Amit Phull, MD

With the decade having ended just a week ago, early January is the perfect time to take inventory and think about what lies ahead in the 2020s. With big tech, regulators, insurance companies, pharma and major healthcare systems all jockeying for position ahead of next year’s elections—and patients taking greater interest in how the healthcare system impacts them financially&mdash;2020 is poised to be a time of innovation, turbulence and major shifts in how we take care of people who are sick.

As a humble doctor, who also happens to work in the digital health world, my sense is that the pace of change is accelerating in ways that we haven’t seen before. With this in mind, here are my predictions for what’s coming our way:

Big tech will tackle real problems for doctors:

 Apple, Google and other technology giants have been battling for a stronger foothold in healthcare over recent years—building everything from fitness trackers to voice-enabled prescription refills. This coming year, we will see them venture further into technologies that will have a much bigger impact on the physician community. Google, for example, is determined to fix universally hated electronic health records (EHR) by developing its own integrated charting system, which will make it easier for doctors to search for data such as vitals, labs and notes from a single login&mdash;potentially unifying access to information normally spread across multiple systems. Typos won’t be a problem anymore as Google’s “smart compose” technology can help clinicians enter even clinical information more accurately. The product will also have the ability to search scanned documents, such as faxes, and handwritten or typed notes. Google and beyond, look for EHRs to continue to evolve to be more physician-friendly, disrupting the health technology market by coming closer to enabling the ideal: providers being able to spend less time interacting with their computers and more time caring for their patients.

Telemedicine growth will kick into hyper-drive:

 Research has shown that patient demand for telehealth services is growing at an incredible clip. According to a study published in JAMA, patient telemedicine visits grew 261 percent between 2015 and 2017. This growth correlates with physicians’ growing interest in practicing telemedicine, with the number of physicians who self-report telemedicine as a skill doubling— increasing approximately 20% per year&mdash;in just 3 years (2015—2018). The government is beginning to see the benefits of telemedicine as well. This fall, President Trump signed an Executive Order outlining measures for Medicare reform which included a directive that the Secretary of Health and Human Services must propose a regulation to enhance access to care through telehealth services or other innovative technologies within a year. Additionally, the US Department of Veterans Affairs is focusing more efforts on telemedicine to benefit veterans in need of care. Expect to see greater surges in consumer demand, physician interest and federal support for telemedicine in 2020.

Vaping will face more scrutiny and federal regulation:

 Traditional tobacco use remains one of the most pernicious public health challenges of our time. While the initial promise of e-cigarettes, or vaping, as a smoking cessation tool was quite alluring—so much so that the US Food and Drug Administration (FDA) fast tracked several of these products to market - recent reports on vaping-related deaths and illnesses are alarming. Currently, the Centers for Disease Control and Prevention (CDC), FDA and state and local health departments are investigating a multistate outbreak of lung injury associated with vaping product use. As of November 20, 2019, 47 deaths have been confirmed across 25 states. We have already seen multiple state health officials call for bans on vaping products targeted toward teens and, as we learn more about this mysterious new vaping-related illness, we will see increasing scrutiny on the practice and its potential long-term impacts. Expect more state bans and potentially even action at the federal level in the coming months, as well as the development of greater resources for clinicians caring for people with vaping-related injuries.

Prescription drug adherence will improve: 

One area in particular where technology has enormous potential to benefit patient care is medication adherence. Several non-healthcare companies have recently announced new programs in this space. Amazon partnered with pharmacy chain Giant Eagle to utilize its Alexa virtual assistant to remind people to take their medications. The internet retailer also rolled out its PillPack pharmacy service to Amazon Prime members. Additionally, Costco teamed up with Instacart to test free delivery of prescription drugs to its members. With an aging population, more people in 2020 and beyond will be taking medications to help manage chronic conditions. We will continue to see innovations in health technology that aim to make it easier for patients to take their medicines and stick to the treatment regimens prescribed by their doctors.

 The past decade proved that there is no longer a 'one size fits all' approach to medicine. Although individualized medical therapies are not yet available on a wide scale, we are on the path to making significant life-saving strides in the very near future. Our ability to leverage a person's individual genome to create customized medical therapies will only get better in 2020, giving physicians a more targeted arsenal of treatment options and potentially enabling people to survive an even broader group of what are now terminal conditions.

These trends, and more, hold a lot of promise for the medical world. The industry has made huge strides in the past few years. There are still big challenges to overcome, but the future is bright for healthcare providers and patients alike.

Amit Phull, MD is the Medical Director and VP of Strategy & Insights and Doximity. The presented analysis reflects his views, not necessarily those of the publication. 

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