If 2023 promises anything for the healthcare industry, it’s increased complexity in decision-making around digital transformation and healthcare professional development—but in looking forward, patterns and paths are emerging. Next year is poised to be one in which pandemic-field disruption morphs into coalescing areas of clarity and reduced variability.
Forging a path forward will require high-level, holistic perspectives—our Wolters Kluwer experts have used their decades of experience in the industry to simplify into three spheres of predicted change.
1. Extending the clinical revolution beyond the office
Considering current trends, the state of the clinical side of healthcare could be unrecognizable by the end of the decade and 2023 will likely mark a tipping point in that clinical revolution. Look for changes in how pharmacy, telehealth, and research are incorporated into the care ecosystem.
Pharmacy roles continue to expand
Globally, pharmacists played a critical role during the COVID-19 public health emergency, supporting patient education and ensuring the supply of non-routinely stocked medicines in hospitals. Pharmacy technicians also stepped into the spotlight, providing mass immunization and gaining public visibility in medication dispensing and interventions, and in point-of-care testing and specimen collection. Annie Lambert, PharmD, BCSCP, Clinical Program Manager expects to see this trend accelerate. “Pharmacists and pharmacy technicians are often the most accessible healthcare providers in their communities. Both roles will continue to see an evolution in their scope of practice to include direct patient care that will only increase in the year ahead.”
This shift is colliding with the “retailification” of healthcare, as players like CVS and Walgreens fuel consumerization with pushes into the primary care and home health spaces. But the result is the potential for more clinical fragmentation and a need to prevent emerging silos. Greg Samios, President & CEO of Clinical Effectiveness, sees this as an opportunity to build more order into the patient’s healthcare journey through technology. “Clinical decision tools capable of bridging the gaps between settings will be needed to eliminate care variability, better coordinate care, and ensure a single source of evidence-based information exists at every touchpoint.”
This potential for change will be driven by regulations and restrictions that have largely been relaxed during the public health emergency. Expect this shift to continue as a new pharmacy practice model emerges.
Telehealth and health content advance to next level maturity
The quarter-trillion dollar potential of post-COVID telehealth and telemedicine has garnered increasing attention—attention that’s fueling a wave of new entrants and innovation. But this new energy will need to be balanced with accurate clinical information and evidence-based research (EBR).
The rise of telehealth and telemedicine as mainstream solutions has increased questions around the quality and outcomes of virtual care as well as the underlying data driving clinical decision-making. In the United States, the Evidence Based Telehealth Network Program broke critical ground with its efforts to demonstrate how telehealth can increase care access and to assess the effectiveness of telehealth care for patients, providers, and payers through an established evidence base.
As private and public entities continue to fund telehealth research studies and work to improve accessibility, expect to see more energy behind evidence-based telehealth, answering questions around patient targeting, the use of remote teams, and the differences between telehealth being offered as a choice vs. being used to address access issues. Additionally, keep an eye on continuing comparisons to in-person care, especially as chronic conditions continue to be a major burden on healthcare systems around the world.
Successful application of clinical information and research in telehealth requires coordination across the increasing number of technology players. As Yaw Fellin, Vice President, Product and Solutions, Clinical Effectiveness stresses, “addressing this ‘last mile’ of virtual care will be an industry priority in 2023, starting with a focus on scaling the latest evidence-based care standards to foster alignment among stakeholders, including tech developers, patients, and providers.”
Evidence-based practice (EBP) has its own challenges. As pressure increases to incorporate EBP, most organizations will find it difficult to execute on their goals consistently and efficiently. Stakeholders may focus on artificial intelligence (AI) to close that gap. Vikram Savkar, Senior Vice President & General Manager, Medicine Segment of Health Learning, Research & Practice, predicts that, “in 2023, hospitals and health systems will seek out AI-powered solutions capable of standardizing and accelerating the EBP research process so that continual clinical improvement becomes a core element in hospitals’ culture.”
Patient communication will become more personalized and accessible
Providers will need to be mindful of the need for customized, inclusive educational content for patients in both virtual and traditional healthcare environments. Jason Burum, General Manager, Provider Segment, Clinical Effectiveness sees a new wave of personalized digital content emerging to support patients navigating their own health journeys. “In 2023, expect to see investment in outreach solutions that can deliver more personalized and inclusive educational content that better reflect diversity of patients in age, gender, race, family structure and more.”
2. Sculpting a complete patient story through compliance and specialty medicine
The goal of mapping a holistic patient journey is nothing new, but in 2023, you can expect to see significant headway thanks to a couple of emerging factors.
Improved data coding and interoperability will facilitate clear, accurate health documentation
COVID-19 has had a massive impact on the patient story, leaving millions of patients navigating questions of prevention, the long-term impact, and how prior infection will intersect with pre-existing chronic conditions. The value of a complete and precise health record is critical to accurate reflection of the severity and risk of illness—but also to population health management, quality metric reporting, and the success of value-based care relationships.
This all starts with accurate clinical documentation—and the rise of CDI specialists. Amy Campbell, RN, MSM, CCCDS-O, Clinical Documentation Improvement Manager, Health Language, relates the potential of these professionals in closing pressing gaps in the healthcare system. “There is a chasm in how a provider documents patient care and how this information is then translated into ICD-10 codes for the health plan company and CMS. Central to this divide is the difference between clinical and coding logic.”
As more care shifts to the outpatient space, expect to see more reliance on clinical documentation improvement/integrity (CDI) professionals beyond the traditional home on the inpatient side. The payoff will be closing gaps between health plans, CMS, and clinical practice, increasing provider efficiency and improvements to overall patient care. But this trend will also be fueled by government pressure. Michael Stearns, MD, Specialized Consulting Director - Medical Informatics, Health Language warns that “Medicare Advantage Organizations (MAOs) will see increased regulatory pressure in 2023 due to the cost of the program exceeding traditional Medicare and concerns over adequate documentation of reported conditions.”
Drug prices will fall as specialty medication management ramps up
2023 is anticipated to be a bright year for specialty medications, with biosimilars and FDA approval of biologics making headlines in the United States. As use of these drugs ramps up, the need to understand their clinical impact will only increase. Peter Bonis MD, Chief Medical Officer, Wolters Kluwer, Health sees next year as one of increasing need for insights into specialty drug outcomes for patients.
“High prescription drug prices made headlines in 2022 and rightly became the focus of legislative action in the United States," he says. "Spending on prescription drugs will continue to increase, compelling added focus on their safe, appropriate, and cost-effective use. We can expect particular attention on specialty medications (such as expensive biologics).”
Patient safety and compliance will put new pressure on HIT innovators
2022 is closing out with the U.S. FDA issuing two final guidances meant to enhance patient safety through post market surveillance and post-approvals studies, setting the industry up for even tighter health IT oversight and closer monitoring of patient safety in medical devices. While startups and manufacturers might be ready for an increasingly intense regulatory environment, less agile providers might be in for a shock.
Karen Kobelski, Vice President & General Manager of Clinical Surveillance, Compliance & Data Solutions, Wolters Kluwer, Health outlines a path forward. “In 2023, we expect clinical leaders trying to build solutions will experience pushback from internal legal and regulatory teams challenged to manage the burden of compliance. By partnering with companies that have already taken on this burden of compliance, health system leaders will be able to keep internal teams focused on providing the best care to patients.”
3. Adapting clinical knowledge and institutional wisdom
With the pandemic placing additional strain on an already overstretched clinical workforce, ensuring clinical teams have access to the latest evidence-based information and are staffed to adequately support patient care will be essential.
Innovation in nursing staffing models and clinical knowledge
One of the most concerning trends in healthcare has been a surge in nurse retirement. A global report from the International Council of Nurses estimates a global shortage of 13 million nurses by 2030. Even before the pandemic, 62% of US nurses over 54 were considering phasing out of their careers. In 2022, 29% of RNs surveyed in the United States indicated a desire to leave their current work in direct patient care, with many planning to drop out of the workforce completely. This brain drain will be highly variable, and for most organizations, difficult to predict. The result is a loss of some of the most knowledgeable clinical workers and nursing teams facing challenges in properly staffing and supporting patient care.
Expect to see providers and academic institutions that are pressed for experienced talent using advanced technology to scale already-strapped resources in order to reach more learners, promote competencies, and establish themselves as invested in digital transformation. They will also be exploring alternative care models to support patient care. In the eyes of Anne Dabrow Woods, DNP, CRNP, ANP-BC, Chief Nurse of Health Learning, Research and Practice, these organizations will be the winners in the face of a persistent staffing shortage. “Nurses will continue to seek out forward-looking healthcare organizations that have embraced innovative care models and competency-based staffing approaches to address the issues still happening post-pandemic.”
The nursing workforce will be transformed through virtual training and education
To keep up with the brain drain, most providers and academic institutions will find themselves digging deeper into digital transformation, accessing new digital products and approaches to professional education. The metaverse, for example, has much more practical applications than social media platforms and gaming.
Julie Stegman, Vice President, Nursing Segment of Health Learning, Research & Practice sees expansive potential for the future of this technology. “Virtual reality creates new, immersive learning opportunities so students can enhance their clinical education by practicing skills, working in teams, and gaining exposure to the fuller and more complex caseloads that nurses manage in real life, better preparing new nurses for the demands of real-world clinical practice even when they don’t have physical access to clinical practice settings.” With support from virtual and augmented reality and human-device interfaces, healthcare administrators can use the metaverse to enhance medical training and education.
Looking ahead to healthcare in 2023
Our 2023 predictions are looking towards a more settled but transformed healthcare ecosystem as the disruptions of COVID-19 forever make their mark. Healthcare leaders still have huge challenges when it comes to affordability, regulations, and clinical staffing, but with innovative approaches to extending the clinical setting, engaging patients wherever they are, and exploring new staffing models, leaders can move the needle on advancing the best possible care for all.
To speak with a Wolters Kluwer expert about these and other topics, please contact Ashley Beine at [email protected].
To read the full 2023 predictions from our Wolters Kluwer experts, please download the full PDF.