Editor's note: This is the first in a two-part series. In this interview, HIMSS CEO Harold "Hal" Wolf III explains how hospitals will lean on health technology to ride out new financial pressures and the role of AI in healthcare. In part 2, Wolf will share his thoughts on the federal government's role in fostering innovation and the expanding responsibilities of healthcare CIOs.
Three months after he was appointed as the new CEO for HIMSS, Harold "Hal" Wolf III is already thinking about the financial tension healthcare providers will face over the next decade.
The economic pressures surrounding the healthcare industry are poised to get a lot more intense, Wolf said in an interview with FierceHealthcare. The details aren’t exactly rosy, but it boils down to a growing number of older adults leaving the workforce and entering Medicare, which will place a greater strain on hospitals and—perhaps more importantly—hospital budgets.
But it’s not all bad news. Health IT innovations like remote monitoring, telehealth and mobile health are going to play a huge role in making sure providers can navigate those changing dynamics. And the next several years will be a crucial time for the industry to decide where to invest and how to effectively implement those technologies.
FierceHealthcare: In your keynote speech at the Big Data and Analytics Forum in Boston last week, you mentioned that in five to 10 years the economics of healthcare will be even harder than they are now. What do you mean by that?
Hal Wolf: The reality is there is a demographic shift taking place. We have the silver tsunami—a huge wave of people in the United States that are turning 65, which means a large number of retirement-aged people. That’s a wave of folks that are that are living longer than ever before and carry with them chronic diseases during those longer lifespans.
So we have a change in demographics where fewer individuals are generating GDP in industrial nations. There are fewer people paying taxes to support the healthcare systems against this growing number of dependents. In the United States, we think of Medicare, and we know there is going to be a huge surge and fewer working people.
With the economics that we’re seeing globally, budgets that are already pushed are going to be pushed even more. You cannot build more hospitals—nor would you want to—that can accommodate everyone that's going to need a bed. We’re not going to have enough doctors, and we’re not going to have enough nurses. These are just basic numbers that healthcare systems recognize.
Developing digital health capabilities, the need to have connectivity with families and providers and patients and consumers, are really huge challenges that are going to be under continuing financial pressures.
FH: How does digital health help with that?
HW: The extension of digital health is the ability to deliver care and develop connectivity outside the walls of the clinic and outside the need for a physical hospital bed. It’s the ability to discharge a patient earlier who can be monitored at home. That relieves a certain layer of pressure because you don’t have to build more buildings. It extends the system.
Secondly, as we think about the development of AI, clinical decision support and early warning systems, you see the fundamental ability to anticipate and help decision-making with fewer resources and better predictive models so we can get people out of trouble before it occurs.
There is a lot of upside that systems are focusing on to help them get ahead of challenges they know are coming and to deal with them with fewer resources at the same level of quality, if not improved.
FH: That requires some level of investment in IT systems and software. How can providers balance the need to integrate some of these technologies with the budget constraints that go along with that?
HW: People have been making investments in EHRs and backend systems and deploying population health capabilities. They are recognizing that we have a wealth of information and data sets available that we didn’t have before. So we’re beginning to shift investments away from baseline technology and into information and use of information.
The hope and expectation is we’re beginning to say, “OK, I’ve got the infrastructure in place, how do I use this information in the digital health space in day-to-day operations? How do I use analytics to improve costs and deliver better care?”
That level of investment will not be at the same trajectory that we’ve been spending on the foundation we’ve put in place. It will be more targeted based on what a system or a hospital or particular government will need.
FH: There has been an ongoing debate about AI replacing physicians, but how do you think physicians will work with AI or adapt their role to make room for new technology? How will the provider community manage that transition?
HW: We’re becoming more and more reliant on the enablement of information to give us treatments. As we move towards personalized care segmented to individuals based on their personal circumstances, and when we think about genomic information and the way it will tailor care at an individual level, the starting place is large-scale population health data sets that we can narrow down. That relies on consistent learning.
That’s where AI really steps in. That’s where AI starts to create better learnings and faster learnings to understand the impact of one type of care on particular datasets or groups of individuals. That level of sophistication is where AI is starting to make an impact.
It’s not overnight. It’s not a light switch, but you can see certainly see it. The improvement in clinical decision support has been amazing.
FH: But you see that as more of a symbiotic relationship rather than robots replacing physicians?
HW: I do see that as symbiotic. There will always be the importance of human touch in patient care. Robots and the use of AI, these are tool sets. Let’s go back to the math: There are going to be more people and we’re not going to be producing enough physicians, or nurses or clinicians to take care of everybody who is outside of the hospital. So we’re going to need all of these tool sets.
FH: In your mind, what is the most pressing health IT issue right now ... other than interoperability?
HW: I’ll give you one answer, which is nonphysical. Healthcare recognizes it is in the midst of a very large change management effort. Change management is leadership and management understanding that the world they are in right now is shifting and they’ve got to prepare their workforce.
We need to think through the workforce of tomorrow and we need to think through the utilization and implementation of innovation on a scale we have never thought through before. The timeline I used in this morning’s keynote was the next 5-10 years. The financial pressures five years from now will be prominent and between 5-10 years, it’s really going to impact us.
Change management and preparation for that is truly the most important thing healthcare systems can be doing.
The second part is the implementation of innovation. You need to prepare yourself for change management so you can innovate and change and incorporate all of these capabilities of digital health, and so you can understand how to maximize your workforce to take care of more people, at a lower cost, at a higher level of acuity and at a faster speed in order to keep up with the challenges and demands that are coming at us.
FH: Do you think the medical education of today needs change to include more emphasis on data and analytics?
HW: Absolutely. One of the new opportunities at HIMSS falls exactly to that spot. One of the strategic changes to HIMSS is a focus on the use of information and the capabilities in the digital health space. How do we support medical schools, continuing medical education programs, professional development and workforce devolvement to use information? And we need to understand what information the provider community needs that we may not be supplying.
That’s one of the reasons for our acquisition of Health 2.0—to be deeper involved in upcoming innovations and to help support the provider community to use that information and that capability.
Editor's note: This interview has been edited for length and clarity.