Trends in Healthcare & Governance

From the Executive Director

HTNYS’ monthly Trends updates provide trustees with information about emerging developments in governance and healthcare. Published by HTNYS Executive Director Sue Ellen Wagner on the second Wednesday of each month, Trends’ timely statistics and insights help trustees fulfill their roles and responsibilities while adapting to the changing environment.

The Growing Impact of Technology on Healthcare
June 2018

  • Technology’s Impact on Healthcare. Telehealth is becoming mainstream; retail clinics are reshaping local care access; and social networks and “Dr. Google” have become major factors in determining where patients go for care. Understanding how these trends impact consumers’ healthcare decisions is important for ensuring future market share, and for making sure our customers and patients are satisfied with the healthcare experience. (Recent studies indicate that an estimated 81% of consumers are dissatisfied with their healthcare experience.)
  • Cloud Technology Expanding in Hospitals. About 51% of hospital executives think that by 2022, their hospital will implement secure, Health Insurance Portability and Accountability Act (HIPAA)-enabled cloud technology to promote collaboration and information-sharing across the organization and among providers, regardless of location.
  • Lawmakers Examine Mobile Health. The U.S. Senate Commerce, Science, and Transportation Committee is examining the state of the mobile app economy. Since mHealth (mobile health) could be the wave of the future, this discussion bears watching. mHealth is a general term for the use of mobile phones and other wireless technology in medical care. The most common application of mHealth is the use of mobile phones and communication devices to educate consumers about preventive healthcare services.

Note: HTNYS’ Executive Director Trends updates will not be produced during July and August, but will resume in September.  Have an enjoyable summer.

Significant Need for Psychiatrists
May 2018

  • Psychiatrists Needed: There is one licensed psychiatrist for every 30,000 people in the United States. With the increasing mental and behavioral health problems our society faces, we clearly need more psychiatrists.
  • Physician Shortage Approaches: Our nation faces a growing shortage of physicians that is projected to reach up to 104,900 by 2030. Shortages are expected in both primary and specialty care. Because it takes up to ten years to train a doctor, projected shortages need to be addressed now so that patients will have access to the care they need.
  • Registered Nurse Shortage: The U.S. is projected to experience a shortage of registered nurses (RNs) that will intensify as Baby Boomers age and the need for healthcare grows. RN is among the top occupations in terms of job growth through 2024, according to the Bureau of Labor Statistics’ Employment Projections 2014-2024. The Bureau projects the need for 649,100 replacement nurses in the workforce, bringing the total number of job openings for nurses due to growth and replacements to 1.09 million by 2024.

The Emergence of Micro-Hospitals
April 2018

  • Micro-hospitals seem to be popping up across the country. What are micro-hospitals? They are independently licensed facilities with acuity comparable to a community hospital, but at a fraction of the size: 8 to 15 beds. The idea is to deliver pre-acute care in a given neighborhood in a place where people work, live, and play, and to bring a higher level of service than what you would find at a retail clinic or urgent care center. Micro-hospitals strive to provide patients a compassionate and patient-friendly experience. While there are some challenges with micro-hospitals, the small format helps drive high-quality care and higher patient satisfaction by enabling providers to focus on fewer patients and produce better outcomes.
  • Cybersecurity risks are likely to continue to grow in healthcare. Boards should ensure their executive staff develop a cybersecurity strategy and culture that ensures proper defense and postmortem measures. Cyberattacks? Especially a ransomware infection that blocks access to critical medical data?are a human safety issue. A new trend: developing a Cyber Security Board Committee.
  • Population health is a hot topic, as hospitals and health systems navigate the expansion in coverage and payment incentives. Board members should work with leadership to ensure there is a quality improvement approach to community benefit that helps to build internal population health capacity. Focusing resources on sub-county areas where health disparities are concentrated is a good starting place.

Some Consumers Likely to Use Amazon for Healthcare
March 2018

  • Amazon and Healthcare: A survey recently conducted by LendEDU of 1,000 consumers who purchased something from Amazon in the past 30 days, revealed 35.8% of consumers would use an Amazon health insurance plan, and 54.7% would trust Amazon to provide them with over-the-counter and prescription medicine.
  • Alcohol-related ER Visits: Hospital emergency department visits related to alcohol use increased 47% between 2006 and 2014, averaging 210,000 per year, according to “Trends in Alcohol-Related Emergency Department Visits in the U.S.” a report from the National Institute on Alcohol Abuse and Alcoholism.
  • Spending on Prescription Drugs: Total annual spending on prescription drugs has reached $309 billion, the fastest growing segment of the U.S. healthcare economy. The price of drugs, not utilization, is the predominant contributor to the increase.

Use Board Self-Assessment Results for Board Performance Improvement
February 2018

  • Board Self-Assessment. The best way to actively create the future of board governance is to bring annual goals front and center. If the board clearly writes down its annual goals at the beginning of the year, that same document can act as its self-evaluation template at the end of the year. The self-evaluation—administered by the board’s governance committee or an outside organization—can ask trustees to judge whether each of the board’s goals for the year have been met and if they have satisfactorily contributed to achieving those goals. Visit the HTNYS website to help improve your self-assessment process.
  • We need to continue to improve the customer experience; otherwise patients will go elsewhere for care. The more competitive the market becomes, the more work providers must do to continually improve the patient experience and develop customer loyalty. This can partly be done through improving communication and creating a more retail-focused experience. Online and mobile platforms are already important for engaging customers, and they will only grow more essential in 2018.
  • Self-monitoring health is a rapidly expanding business. As you might know, Apple recently announced its latest iPhone iOS beta update that will include an option for patients to input their electronic medical records. The Health app update marks a key step in solving interoperability issues with electronic health records. Eventually, the update could turn into a platform for patients to add real-time data to their medical records, which could give care providers a more detailed look at patients’ health.

NYS Ranked in Top 10 for Health
January 2018

  • Congratulations to New York State for being ranked in the Top 10 states for improving their health. The hard work of our hospitals and health systems have contributed to this Top 10 ranking through their efforts in working on New York State’s Prevention Agenda.
  • The social determinants of health are an increasing focus of hospitals and healthcare systems as they continue work to improve health outcomes in their communities. Social factors such as income, education, and food security can determine health status, health needs, and health outcomes.
  • Genomic medicine is increasingly being used in patient care. Cancer screening and treatment, and rare diseases are some of the areas in which genomics has been transformational. Some experts say that hospitals should consider genomic medicine as they plan to strategize for the future.

Hacking Into Healthcare Data Affects Millions of Americans
December 2017

  • According to data reported to the Office of Civil Rights at the Department of Health and Human Services, hacking or information technology-related incidents in healthcare compromised the records of 111 million Americans.
  • Did you know that most hospitals in New York State have chosen to focus their Prevention Agenda efforts on preventing chronic disease and substance abuse, and addressing mental health issues? The Prevention Agenda is a state initiative designed to get hospitals to focus on prevention to make New York State the healthiest state in the nation. If you are unaware of your hospital or health system’s Prevention Agenda efforts, please ask for an update at one of your upcoming board meetings.
  • As hospitals and organizations mature, effective boards update how their members are selected-moving away from informal, relationship-based board formation to a more intentional, competency-based process.

Patients Want to Be More Involved in their Care
November 2017

  • About 70% of patients say they have become more engaged in their healthcare. By 2021, 99% of hospital executives think it is at least somewhat likely that their patients will demand a greater role in planning their own treatment.
  • According to the American Hospital Association’s Institute for Diversity in Health Management, although minorities represent 32% of patients in hospitals, they represent only 14% of hospital board members. HTNYS will unveil a new online resource in the first quarter of 2018 to assist boards with strategies and tactics on board diversification.
  • As the size, scope, and scale of healthcare systems grow, so does the complexity of effective system governance. Hospitals and health systems should look at competency-based board composition when recruiting new board members.

Ask These Disruptive Leadership Questions
October 2017

  • As hospitals and health systems grow increasingly complex, they are creating dedicated leadership staff for their boards. These positions include: manager, director, and chief governance officer. Texas Health Resources, a 24-hospital system, is using a chief governance officer to oversee its governing board functions.
  • By 2020, mental health and substance abuse disorders are projected to surpass all physical diseases as a major cause of disability worldwide.
  • According to a presentation for HTNYS by governance expert Jamie Orlikoff, boards should begin to ask key disruptive leadership questions as they govern through rapid change and complex challenges:
    • How can we save money for our patients?
    • How can we provide value based on how patients define value?
    • How can we give patients a better experience, and safer care?
    • How can we achieve the above and still stay in business?