By Michael Robinson | February 8, 2018

In what seems like ages ago, the advent of the fax machine promised to transform the integration of health providers across the spectrum of health care in the delivery of care. Today, of course, the medium has changed but the concept is alive and well, as the use of electronic health records (EMR) is now nearly ubiquitous. According to the U.S. Department of Health and Human Services, the number of office-based physicians in the U.S. using EMR has nearly quadrupled in just a decade, rising from 24 percent in 2005 to 87 percent in 2015.

Health care has always been a rich sandbox of creativity and innovation. The past year was no exception: 2017 was marked by the advent of new technology – most notably an explosion of wearable devices and the continued exploration of blockchain’s practicality in securing health care IT. We also saw glimpses of the devastation security threats such as the WannaCry ransomware attack and breaches at health care institutions across the country.

These continuing threats require constant vigilance and innovative approaches to health care IT. In 2018, we can expect a broader adoption and normalization of emerging technologies, as well as a heightened, hyperfocus on securing health information technology architectures and sensitive patient information.

1. IoT Explosion Drives Diversification of Devices and New Challenges

The “internet of things” is fundamentally changing the way people live – an effect that is also launching change and innovation in health care. As IoT continues to spread globally – market intelligence firm IDC expects nearly $1.4 trillion in global IoT spending by 2021 – its expansion will continue to drive proliferation and diversification of medical device innovation and the associated challenges.

 It seems that every day, developers introduce new IoT platforms, solutions and open standards or protocols. They promise greater insight into patient health, physical performance and monitoring of vital signs, in facilities and at the patient’s home.

Practically, the direct value these devices bring to patients is up to the determination of care teams. From an IT perspective, organizations must acknowledge a business case for incorporating IoT devices and ensure monitoring and analysis of connected equipment and sensors occurs reliably.

Organizations building hyperconverged infrastructure will allow for the seamless rollout of new IoT solutions throughout their HIT enterprises. We can also expect the health care industry to expand its reliance on artificial intelligence, machine learning and deep learning technology to work in concert with IoT infrastructure and manage the growing number of communications standards being employed.

2. Widespread Adoption of Digital Clinical Workspaces

The demand for digital clinical workspaces will intensify as the natural productivity and mobility benefits they afford become more integrated into health care delivery strategies.

In a digital clinical workspace environment, the health IT enterprise is expanded beyond the four walls of a facility and beyond regular operating hours. Doctors hoping to check in on a patient’s overnight progress can do so at home from work-issued or personal mobile devices. IT administrators can correspondingly monitor the health and viability of the enterprise. If secured appropriately, digital clinical workspaces can transform workplace technology from the cliché obstacle into a purveyor of productivity and convenience.

 This convenience is especially important to new professionals entering the workforce. They have come to expect reliable, on-demand access to job-critical functions and applications without delay or interference. User experience is increasingly becoming a workforce recruitment and retention consideration as well as a productivity consideration.

This natural trend across industries will especially continue to permeate health care IT, and administrators seeking to further their digital transformation journeys will increasingly consider the digital clinical workspace not as a luxury, but rather as table stakes to enable professionals across the spectrum of care.

3. HIT Cloud Adoption Will Begin a Steeper Increase as Security Concerns Decline

Partly driven by the expansion of IoT devices and the growing need to manage them, we also expect heightened use of cloud technologies in health care. Organizations undergoing a digital transformation will reinvest in core applications that live in the cloud, off-premise, to enable greater agility. The evolving continuum of care also requires that patients’ EMRs are accessible and transferrable by care providers, community partners and health care payers alike.

The cloud does face a cultural obstacle, however, to more widespread adoption. At the 2017 CHIME CIO Fall Forum in San Antonio, 45 percent of focus group participants told us they believe that most of their core applications will live off-premise in one to three years, while 40 percent said that all their core applications will stay on-premise throughout that time.

This split clearly marks the disparity in how cloud technology is perceived among health care IT executives. It is also further indication that this technology is on the cusp of a meteoric rise in use once security concerns are assuaged.

 Anecdotally, those IT administrators hesitant to embrace the cloud told us that they felt cloud providers lacked accountability for the protection of data. It’s an understandable concern – increasingly, applications contain personal health information, requiring a focus on security. Many primary clinical labs seem to want to run their own private cloud environments instead of incorporating public or hybrid cloud architectures.

However, it is a fallacy to assume that health care organizations are better equipped to secure data better than larger organizations managing or running cloud infrastructures. Most of the breaches across the health care industry involve individuals on the inside of organizations: improper use of flash drives, lost laptops or compromised passwords.

Larger cloud organizations and IT infrastructure providers are better equipped to secure data because of their dedicated investments in creating the technology itself. Capital investments, research and development have yielded disruptive technologies such as microsegmentation that promise to be security game-changers and take the burden of IT management away from health care institutions, allowing them to focus more on the actual delivery of care.

4. More Devices = More Threats = More Security Frameworks

The adoption of cloud technology and proliferation of the clinical workspace to include IoT-enabled devices and allow for anytime, anywhere, any device will necessitate health care organizations taking a new or closer look at how they are securing their entire enterprise, as well as their patients’ sensitive medical information.

 Applications with sensitive information will be the main driver of this shifting dynamic. To afford care teams the agility to work from anywhere on any device at any time and access these critical apps, health care IT admins must ensure that security is innate throughout the IT enterprise, not just its perimeter or the data center.
A reliable way to achieve this is micro-segmentation. This security architecture divides the IT environment – networking, storage, applications, the gamut – into small parts that are more manageable to protect than an enterprise-wide perimeter net. Security frameworks are embedded into all IT services and functionalities – each workload serves as its own security perimeter. In the event of a security breach, micro-segmentation mitigates and minimizes the spread of damage and the impact of compromised data.

Micro-segmentation is poised as a technology disruptor much like IT virtualization was at the outset of its development, with app-level security the main driver. Much excitement also surrounds another new technology: blockchain. While still an immature technology within the context of the health care industry, the concept of blockchain offers potentially promising utility if regulated appropriately and managed strategically by health care entities seeking to use it.

Blockchain offers a tamper-proof information sharing mechanism that reduces storage costs and integrates accounting into the transaction records. However, it is potentially in conflict with existing regulatory compliance approaches, and potential health care use cases lack a clear vision for how to use it. Health care organizations must avoid the hype of this innovation and be strategic in employing it.

 While it continues to mature, blockchain could today be useful in several ways, including the management of clinical trials, provider credentialing, processing medical claims payment, Medicare/Medicaid eligibility and as a patient-consent model for health data exchange.
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