Patient Safety Predictions for 2023

By Jay Kumar

PSQH reached out to professionals throughout healthcare to get their predictions for what will happen in patient safety and healthcare quality in 2023. Here’s what they had to say.

Dr. David Feldman, Chief Medical Officer, The Doctors Company

The “Tripledemic” will continue to stretch our healthcare systems: With fewer Americans wearing masks and social distancing and an established immunity gap, we can expect higher levels of respiratory diseases in 2023.

• This winter, the mix of the flu, COVID-19, and RSV will push our healthcare systems and care providers to the limit.

Beyond resilience: Clinicians are tired of hearing that resilience is the key to burnout and staffing shortages. They are looking for more impactful structural changes. While the most meaningful structural changes are incremental, the pandemic has highlighted workflow and technology improvements that can help “rehumanize” providers’ time.

• From a medical brain that reviews EHRs for predictive diagnoses to patient monitoring tools that send alerts that escalate in the care team, technology can help physicians anticipate potential issues as well as handle complications when they arise.

Telehealth is here to stay: Despite the end of the Public Health Emergency Act, we can expect telehealth to remain a fixture of the way care is delivered. However, we can also expect telehealth usage to decrease over the next year as patients return to the doctors for in-person consultations and treatment.

• When providing telehealth, physicians need to remain vigilant, check their licenses, and understand the care they can provide to patients remotely and when to refer to a local provider.

A shift from informed consent to shared decision-making: Video and audio recordings from a physician and patient conversation can help supplement EHR and ensure both physicians and patients are aligned with the treatment plan.

• While this isn’t a mainstay of most current healthcare technology, physicians should assume and act as if every conversation is being recorded by the patient.
• Most states, like New York, already have a one-party consent model: patients do not need to inform physicians that they are recording the conversation.

Increased responsibility for Advance Practice Clinicians: APCs are set to take on more of a primary role in the delivery of healthcare.

• With more and more states allowing APCs to practice independently, many see this as an impactful way to reduce burnout and increase access to care. However, questions remain on how this will impact patient outcomes.

Irfan Shakeel, VP of Training and Certification Services, OPSWAT

Cyberattacks on the healthcare industry will continue to increase.

The healthcare industry is most vulnerable to cyberattacks, which makes it a lucrative target for cybercriminals; attacks on the healthcare industry have grown significantly in 2022, and attacks will even go further in 2023. According to IBM, healthcare breaches cost the most at $9.23 million per incident. And, most importantly, cyberattacks not only affect human lives directly—they also impact patients’ mental well-being.

Additionally, according to a recent SANS and OPSWAT report, “State of ICS/OT Cybersecurity in 2022 and Beyond,” 26% of respondents reported that the healthcare and public health sector is likely to experience a successful ICS compromise with impacts on safe and reliable operations. Lastly, with healthcare staff generally unaware of the extent of cyber risks and best practices, educating them is of vital importance to protect the healthcare industry from cyberattacks.”

George Prichici, VP Products, OPSWAT

Cyberattacks on the healthcare industry will have direct, fatal outcomes.

In the case of most cyberattacks, profit is the motive and rarely the aim is to kill. Killing is an unfortunate side-effect of the problem, such as high-stakes situations where hackers take control for ransom thinking most hospitals will comply to save lives. For instance, a major U.S. hospital system—CommonSpirit Health—recently suffered a ransomware cyberattack and a three-year-old was given a fatally large dose of pain medication as a result.

However, a lack of defined response, or coordinated and up-to-date protocols, leads to mistakes, including not paying the ransom in time or not having disaster recovery or backup in place. Whatever the reason, small mistakes have deadly consequences in healthcare, even if organizations are willing to pay the ransom. They also have to think about violations of data privacy regulations and repercussions.

That is why zero-trust is so important for healthcare, as well as having a solid response plan in place for recovery/backup (similar to generators for a power outage), so that operations don’t get stopped midway.

Joerg Schwarz, Senior Director for Healthcare Interoperability Strategy, Brianna Zink, MSN, Senior Director of Healthcare Product Strategy, and Chuck Whinney, VP of Healthcare Strategy at Infor

A need for increased flexibility: With all the challenges currently facing the healthcare sector, from financial viability to burnout and staff shortages, success in 2023 will be defined by the organization’s ability to be flexible and implement technological solutions that will reduce costs and rehumanize time.

We will see AI being implemented in a number of different ways, from interactive patient monitoring within hospitals to supply and stock management, which can greatly reduce the burden on providers.

Despite staffing shortages, organizations that provide more flexible working opportunities, such as shorter shifts or a four-day work week, will ultimately perform better and see better long-term viability. Ultimately, flexible APIs facilitate workflows, which are crucial to be competitive and productive in a composable healthcare enterprise.

Increased collaboration: Alongside the need for more flexibility within our healthcare systems, in 2023, we can expect to see more partnerships between retail health organizations and traditional hospital systems, as witnessed with Walmart and the Cleveland Clinic.

We can also anticipate more M&A activity in the healthcare industry as larger hospital organizations scoop up smaller organizations that can’t weather the systemic challenges in this industry.

Financial viability will remain a top concern for healthcare leaders, with many questioning whether the healthcare industry can still be considered recession-proof. However, an organization’s flexibility and compliance with new regulations will help ensure success.

Compliance is an opportunity for better financial stability. For instance, by identifying and publishing attractive costs, we will see an increase in proactive appointments and elective surgeries, which will drive more revenue.

Value-based care will also be an area of renewed focus for healthcare organizations. With an increase in at-home monitoring and consumer-based IoT devices providing more data, reimbursement models will continue to be tied to patient experience and outcomes.

Universal EHRs & Interoperability: Despite industry moves like Oracle’s acquisition of Cerner, don’t expect to see a universal or national electronic healthcare system emerging in the coming year. Instead, we anticipate a desire for more custom solutions and a mix-and-match approach to EHRs and ERPs.

Chris Luoma, Senior Vice President of Global Project Management, GHX

Historic financial pressures will drive greater investments in digital transformation and care delivery. Between evolving reimbursement models, the move from fee-for-service to value-based care, record inflation driving up costs for labor and supplies and new resiliency requirements pushing providers to carry a different inventory profile than they’ve had in the past, health systems are facing historic financial pressures. In response, organizations are focusing on a few key areas to better balance their budgets, including:

• Prioritizing advanced technologies like predictive and prescriptive analytics. Advanced technologies like these hold the power to help enable efficient and repeatable processes that allow supply chain teams, clinicians and other key stakeholders to spend more of their time collaborating and problem solving to address patient needs. As providers increasingly embrace the digital transformation of healthcare in the year ahead, they will be better poised to leverage and extract value from more sophisticated analytics that will help drive a more resilient supply chain.
• Evaluating how they deliver care, where they deliver it and balancing financial and clinical outcomes. In some cases, provider organizations have canceled services outright. Others have gone through very robust supply standardization efforts to eliminate variation and its associated costs. Care also continues to move outside the four walls of the hospital as both a cost-containment strategy for providers and to provide increased accessibility to patients.

More transparent conversations will be held around healthcare industry burnout. The industry is starting to talk more openly about how the last few years have affected healthcare workers’ mental health and physical wellbeing and will continue to implement strategies to improve work environments.As industry-wide staffing shortages further exacerbate burnout, digital transformation will increasingly play a pivotal role in tackling the issue. In spring 2022, GHX conducted a survey among senior healthcare leaders in the U.S. and found that 80% of respondents believed increasing automation to reduce manual labor was a key organizational strategy to combating workplace shortages and staff burnout. With automation, organizations can eliminate some of the mundane tasks that don’t need to be done manually. By offloading workstreams to partners in areas that are not critical to their own subject matter expertise, clinical, financial and operational teams can focus their efforts on the most value-added tasks to patients and the business overall.

Mega-mergers of large health systems will help scale businesses and compete with payer organizations.

M&A activity in the healthcare industry has been hot for a while, and as hospitals continue to seek out strategic partners to help overcome the financial impacts of the pandemic, there are no signs this will slow down. Providers are also looking for new ways to compete with payer organizations. As they reassess how they negotiate contracts with payers, hospitals are posed with three options:

• Accept the status quo when it comes to reimbursements.
• Scale their organizations in a way that allows them to better negotiate with payers across multiple markets.
• Become a “payvider” by forming a mutually beneficial partnership with a payer organization.

While the “payvider” footprint is fairly small, it is growing. Since payers need to include hospitals across markets in their network, this allows providers to assert greater cross-market power when negotiating contracts. For example, large health systems like Spectrum Health and Beaumont Health in the Midwest formed Corewell Health, creating a multi-state presence for the new health system to provide better care at scale.

Punit Soni, CEO of Suki

Several predictions for 2023:

• Voice interfaces will cross 70%+ adoption in health settings from the current 30% or so backed by natural language, large language model systems and consumer mobile app interfaces.
• Investments in healthcare tech startups will continue but focus on revenue will intensify. This coupled with long healthcare sales cycles will mean a quite a few will run out of cash and shut down.
• Chief AI officer will become a position in health systems differentiated from CIO and Data/digital executives.
• Ambient documentation will become a reality in some controlled healthcare settings using pure software not the current human backed systems like DAX.
• Companies that will build the plumbing required to work in health settings (integrations, compliance, infrastructure) will win at the cost of pure play innovation startups. Lack of resources implies contracts and pilots will go to those that actually work end-to-end instead of shiny ideas.
• A large number of transcription services, virtual scribe companies will go out of business because margins will shrink and high-cost systems like these will be cut from budgets.
• EHRs will become even more interoperable. However, only a narrow set of high integrity services will be able to leverage them. Open marketplaces will be shut down because of security concerns.
• The M&A market will be bleak but expect big ticket acquisitions to happen post-second half of 2023 fueled by the rapidly changing technical landscape and the need for large players to keep up.