“Trust me, you can’t change anything without causing some degree of disruption. It’s impossible, that is exactly what change is. Some people are uncomfortable with the disruption that change causes, but the disruption is necessary if anything is going to change.”

Afeni Shakur, American Activist

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“Old habits die hard”

Anonymous

After nearly twenty years of debating which technologies will significantly impact the coming year, the exercise almost becomes a part of your professional DNA. So, in Q4 every year, I start looking at all of the Tech Trends for the next year and thinking about which will rise to the top of my list. But this year is different in so many ways. 2022 was a very strange year. The stock market plummeted, interest rates rose, and inflation skyrocketed, creating problems for companies across all stages of growth. Healthcare companies weren’t immune as VC funding plummeted, and purchases by health systems were deferred to preserve scarce capital.

To be clear, there was no shortage of technological innovation in healthcare in 2022. Just read any of my weekly Tech News posts, and you’ll find dozens of companies creating innovative digital health solutions to many pressing problems providers face in caring for patients and their families. What has changed is the market we’re operating in. There are several reasons for the change.

We’re coming out of year three of the pandemic, and health systems are still under pressure to care for patients. For over three years, daily, under exhausting and often dangerous conditions, healthcare workers across the country have continued to care for the nation’s sickest Americans who have fallen victim to coronavirus. The burden on the health care system is made worse by nationwide staffing shortages and hospital capacity at elevated levels as many other patients seek care for non-virus-related reasons. As we close out the year, the “triple-demic” of COVID, seasonal flu, and RSV infections (especially in children) is straining the health system to its limits again.

More than half of U.S. health systems will be operating in the red in 2022. According to reporting from Kaufman Hall, More than half of U.S. hospitals (53%) are projected to have negative margins for the rest of the year. Under more pessimistic scenarios, more than two-thirds of hospitals (68%) could have negative margins this year, their report stated. Hospitals have been confronting much higher expenses this year. Hospitals’ expenses are projected to rise $135 billion in 2022, compared to the previous year, according to the report. Labor accounts for the bulk of the increase, a projected $86 billion, with non-labor expenses rising $49 billion.

The top three issues for health system executives and boards are staffing, staffing, and staffing. Hospital leaders in multiple interviews all said they are struggling to find talent. The labor shortages are forcing hospitals to close beds and scale back some services. Hospitals are seeing longer waits in emergency departments, and surgeries and other procedures are being delayed.

“The crisis is real. The shortage of healthcare workers is nothing like we’ve seen before.”

Mike Slubowski, President and CEO of Trinity Health

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So, the disruption in healthcare in 2023 comes from these three drivers and will challenge innovators to come up with solutions for several major issues:

Cybersecurity and Ransomware attacks remain top of mind for health systems in 2023. Hospitals, pharmacies, care centers, and other healthcare organizations are prime targets for malicious cyber-criminals. There are a few reasons for this: healthcare organizations deal with vast amounts of personal and private data, which can be hugely valuable for criminal groups. Healthcare organizations often cannot afford to invest in the latest and greatest security technologies, making them an easy target for every type of cybercrime, from gift-card scams to sophisticated ransomware. Exacerbating these issues, the healthcare industry has been under immense pressure over the past three years, dealing with unprecedented challenges during a worldwide pandemic.

“We have to realize that cybersecurity isn’t just about data security; it’s also a matter of life and death.”

Michael Archuleta, CIO, Mt. San Rafael Hospital and Clinics, Trinidad, Colo.

Cybercriminals have cynically exploited the COVID-19 pandemic. The healthcare sector is on track to meet or exceed the more than 50.4 million patient records breached in 2021. Since cyber threats only seem to be getting worse, healthcare executives are planning on increasing their cybersecurity budgets for increased training and infrastructure in 2023 to fend off these kinds of attacks, according to a recent survey from software firm Ivanti. It has been estimated that over the next three years, healthcare-related data breaches will cost healthcare companies a total of $6 trillion. Healthcare organizations will spend $125 billion on cybersecurity from 2020 to 2025.

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Addressing staffing and capacity constraints drives broader adoption of command centers in health systems. In the past half-decade, command centers have been gaining ground as permanent fixtures in healthcare organizations — a sort of air traffic control for patient care. When the COVID-19 pandemic hit, health systems with command centers up and running were well-positioned to deal with the overwhelming demand for care, providing hospitals with real-time insight into bed availability, staffing levels, and patient journeys. Health systems with command centers have real-time visibility into staffing levels, which can improve coordination between care teams and break down silos. Staff will appreciate the efficiencies command centers can bring. For example, patients who can be discharged aren’t left lingering in beds, and rooms can be cleaned more quickly. This level of coordination requires well-designed communication channels across departments, ultimately improving processes systemwide.

With the incorporation of remote solutions, these command centers can offer an opportunity to combat clinician burnout. If integrated with a virtual nursing program, for example, overextended nurses might rotate off the floor and remotely support newer nurses at the bedside. In this way, newer nurses benefit from the older nurses’ years of experience, and older nurses get a better work-life balance. Imagine how that translates into improvements in employee satisfaction and clinical outcomes.

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“Nice-to-have” solutions go on the back burner. “Mission-critical” solutions get attention. 2023 will not be a year where buyers take chances on unproven technology. Startups need to sell solutions that solve problems in the short term and figure out a way to prove they can do that as quickly as possible. Getting an executive team to act on sourcing a digital solution means making a solid case around how the solution either reduces costs, increases revenue, increases staff productivity, or improves clinical outcomes. I’ve found this equation developed by Alex Lindsay of Office Hours Global to be an effective way to discuss that concept with startups (who are often frustrated by the length of time it takes for a healthcare executive team to make a decision) looking to sell their solutions into healthcare.

The gist of the equation is that action occurs when the vendor can demonstrate that the possibilities when implementing the solution exceed the current circumstances. What does that mean in today’s healthcare market?

Health systems that are bleeding cash are primarily looking for anything that supports payment, ideally upfront, or any tools that reduce burnout or help them solve the ongoing staffing crisis. On the other hand, employers are increasingly looking to whittle down their digital health vendors, particularly when utilization is low and outcomes are still to be determined.

So what technologies will get an audience with C-Suite Executives in 2023? Christina Farr from Omers Ventures expects the essential products that will sell well next year to include: Revenue cycle management tools, anything in labor/staffing, and solutions for burnout.

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So, this year I’ve taken a different approach to characterize disruptors to health care in 2023. Such exercises are always interesting but also inherently risky – particularly in uncertain times like those we have recently experienced and continue to live through. So perhaps the most significant benefit of the annual round of tech soothsaying is not so much the fine-grained detail – often derailed by contact with unexpected events – as the chance to take stock of the industry’s general direction. These are my educated and informed predictions based on the current situation. I’ll revisit them at the end of 2023 to see if they came to pass. Happy New Year!