The year ahead: Transparency, mobile health, patient safety and health reform implementation

My crystal ball is a little foggy so I decided to ask my Twitter followers (@HealthBizBlog) to help compile a list of health care predictions for 2011. I’ve integrated my thoughts with theirs and organized the predictions into four themes:

1. Transparency will change from buzzword to reality
2. Information technology progress will be uneven, with the biggest breakthroughs in mobile
3. A culture of patient safety will begin to take root
4. Health reform implementation will advance despite some ugly battles

Transparency will change from buzzword to reality.The health care industry is tremendously opaque. Patients and doctors don’t know the price of medical services, while pharmaceutical and medical device makers maintain secret financial arrangements with physicians.Much is likely to change for the better in 2011. Giovanni Colella, CEO of health care transparency company Castlight Health (@CastlightHealth) predicts, “Consumers will increase their demands for personalized information about health care cost, quality and convenience and will turn to innovative applications to address these needs.”Bright lights will be trained on the interaction between industry and physicians. The Affordable Care Act requires pharmaceutical and device companies to report payments to physicians starting in 2013; voluntary reporting is likely to pick up next year. Beyond that, @PharmaGossip predicts, “PharmaWikiLeaks will become a force for good,” citing a recent leak about Pfizer in Nigeria as Exhibit A.Information technology progress will be uneven, with the biggest breakthroughs in mobile.AOL founder Steve Case (@SteveCase) tells me, “Mobile health will be a game changer in health and wellness.” I agree that mobile apps and devices present a big opportunity to prevent and manage chronic illness.Thanks to advances in IT adoption by providers and patients, Kaiser’s Dr. Ted Eytan (@tedeytan) expresses confidence that, “The patient will finally become a customer of health care.”Meanwhile, physicians, hospitals and vendors will continue to make slow, uneven progress on electronic health record implementation in the quest to meet Meaningful Use requirements that qualify them for federal stimulus funds. Health IT expert David Ahern (@dahern1) says, “EHR vendor consolidation will be the order of the day, especially as companies discover how difficult it will be for them to reach Stages 2 and 3 of Meaningful Use on their own.”A culture of patient safety will begin to take root.Beth Israel Deaconess President and CEO Paul Levy (@Paulflevy) writes, “Too many people will still be harmed in clinical settings because of a lack of focus in redesigning the work done in hospitals.”Dennis Ferrill (@DennisFerrill), CEO of eLearning company APS offers a path forward, “We will approach a tipping point in the culture of patient safety as institutions find that significant adverse events occur under their watch, while more of their peers take concrete steps forward.  Among the observable data points supporting this movement will be an increasing tendency to mandate key protocols and safety training for nursing and physician staff as hospitals gain confidence in their duty to control quality and outcomes.”Since the Vioxx debacle, FDA and patients have sought reassurance on patient safety, a shift that will continue in 2011, according to iCardiac Technologies CEO Mike Totterman (@mtotterman). “Regulatory cardiac safety requirements will tighten, but emerging technologies will facilitate compliance with new standards to produce better, more reliable results in clinical trials.”Health reform will prevail despite ugly battles.“Always an optimist, I think 2011 is the year that economic recovery takes hold,” writes Dr. Bruce Siegel (@siegelmd), CEO of the National Association of Public Hospitals. “This changes the national health care debate dramatically as the Administration's leverage is bolstered. There are some very ugly battles ahead, especially in the state houses, but overall it's a year of consolidation.”  To demonstrate he’s a realist, he adds, “Also, the Redskins won't go to the Superbowl!”I’m a little less sanguine than Dr. Siegel about the prospects for the Affordable Care Act. I expect Republicans to make moderate progress chipping away at the law, even though repeal is not in the offing. The recent one-year Sustainable Growth Rate (SGR) fix, which halted the automatic cut to Medicare reimbursement rates, was financed by snatching a little bit from PPACA insurance subsidies. Expect more gambits like that, along with objections to proposed rules, attempts to defund or delay specific provisions, and continued court challenges to the law itself.