Consumerism, autonomous operations, interoperability, healthcare access, health equity – these are some of the top issues facing healthcare CIOs and other health IT leaders in 2023, according to Pega Vice President of Healthcare Life Sciences Susan Taylor.

We spoke with the health IT vendor executive to get her expert views and 2023 predictions on these issues as well as other topics such as social determinants of health and EHR optimization. Her informed takes on these important subjects can help guide leaders through the year to come.

Q. What do you think will be the top health IT priorities for 2023?

A. As we enter 2023, healthcare organizations are still emerging from COVID-related challenges, dealing with critical staffing shortages, and facing strong inflation across labor and supply chains. The constraint on health IT to deliver immediate value has never been more severe, and the opportunity for technology to deliver value has never been greater.

With that in mind, organizations are focusing on areas that will give them the agile operations platforms foundational to accelerate innovation and outcomes.

There is the issue of creating autonomous operations. Labor shortages across clinical and administrative staff continue to impact organizations' top and bottom lines and frustrate and exhaust employees. I recently spoke with a CMO who shared that a health system's MDs were operating well below their capacity due to shortages in administrative staff.

Another CEO mentioned they could no longer afford to staff traditional call centers: "By the time staff are trained, they are out the door."

Reimagining operations to optimize the volume of work with automation and improve the impact of administrative work through insights is a trend in high-volume, high-value operations. An effective strategy for healthcare organizations to address the critical gap in administrative staffing is to bring to bear all the automation tools that dramatically accelerate work and other service businesses.

From automated agents to workflow automation, getting work done even when no one is watching positions an organization to ensure every staff member is operating at their highest level of training and productivity and contributing the most to organizational outcomes.

The heart of the matter in healthcare outcomes is consumerism. As we enter 2023, digital consumer engagement in healthcare will emerge as a cost-effective choice for care engagement. COVID accelerated the transition to digital health as a channel for visits, including sustained transformation from in-person chronic care management to telehealth.

With the digital channel open for visit delivery, and evolving CMS regulations putting patient consumer experience front and center for both payers and providers, there's tremendous pressure to expand digital services and deliver on patient expectations for personalized, empathetic care experiences that address whole-person health, builds the trust needed for long-term adherence, and aligns patient and healthcare provider outcomes.

Whole health will truly become whole person health. When looking at the compelling impact the financial burden of healthcare places on consumers' healthcare actions, it's time for empathetic financial relationships to become a critical component of personalized whole health.

Empowering consumers' confidence in their ability to manage all aspects of their health – clinical, financial and administrative – can be easily supported by technologies that exist today and can be used to engage, assess and adjust in real time, in the moment of patient need.

Then there is interoperability in moments that matter. Years of acquisitions, service-line-based investment strategies, and incremental technology advances have created islands of information across healthcare organizations.

Patients and staff have been forced to navigate these islands to understand care. For patients, this creates friction, wasteful care use, and even experiences that erode trust and can lead to abandonment.

EHR optimization begins to address this problem but can create long projects with slow ROI as mountains of data are moved when only a small amount of it will be used to drive patient care. To move faster, organizations are starting to leverage outcome-driven models to ensure the best enterprise information is available as needed.

It will require interoperability and agility to create integrated digital records for consumers as their healthcare technology continues to accelerate advances.

For example, access to dental records outside the health system would support a meaningful exchange of information to manage the link between oral health and overall health. Or interoperability in support of prior authorization, as proposed by recent legislation, will accelerate access to care.

This will come as payers rethink provider organizations' impact on their consumer satisfaction scores. In meeting with payers, they will see the effect of patient service delivery on their consumers and their top and bottom line. They are rethinking the nexus of interoperability and looking at ways to leverage technology to streamline the experience for their members and providers.

Q. How may the democratization of care – access and equity – advance in 2023?

A. When I started computing, it took years of study to become a competent coder who could optimize the bits of storage required to compute an answer.

Over my career, the common threads that led to the explosion of access and availability across semiconductors, satellite meteorology, and healthcare are the best outcomes that have come from (1) real-time dynamic context evaluation and (2) focus on empowering the experience of the end-user in achieving their goals. Access to creating new technology has powered a new world of engagement for developers and their customers.

I have had this experience throughout my career in healthcare IT. My first project, in 1995, enabled remote image capture for radiology with the digital transfer of images and data to a centralized medical center creating access to care.

The next project demonstrated integrated benefits using smart card technology to give consumers a portable benefit record, holding WIC, EBT, Head Start and immunization data.

Today, digital experience technology, including voice technologies, is available to create personalization at a scale that empowers and informs consumers to ensure they are always taking the next best action to inform their health outcomes and address their health-related issues – no matter the source.

In Pega's 2021 survey, nearly half of consumer respondents said they trust AI to help their doctors make better decisions about their healthcare. Digital connections to community resources, support services, or even telehealth counseling are all happening today but are not widespread.

Widespread deployment is possible and must be prioritized. With all this opportunity, technology also holds the risk of bias.

As we deploy technology to open access and address equity issues, it is critical to insist on ethical AI with transparency and explainability.

Q. What will be technology's role in better understanding social determinants of health next year?

A. Technology holds the potential to recognize and act in real time on SDOH issues as they emerge. Progressing from assessment to an action plan for consumers with complex needs requires the ability to quickly look across all potential actions and suggest the most immediate action – whether that's an action from the care team or guidance to the consumer.

If that action is a referral to a CBO, leveraging technology like Aunt Bertha may allow digital engagement to manage that complete handoff and, ultimately, the timely follow-up.

With richer consumer data collection and self-management, healthcare machine learning technology can support going beyond Z-code capture to analyze consumer data and ultimately drive the development of adaptive and predictive models to engage and address SDOH issues more quickly when it is meaningful to consumers and their health outcomes.

Lastly, the most significant return on investment that communities can have with SDOH programs is the effectiveness of empowering consumers to manage their health and healthcare programs, including adherence. Digital experiences can be used to deliver incentive programs to support ongoing adherence according to preferences expressed by the consumer.

An NIH study showed a positive adherence impact for adherence rewards delivered periodically and at the point of interaction. This concept holds the promise for technology to empower health outcomes.

Q. What does the future hold for EHR optimization? What can it unlock?

A. EHR optimization can create an agility layer that unlocks insights needed to address whole-person health more deeply. The potential of EHR optimization to identify gaps in care more efficiently or the potential for duplicative care would be a significant contribution.

The COVID-19 pandemic has illuminated preexisting problems in the healthcare delivery system and taken a toll on the U.S. physician workforce. Taxed to their limits, we've seen a dramatic increase in occupational burnout and decreased satisfaction with work-life integration – affecting the quality of care, turnover and reductions in work effort.

Findings from the Mayo Clinic suggest that ongoing efforts to mitigate physician burnout are critically important for the U.S. healthcare system.

The best near-term outcome, however, would be for EHR optimization to be a tool that can be used to reinvent administrative operations. Well positioned, such an effort would dramatically reduce the administrative burden placed on healthcare workers – clinical and administrative staff alike – leaving them with more time for patient care and the self-care necessary to build a resilient healthcare system.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email the writer: bsiwicki@himss.org
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