Why providers now need a stronger game plan for leveraging AI, data, and analytics
Healthcare is undergoing significant transformations driven by rapid technology advancements and the inevitable march to value-based care. These changes are marked by big tech entering the healthcare space, establishing strategic partnerships with electronic health record providers, and leveraging advancements in AI and data analytics that are reshaping care delivery.
“Increasing access to patient data coupled with technology innovations, especially in generative AI, is ushering in substantial changes within the healthcare sector,” says Kari Hall, Chief Strategy Officer at PointClickCare.
In this discussion, Hall addresses the dynamics behind the increasing number of healthcare deals, the strategic maneuvers of major tech players in healthcare, the emergence of ‘payviders,’ and the critical role of data in modernizing healthcare practices. She offers insights into current industry trends and essential strategies for leaders navigating this tech-driven landscape.
Q: What factors are driving the recent surge in merger and acquisition (M&A) and initial public offering (IPO) activities within the healthcare sector?
Hall: The uptick in M&A and IPO activities in healthcare IT is fueled by technology advancements, regulatory changes, and increasing demand for integrated solutions. The push towards value-based care, with CMS mandating a transition by 2030, is driving a need for improved care coordination, while a significant labor shortage has impacted provider efficiency, costs, care quality, and outcomes. These factors have led to a substantial demand for technology and emerging care delivery models that can enhance efficiency.
Meanwhile, advances in generative AI are creating new use cases and attracting investment interest. I anticipate considerable growth in areas like clinical productivity and decision support tools. Additionally, the increasing use of medical services, particularly among seniors, presents opportunities for technology to enhance service visibility and support care plans with data insights at the point of care. The rise of payviders—providers taking on risk and managing longitudinal patient data to close care gaps—is expected to increase, driving improvements in care quality and outcomes. Collectively, these trends are creating a dynamic investment landscape.
Q: How will the use of healthcare data reshape the industry’s future? What role will tech giants play in driving this trend?
Hall: Healthcare data is pivotal in addressing the above trends, which seek to improve patient outcomes and overall healthcare delivery. With an aging population increasing utilization of services, a shift to value-based care, and the necessity to improve outcomes with fewer staff, organizations will increasingly need technology and data to work more efficiently.
Integrating technology with real-time data is crucial for value-based care models. By harnessing insights from comprehensive data sets, we can predict health risks and enable providers and their healthcare IT companies to precisely understand the care that is needed at the right time. Equally important is embedding these insights directly into workflows, where physicians can take informed actions. The use of advanced technologies like generative AI hold great potential for developing predictive models that integrate seamlessly into daily operations.
Q: What are the strategic implications of tech giants’ integration into healthcare, particularly regarding their partnerships with EHR providers and the potential of AI applications for advancing value-based care initiatives?
Hall: We’re witnessing significant engagement from tech giants like Amazon and Microsoft, which brings tremendous opportunities, including strategic partnerships with EHR providers.With technology such as generative AI, providers can then deploy robust predictive models to deliver actionable insights directly to physicians when they need them most, reducing rehospitalization rates, improving outcomes, and accelerating the transition toward value-based care.
Q: You mentioned the emergence of payviders, bridging the gap between payers and providers. What are the key drivers behind this trend?
Hall: As value-based care and care coordination take center stage, many providers are exploring how to assume financial risk and effectively manage their patient panels to enhance outcomes. Payviders are well suited to facilitate seamless care coordination and drive that longitudinal visibility to patients and full member panels.
We certainly see this in our market as it relates to the senior population, where patient care complexities are significant. Our customers are pursuing better outcomes through diverse payment models. We’re also seeing physician groups either partnering with health plans or taking on risk directly as a delegated risk model. Initially, they took on upside risk, but as visibility into their outcomes has improved, they are moving towards more full-risk models.
The transition to delivery models that optimize care outcomes and quality is accelerating, allowing providers to capture financial incentives that align with better quality. We anticipate this trend will continue to grow across the senior care population, further fueled by more payviders entering the market and CMS’s ongoing commitment to expanding value-based care.
Q: What are key considerations for industry stakeholders seeking to navigate the complex intersections of healthcare and technology, particularly given shifting regulatory landscapes and evolving consumer expectations?
Hall: Navigating the shift towards value-based care and integrated healthcare ecosystems requires prioritizing care coordination across all teams—from primary care providers and specialists to emergency departments. Aggregating and integrating real-time data, along with leveraging advanced analytics, are crucial for developing a longitudinal view of patient health and accessing real-time insights. Collaborating with technology partners, such as EHR vendors, to embed these insights directly in front of the physician is essential. It’s also vital to maintain strong member engagement platforms to manage risk and improve care outcomes effectively. These capabilities are fundamental and unlikely to change in the near future.
Q: What trends do you anticipate shaping the future of healthcare and technology convergence? How should industry leaders prepare?
Hall: Several major shifts are on the horizon, especially given the aging population. Effective coordination across the entire care journey will become crucial. This includes improving visibility into patient journeys, expected outcomes, and care strategies as risks are managed. Emerging care models will meet patients where they are, whether in the hospital, home, post-acute care, or in community settings, requiring technologies that support care delivery across these diverse environments. At the same time, following their proliferation, value-based care models and their technologies will consolidate.
Persistent labor challenges highlight the need for operational efficiency. Industry leaders should leverage technologies like generative AI, along with clinical productivity, telehealth, remote monitoring, and virtual scribe solutions to improve care delivery. The importance of advanced analytics and data aggregation cannot be overstated, especially as we think about the need for real-time data. Despite serious challenges ahead, the evolving landscape offers substantial opportunities to ingest, aggregate, and contextualize data more effectively. I am optimistic about the accelerating pace of technology advancements and the potential to transform our industry.
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