2013 in the Rear-View Mirror

We’re trudging ahead (some of us deep in a couple of feet of snow) into 2014. As we do, it’s fun to look back on the trends from the past year.

Patient Engagement

This was one of the most widely used terms this year in digital health. It seems like we heard "patient engagement" almost as much as Meaningful Use, ICD-10, and big data.

Patient engagement is seen by many as the key to the triple aim:  better outcomes, lower costs, better patient experience. It is seen as an essential part of accountable care and readmission prevention, two other massive trends in health. As the financial burden on patients increases, patient engagement might start to scale, but it is far from there today. Many vendors are expanding into this area (though EHR personal health records aren’t patient engagement) and new ventures are launching and getting funding.

With a definition that is still somewhat up for debate — at least from the widely varied uses of the term — we at least now have a framework from National eHealth Collaborative for patient engagement. Patient engagement is a trend that will only grow in 2014 as we start to get a better understanding of what it means for patients, providers, systems, and payers. Hopefully we’ll start to see more of a systematic and critical approach mapped to something like this framework.

mHealth Identity Crisis

I wrote about this after the mHealth Summit. Mobile and connected health seems to be lumped with a host of non-EHR and non-PM health IT such as telehealth and startups. We do the same thing here at HIStalk Connect in including new ventures, telehealth, and even APIs into connected health. Health 2.0 got the naming right and is at least consistent.

This is another trend we’ll see more of as people start to focus less only on mobile and more on digital health and innovation.

Compliance and Regulation

The FDA finally provided more clarity into what types of mobile health apps and devices will require its clearance, though my experience is that most smaller vendors are still confused about the need to apply. This was a long time in the making for the FDA and will continue to evolve, hopefully with more concrete examples.

The FDA also made waves recently with its public shaming of 23andMe. The FDA ordered 23andMe to stop marketing its genetics testing kits to consumers for health benefits. 23andMe complied when it stopped telling customers about predispositions to certain medical conditions based on genetics data. I assume you can still learn who your second and third cousins might be.

Also in 2013, the HIPAA Omnibus Rule went into effect in the fall, expanding the scope of HIPAA and definition of business associate. The most affected areas seem to be cloud-based vendors and services that process, store, or somehow transmit ePHI. HIPAA compliance is an area that will continue to be big news as more ePHI flows into and through cloud-based infrastructures and APIs open up so data flows more freely.

Wearable Everything

The isn’t a new trend, but it certainly continued its trajectory this year. The biggest news was in the quantified self realm, with Fitbit still ruling supreme and raising money to tell everybody about it. Lots of other companies launched, many of which are using crowdfunding to get off the ground.

The most exciting wearable company for me this year was Sqord. That’s probably because I’m obsessed with kids’ health, I think physical education in its current state is a joke, and I recently saw how much my kids love wearing Sqords.

The other big wearable news was of course Google Glass. Glass is getting a lot of attention in health. Surgeons are recording surgeries. A health system launched an incubator for wearable such as Glass. Docs started using it to stream data for remote data entry and consultation. All that and Glass is still very early. 2014 will be a big year for Glass in health, though I’m skeptical it will be involved in anything more than new pilot projects.

From App to Platform Moves

This is a trend that started last year. Companies like LostIt! and Fitbit have begun to make the shift from app to platform. CarePass is vying to be the place where people combine data from multiple tracking devices and apps. I think it will be another year or so before we start to see winners emerge, but we’ll see a lot more apps become platforms before then.

APIs to Solve Health Data Interoperability

Enterprises (from Kaiser to Aetna to Walgreens), vendors (from athena to Greenway), and startups such as Eligible and Validic are bringing the API revolution to healthcare. Even “we don’t partner” Epic announced Open.Epic.com. API management companies, especially Mashery and Apigee, had good success selling into healthcare enterprises (Mashery and Apigee manage APIs for most of the entities I listed).

The most interesting APIs are probably those of Walgreens and Eligible because their APIs are better thought out and are more usable for developers of applications. The major problem with EHR APIs — at least the current available or planned versions – is that they are resource based. Simply puking out a laundry list of API routes that provide access to individual aspects of the EHR data models, while a great start, is hard to use. I think we’ll start to see more purpose-built APIs that combine different data into more usable routes that are easier to use to build real applications.

Big Data

Where would we be without big data? Probably right where we are since we aren’t really realizing the power of big data yet.

Big data is still all hype in healthcare but, if you’re looking for an industry that has lots and lots of data with more being generated all the time, healthcare is a good one. Big data analytics is super powerful, but it’s a lot of work and requires significant changes to existing workflows, training, and interactions to get a good ROI. In healthcare, we still need to combine the data and make meaning from it before we can then make the organizational changes required to inform and change care.

TGphoto

Travis Good is an MD/MBA and co-founder of Catalyze. More about me.

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