be clear how it arrived at the solution. Physicians are unlikely to trust clinical ideas that come from a black box, e.g. an opaque system that doesn’t explain itself.

Don’t get me wrong, I’m a huge fan of healthcare AI and excited by its power. One can argue over which solutions are the most practical, and whether AI is the best possible tool to solve a given problem, but most health IT pros seem to believe that there’s a lot of potential here.

However, it’s still far from clear how healthcare AI applications will evolve. Let’s see where they turn up next and how that works out.

Are Patient Portals Really Helping Patients?

Posted on December 4, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

One thing’s for sure about patient portals: They’re a hot commodity.

What’s less clear is how much good they’re doing for health care.

The popularity of patient portals stems from Meaningful Use Stage 2 patient-engagement requirements. The market for the products is expected to approach $900 million by 2017, up from $280 million in 2012, according to a report from Mountain View, Calif.-based research firm Frost & Sullivan.

Patients like at least one aspect of the portals — the ability to access their own medical records. In a recent Accenture study, more than 40 percent of consumers who can’t access their own records online said they’d consider switching doctors in order to get access.

But several recent studies suggest that currently available products have a way to go before they can consistently improve care, reduce costs or perhaps even increase patient engagement.

In a review of 46 studies, researchers found little evidence that portals were helping much of anything. The doctors from Veterans Affairs Greater Los Angeles Healthcare System and other institutions wrote that it’s “unlikely that patient portals will have substantial effects on utilization or efficiency, at least in the near term.”

Some of the limitations of the products, they wrote, included “disparities in who accesses these portals and instances of suboptimal patient attitudes of their worth.” The portals typically gave patients options such as looking at their test results, refilling prescriptions and communicating with doctors.

Patient portals likely are most beneficial, the authors wrote, when they’re part of a more comprehensive quality-improvement strategy.

Another study also found that patients, in many cases, fail to see the value of a portal — or at least some parts of it. In questions about hypothetical features, consumers showed interest in “back-office” tasks such as seeing their own medical records. But clinical digital communication capabilities, such as online video consultations with doctors, failed to impress.

The bottom line was that patient portals “may act as a complement to health-care service delivery, while substitution for clinical in-person interactions may not be viewed positively.” In other words, most people just don’t seem to be ready to give up face time with their primary-care physician.

When MU2 starts on Jan. 1, physicians will be required to give their patients electronic access to their health records. The requirement went into effect for hospitals in October.

The U.S. health care system is, with government prodding, investing a huge sum in patient portals. The idea sounds empowering for patients. But given the lack of solid evidence for a benefit at this point, it’s concerning to think the money might be better spent on something else. Let’s hope that vendors and providers are soon able to turn portals into something with tangible benefits for quality care.

Mobile PHRs On The Way — Slowly

Posted on October 24, 2013 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

On-demand mobile PHRs are likely to emerge over time, but not until the healthcare industry does something to mend its interoperability problems, according to a new report from research firm Frost & Sullivan.

As the paper notes, mobile application development is moving at a brisk clip, driven by consumer and governmental demands for better quality care, lower healthcare costs and improved access to information.

The problem is, it’s hard to create mobile products — especially a mobile PHR — when the various sectors of the healthcare industry don’t share data effectively.  According to Frost  & Sullivan, it will be necessary to connect up providers, hospitals, physician specialty groups, imaging centers, laboratories, payers and government entities, each of which have operated within their own informational silos and deployed their own unique infrastructures.

The healthcare industry will also need to resolve still-undecided questions as to who owns patient information, Frost & Sullivan suggests.  As things stand, “the patient does not own his or her health information, as this data is stored within the IT  protocols of the EHR system,  proprietary to providers, hospitals and health systems,” said Frost & Sullivan Connected Health Senior Industry Analyst Patrick Riley in a press statement.

While patient ownership of medical data sounds like a problem worth addressing, the industry hasn’t shown the will to address it.  To date, efforts to address the issue of who owns digital files has been met with a “tepid” response, the release notes.

However, it’s clear that outside vendors can solve the problem if they see a need. For example, consider the recent deal in which Allscripts agreed to supply clinical data to health plans.  Allscripts plans to funnel data from participating users of its ambulatory EMR to vendor Inovalon, which aggregates claims, lab, pharmacy, durable medical equipment, functional status and patient demographics for payers. Providers are getting patient-level analyses of the data in return for their participation.

Deals like this one suggest that rather than wait for interoperability, bringing together the data for a robust mobile PHR should be done by a third  party. Which party, what it will it cost to work with them and how the data collection would work are the least of the big problems that would have to be solved — but might be that or nothing for the foreseeable future.

$3 Billion Ambulatory EHR Market

Posted on September 2, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This recent Frost and Sullivan study (requires registration to access) has been making the healthcare IT and EMR blog rounds lately. The parts of the study that are most interesting to consider is their estimated EHR market size.

A study by Frost & Sullivan predicts that revenue for the U.S. ambulatory electronic health record (EHR) market will double from $1.3 billion in 2009 to an estimated $2.6 billion in 2012. Further, by 2013, the market will reach its peak, posting revenue of $3 billion. However, by 2016 market saturation will have occurred and revenue is expected to fall to $1.4 billion.

That’s right. They estimate in 2013 the ambulatory EHR market will be $3 billion. Now compare that number with the $36 billion of EHR stimulus money that’s available (or whichever ARRA EMR stimulus projection you prefer). Are hospitals really going to take that much of the EHR stimulus money? Something just doesn’t feel right about these numbers.

Other salient points from the study I wrote about in my posts about Complex Reimbursement as the Real Driver in EHR Adoption and the reshuffling of providers favoring Large EHR vendors.

Reshuffling of Ambulatory Physicians Favors Large EHR Vendors

Posted on September 1, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

She [Nancy Fabozzi, a senior industry analyst at Frost & Sullivan] said many physician practices are facing financial difficulties and the result is physicians are increasingly selling their practices to hospitals, entering into joint ventures with hospitals, or joining larger group practices.

“This whole reshuffling and realignment among ambulatory physicians is going to have a huge impact on the vendor market because many of these 300 vendors that we talk about are a lot of mom and pop EHR companies that have under a million dollars in sales annually,” Fabozzi said.

She added that if physician practices are going to be a part of a big hospital network or a large medical practice group they are going to buy EHR products from larger vendors.

It’s been becoming pretty clear that many small physician offices are selling off to hospitals or larger group practices. This consolidation has been going on for a while and really is going to change the healthcare industry in dramatic ways. I agree with Nancy Fabozzi quoted by Information Week above, that this consolidation favors the EHR Software that comes from larger EHR vendors. Right or wrong, hospital and large group practices generally select the larger EHR vendors.