As the healthcare industry continues to evolve and transform with providers facing increasing financial burdens and dynamic patient expectations, Signify Research has had the opportunity to speak to 100s of C-suite health IT executives and departmental decision-makers. Our conversations with these healthcare leaders have provided greater insight into their organizations’ technology and business strategies. It has also illuminated their views on the industry’s most pressing issues. Here are five key trends that are driving their purchasing decisions within an evolving healthcare IT ecosystem.
Trend #1: Consolidation of IT Procurement
In recent years, changes to the health systems in countries such as the US and UK, for example, are making standalone hospitals a thing of the past. Today, many hospitals are already part of healthcare networks combined with primary care clinics, allied care providers, insurers, and other agencies working together to coordinate and deliver a range of care services within their communities. This is evident in the US with the insurgence of both IDNs and ACOs, in France with the development of GHTs, and in the UK with the growth of ICSs (Integrated Care Systems). The mandate of these healthcare networks is clear – to improve patient experiences and population health outcomes while simultaneously reducing costs. And a crucial factor influencing this mandate is increasing levels of digital transformation.
As health organizations and care networks regularly depend on the use of digital tools, a larger portion of IT software continues to be sold as either part of regional tenders or as a piece of an enterprise strategy. This has created the emerging role of C-suite health executives as portfolio managers focused on increasing growth, enhancing productivity, and reducing care costs within the organizations they lead. And when it comes to IT procurement processes, decision-making influence has now shifted from departmental users to C-suite health executives or central stakeholders (i.e., CIOs, CEOs, government, etc.) creating tension between these groups when it comes to streamlining purchasing options and the reduction of IT vendor contracts.
Speaking directly to CIOs, many have emphasized to us the myriad of organizational benefits to IT vendor consolidation such as reduced costs, greater purchasing power, improved IT vendor management, increased vendor quality, and efficient processes. However, they have also highlighted several key challenges such as the time, resources, and project management efforts required to make IT vendor consolidation changes within an enterprise. Some departments or physician practices acquired within a network do not want to change to a different vendor, so getting their agreement to roll under one centralized contract can be a difficult process.
Many health IT buyers have also shared their perspectives with us on the changes to their roles over the years that coincide with the growth of the digital economy. For example, CIOs today are no longer just overseers of IT operations and services. They are now acting as key business strategists, working alongside other C-level peers and the board of directors to create business models necessary to thrive and survive in this new era. They manage IT investment processes and frame questions around the potential effectiveness of these opportunities and alternatives.
As a result of this multifaceted role shift, C-level health IT decision-makers also place value on the need to work with IT vendors that offer future-proof technology, access to third-party partnerships, and innovation to continuously support the changing needs of their organizations. In conversations with healthcare IT decision-makers, many have confirmed their need to constantly keep the theme of potential IT vendor mergers and acquisitions at the back of their mind when making any purchasing decisions.
Trend #2: Reducing Data Siloes while Improving Interoperability and Analytics
With the growth of diverse healthcare ecosystems, this evolution continues to be a significant contributor to functional data siloes affecting care delivery services. Added pressures of value-based care and cost-effective population health management are forcing healthcare organizational structures to rethink how they utilize data to support and assess their care delivery paradigm.
Speaking to CIOs, they have made it clear that incomplete patient information at the point of care is a constant problem. Much of patient health data management is still largely siloed, even with information available through EHRs. Data siloes can easily form in any department where data is stored creating the potential for providers to miss out on critical patient information. And most IT decision-makers agree that full EHR interoperability and data standardization remain the holy grail that fuels their drive for employing different strategies within their organizations to access a patient’s complete medical history. This is a major challenge with almost every healthcare system in existence today simultaneously utilizing EHRs from multiple vendors.
While health systems are prioritizing their efforts to improve interoperability between EHRs and siloed patient data, healthcare IT vendors are also following the trend. And many organizations are adopting new international standards like FHIR that lay out how healthcare information can be exchanged.
Healthcare IT decision-makers we spoke to have also mentioned how a patchwork of health information exchanges is attempting to fill data gaps with some EHR vendors such as Epic, athenahealth, and eClinicalWorks, for instance, creating private exchange networks to allow more data sharing between different health organizations with similar platforms. Our conversations with IT buyers also highlight that having appropriate tools to do in-depth data analysis that produces actionable insights is what creates value over and above simply collecting and storing data from different systems. And while EHRs store the bulk of the patient information, these solutions fall short of providing built-in user-friendly analytics tools for measuring things like patient health outcomes or tracking KPIs; thereby reducing timely and efficient reporting capabilities. This shortfall has led to organizations adopting external DIY business intelligence software (i.e., Tableau, PowerBI, etc.) to fill the data analysis gap. The use of external BI software requires additional manual data handling processes which in turn consume greater staffing resources.
While the notion of universal interoperability is a daunting proposition for many healthcare IT buyers to address with current disparate vendor solutions on the market, most agree that once achieved, both health systems and patients stand to gain. And that a key element of this journey is recognizing that any interoperability and data analysis solution needs to be built around EHRs with IT purchasing decisions focused on key drivers such as improving patient care, enhancing clinical staff workflow efficiencies, and reducing data fragmentation.
Trend #3: Ensuring Cloud Success with New Approaches to IT
To achieve digital transformation within healthcare organizations today, investment in cloud migration is a priority. Moving databases, applications, IT resources, and workloads from legacy infrastructure to a cloud environment bring new opportunities for assembling siloed data, increasing interoperability, and improving patient outcomes.
In recent years, healthcare IT leaders have told us about the many benefits of cloud migration within their organizations, such as easier access to data across care settings, reduced capital expenditure costs for maintenance of in-house infrastructure equipment, and improved data and systems backup cover in case of emergency or natural disaster. They also have mentioned how cloud computing enables greater flexibility and scalability for organizations needing more storage capacity or changes in the deployment of applications based on demand spikes or workload. The scalability that comes with cloud migration also offers the opportunity to employ advanced technologies such as AI/ML to run analytics on big data which provides greater insights into patient needs or advances clinical research into effective treatments.
An increasingly common trend within medium to large-scale healthcare settings is to have full EHR or aspects of these systems connected to the cloud, followed by other software such as HR, payroll, and various enterprise applications related to workflow efficiencies, training, or learning. And while there is growing appetite amongst C-suite executive decision-makers to develop widespread cloud-adoption plans, the journey is often cumbersome and slow-moving at best. Only around 15% of health systems we have spoken to, for example, have completed the migration of their EHR to the cloud. The complexity and bureaucracy of health systems or regional procurement contribute to long adoption cycles, with some deals taking up to five years for implementation.
When considering cloud success, health IT leaders agree that a well-thought-out strategy and plan for migrating applications is a necessity. And along with that plan, IT leaders also need to examine their departmental structures and reorganize their technology teams to ensure that they align with the overall cloud strategy. Re-organizing workers will empower staff to make use of the enhanced capabilities that cloud computing will provide.
According to several IT buyers we have spoken to, cloud capabilities of software solutions play a significant role in their purchasing decisions along with the protection of patient’s health data from security breaches. They will only consider cloud providers who ensure sensitive data is stored securely while adhering to industry regulations.
Trend #4: Improving Patient Safety
Patient safety challenges are constantly evolving and within health systems, these challenges are exacerbated by other issues such as staff shortages, workforce burnout, and misinformation about treatments.
Quality improvement issues are paramount for hospitals and health systems to achieve their patient safety goals and health information technology can provide the tools to standardize workflows, improve insights, and aid clinicians and health staff to reduce barriers to equitable care.
Clinical Decision Support (CDS) solutions are an important add-on to EHRs, providing the potential to limit patient care errors and improve adherence to medicines. CDS provides medication reconciliation with the potential to cross-check prescriptions, reduce adverse drug reactions, and assist with ensuring compliance with practice guidelines.
Health IT buyers have told us they recognize that health information technology is a significant tool for ensuring care quality and safety. However, when choosing which technology to invest in, buyers agree that health organizations need to be selective as some solutions have limited evidence in improving patient safety outcomes. When choosing potential solutions to purchase, key factors that tend to be considered most often amongst buyers are the quality and frequency of alerts, clinical flags, or reminders, the tracking and reporting abilities of consultations and diagnostic testing, and most importantly, the availability of complete patient data.
Trend #5: Decreasing Clinician Burnout
Clinical workforce burnout is a significant issue within the health industry affecting healthcare professionals. Burnout is a result of long-term exposure to occupational stressors and can depend on several factors including workload pressures, inefficiencies, or moral distress.
Healthcare professionals are susceptible to burnout from IT solutions such as EHRs and CDS. EHR usability issues can potentially result in an increase in task loads, which consequently limits the amount of available working or cognitive memory for medication decision-making and patient communication. This limitation contributes to clinician burnout.
CDS software can also increase clinician frustrations and lead to burnout. CDS is a significant module of some EHRs, and while the software is designed to reduce medication errors or support decision-making, it can also cause other issues such as delays in treatment. CDS impacts clinicians in several ways, including changing their workflow and volume of tasks, causing alert/alarm fatigue, contributing to loss of autonomy, and the build-up of anxiety due to medical/legal ramifications of potential clinical decision errors.
For a significant number of health IT buyers, reducing clinician burnout is a major reason why an EHR solution would be reassessed or possibly replaced with a new system. And when considering purchasing new software, buyers are prioritizing features that improve efficiency and would support the displacement of existing solutions. Examples of such features include integrations with software applications providing voice dictation or speech-to-text capabilities, improved drug safety, and better integration with billing and practice management.
And there you have it – five significant trends driving IT purchasing decisions of health buyers. Which trends excite you the most?
About Rohinee Lal
Rohinee joined Signify Research’s Custom Research & Consultancy team in early 2022. She brings over 24 years of experience collecting, analyzing, & presenting market intelligence across various industries including pharmaceuticals, medical devices & digital health. She has a master’s in medical Anthropology from the University of British Columbia (Canada).