January 2019

As technology applications in healthcare continue to grow, electronic health records are maturing, interoperability is developing, and patient-facing technology use is expanding.

In the 6 years following inpatient electronic health record (EHR) implementation, an average of 2.5 significant EHR changes per day were made for maintenance and improvement.

Gamification in healthcare is gaining momentum, with attempts to apply gaming principles to improve patient clinical outcomes. This trend establishes the need for a “digital practitioner” who channels these games, monitors progress, and selects the most appropriate ones for a given patient.

Proprietary health information exchanges (HIEs) offer significant but uneven opportunities to advance provider connectivity. Open forms of HIE remain critical for comprehensive coverage of patient transitions.

Telemedicine visits may be used with established patients for follow-up care without a loss of patient satisfaction with communication with providers and with enhanced convenience and reduced travel time; a majority may be willing to pay standard co-pays or more for this convenience. Clinicians see value in this new mode of care to enhance connections with patients.

Geisinger’s Ask-a-Doc program, which enables direct asynchronous communication between primary and specialty care, was associated with lower healthcare utilization and cost, implying more efficient care.

Health information exchange offers significant potential to address unmet informational needs during transitions between hospitals and skilled nursing facilities; workflow barriers and design limitations currently limit value.

Alternative payment models (APMs) introduce value-based incentives for greater hospital health information exchange (HIE) engagement. We find that APM participation is associated with lower HIE volume and greater HIE diversity, breadth, and depth.

This is the first national study to examine the relationship between healthcare system organizational characteristics and adoption of advanced health information technology capabilities.

A hospital data breach was associated with a 64% increase in annual advertising expenditures.