25 HEALTHCARE TRENDS & PREDICTIONS FOR 2022

By Pat Stricker, RN, MEd, Former Senior Vice-President, TCS Healthcare Technologies

Last month’s article, “The Significant Healthcare Milestones and Trends in the Past Decade (2010 – 2020)," looked at the healthcare issues we faced in 2021 and at some of the dramatic challenges and accomplishments that occurred in the previous decade. These included the passing of the Patient Protection and Affordable Care Act (ACA) that occurred at the beginning of the decade (2010) and the unprecedented COVID-19 crisis that occurred at the end of the decade (2019 and 2020). Other significant events included the opioid crisis, the move from standard fee-for-service billing to value-based care, and the actual realization of electronic health records in most hospitals (94%) and provider offices (89.9%). The big push for their implementation began in earnest in 2009 with the Health Information Technology for Economic and Clinical Health Act (HITECH), enacted as part of the American Recovery and Reinvestment Act of 2009. Even though there are several EHRs on the market and they don’t all “talk to each other,” it is a great accomplishment that we are fully moving in that direction. They are a definite, functioning part of the healthcare system.  

COVID-19 changed healthcare dramatically in the past two years. It hit with such speed and severity that we were not prepared for it. However, changes that would have taken months or years to complete, were implemented very quickly due to necessity. For example, telehealth had been tried over the years and some small programs were implemented, but they were not part of the standard healthcare delivery system. However, because the foundational basics were already there, we were able to implement these programs very quickly to allow patients to be seen virtually. COVID-19 also made numerous other changes to processes, policies, and care delivery, and some of these changes will remain now that the pandemic has lessened.     

This article will describe the clinical and technology healthcare trends and predictions for 2022.

Healthcare Clinical Trends and Predictions for 2022

The following list of 2022 trends and predictions were consistently mentioned in researched articles. They are not listed in any specific order, but the ones mentioned more frequently appear at the top of the list.

1. Telehealth services are on most lists as a definite trend for 2022. While we think of telehealth as visits that occur remotely using audio/visual communications technology, it encompasses much more than that. Telehealth is a broad term that the World Health Organization describes as “the integration of telecommunication systems into the practice of protecting and promoting health.” It includes virtual visits, remote robotic surgeries, medical imaging, health alerts to cell phones, remote monitoring, wearable devices, and patient education programs to mention a few. Telehealth has been around for years, but it never became a mainstream delivery option because payments were limited from Medicare, so it did not tend to expand. However, COVID-19 changed all that. Now we just need to make sure it remains a viable delivery model.  

2. Virtual Visits are projected to grow by 22% (average annual growth) over the next five years, reaching $20 billion by 2027. As a component of telehealth, virtual visits became a necessity when clinics and physicians’ offices were closed due to COVID-19. Due to the immediate need, Medicare quickly allowed payments for them. With secure digital tools (online portals, texting, and video options) readily available the virtual visits could be implemented quickly. During the first month of the pandemic, virtual visits increased from 0.1% to 43.5%, and throughout the pandemic, they provided transitional care management to over 44,000 discharged patients and others who could not access their typical care provider. They provided a way for rural, elderly, disabled patients, and behavioral health patients to connect with their physicians privately for routine visits and preventive care. They were also less expensive than in-person visits and were appropriate for a variety of different types of issues. Developing transitional programs for patients moving from hospital or post-acute facilities or home are trends that are being worked on for 2022.

While the percentage of virtual visits has decreased since the height of the pandemic (drop of 26% to 60% depending on the state), the numbers are still much higher than before the pandemic and virtual visits are expected to remain a viable part of the healthcare delivery model. Over time, in-clinic visits are expected to slowly lessen while virtual visits increase. However, because the volume of calls has diminished since COVID-19, we must work hard to secure adequate funding for programs and encourage organizations to continue to support and promote these types of visits.  

3. Remote Patient Monitoring (RPM) is a telehealth application that remotely checks a patient’s status (BP, weight, activity, blood glucose, heart rhythm, etc.) to eliminate the need for in-office visits. RPM had triple-digit growth in 2020. The initial set-up for RPM devices in 2021 increased nearly 40% compared to 2020 and nearly 572% compared to 2019. RPM was critical during the pandemic when it was needed to replace in-clinic visits. RPM is not plateauing like virtual visits, but continuing to increase in volume, especially in chronic condition programs. All four of the RPM procedure (CPT) codes have shown increases from 2020 to 2021 (39.3%, 97%, 147.8%, and 176.5%). RPMs are more convenient for the patient, increase a physician’s productivity, and reduce the cost of healthcare. They are developing more each year, so they are becoming more affordable. This is important since they are needed for minority patients or those in lower-income populations to improve their health equity.   

4. Social Determinant of Health (SDOH) will also continue to expand in 2022, especially in the areas of transportation and housing. Addressing these barriers to conditions in the places where people live, learn, work and play can affect a wide range of health and quality-of-life risks and outcomes. There needs to be a greater focus on care at the population level and an investment in community programs that have significant impact on individuals and access to care. These need to be the responsibility of payers, as well as providers.

5. Healthcare Disparities and Health Equity are other major focuses for 2022. Healthcare disparities, based on race, ethnicity, gender, sexual identity or orientation, disability status, special needs and geographic location are very noticeable and result in poorer healthcare outcomes. Providing health equity to all is a top priority. Initiatives will be implemented by the Centers for Medicare & Medicaid Services (CMS) to ensure better outcomes among minority and lower-income populations. CMS is ensuring that every decision or action it implements improves healthcare equity. The National Committee for Quality Assurance (NCQA) is also working to better identify and act on eliminating disparities and is offering a health equity accreditation. Healthcare organizations need to build meaningful relationships with community partners and develop solutions that will address these disparities. They also need to develop a strategic priority to provide training, cultural competency, and workforce diversity initiatives to assure that programs result in Health Equity for all.     

6. The Opioid Crisis has been an ongoing crisis for several years, yet it was at unprecedented levels during the past 2 years of the pandemic. Working on new programs for this crisis is critical.   

7. Care Is Shifting From Hospitals to Provider Groups and Ambulatory Surgery Centers (ASCs) and ASCs are expected to have an increase in the number of procedures in 2022. Claims from hospitals in 2021 were 32.9%, down from 38.7% in 2016 (a 6% drop), and claims from physician groups were 44.6% in 2021, compared to 42.1% in 2016 (a 2.5% increase). Procedures are also growing in ASCs. Pre-pandemic, procedures at ASCs grew faster than in hospitals (16% for ASCs and only about 6% for hospitals). While the volumes dropped during the pandemic, by 2021 nearly 94% of the volume had been regained.         

8. Home Health and Hospice are Moving to Care Management Models and are adopting care management business models in response to transition of care initiatives. This provides a continuum of care from the hospital or post-acute care to home care and hospice, making care management services available to more patients. Hospice organizations are redefining their programs and making them longer than the last weeks or months of life. COVID-19 issues are pushing programs to provide more home health services with emphasis on care delivered in the home with community and family support.

9. Automated Workflows and Streamlined Processes are definite trends for 2022. Focus must be placed on developing automated workflows to streamline processes, improve efficiency and productivity, and make the nurses’ work easier and less stressful. AI can be used as a tool to help automate these tasks. Time spent on routine documentation and miscommunications increases the staff’s anxiety and stress levels, and keeps them from focusing on patients and key program goals. Work needs to continue on improving automated workflows for as many functions as possible.

10. Care Management ROI and Outcomes. Studies demonstrate care management programs provide vulnerable populations with better outcomes at a lower cost. In 2020, three full-risk ACOs earned shared savings of $15 million for their care management programs and spent an average of 22% less each month on healthcare resources. Care management programs like this need to be developed to demonstrate ROI.

11. Payers, providers, and healthcare systems are using care management to improve health, control cost and drive efficiency. These are ideas of new programs providing better services and reduced costs.

• New companies and lines of business are building solely virtual business models
• Programs that provide an increased focus on better management of comorbidities
• Patient Engagement is being improved by focusing on personalized education and resources

12. Staffing Shortages and an Aging Workforce will continue to be issues in 2022 and for at least the next 10 years. A shortage of between 37,800 and 124,000 physicians is expected by 2034 due to a variety of reasons including: COVID-19 illnesses, burnout, retirement and lower numbers of physicians entering the profession. However, medical school applications increased by 18% - 35% in 2021. The nursing profession is also experiencing shortages. The number of nurses contemplating retirement or resigning their position was 15.9% in 2019 and that increased to 22% in 2021. The prediction is that by 2030 there will be a shortage of 1.2 million new RNs. That is only 8 years from now!

Healthcare organizations need to promote workforce well-being and look into using virtual technologies to help combat the resignations and early retirements of physicians and nurses. Another solution to help compensate for these shortages may be to rely on nurse practitioners (NPs). There are currently more than 325,000 licensed NPs in the U.S. conducting more than 1 billion patient visits each year. They are expected to grow at a rate of more than 45% in the coming years. NPs represent 1 in 4 primary care providers in rural practices and 24 states (ranked as the healthiest states) offer patients full and direct access to NPs. They are directly involved in implementing new, innovative and effective models of care and ensure patients receive the highest quality of care.

13. The Cost of Prescription Drugs continues to be a major problem and must be identified as a strategic goal to work on. The cost of prescription drugs in the U.S. is more than 250% higher than 32 other countries and is 3.44 times higher for brand-name drugs. During the pandemic, there were $134.4 billion in drug charges to insurance companies in 2021, which is a slight decrease from $149.2 billion in 2020 and $154.9 billion in 2019. However, the overall charges were likely lower due to delays in care over the last two years, resulting in fewer physician visits and fewer new and renewed prescriptions.

14. Patient-centered Healthcare will continue to be a focus for 2022 and into the decade. Healthcare is constantly changing, and the next decade will present a great deal of new technological developments and innovations, which will create a re-evaluation of healthcare and its purpose, incentives and business models. These changes will also create concepts focused more on prevention, better outcomes, lower costs and more personalized and specific patient care treatments. As patients take on more responsibility for their health, they will need more support and guidance from healthcare professionals. Because of the demand for personalized products, including at-home testing kits, online counseling and nutrition education, the disparities between socio-economic statuses are more likely to decrease. 

15. Adjustments to the Affordable Care Act (ACA) Are Needed. When it was enacted, the goal was to go back and strengthen portions of the bill. However, that has been difficult. The ACA has had several attempts to repeal it, but it has persisted, since it is a popular program. However, it still needs to be adjusted to meet the healthcare needs even more (less costly, differences by state and employment status). As of July 2021, 23 million Americans were insured under the ACA. It provides insurance for vulnerable groups and young adults that are traditionally underinsured or uninsured; protects people with preexisting conditions allowing them to receive quality, timely care; provides less costly access to prescription drugs; lowers Medicare costs for seniors; and strengthens protections for the disabled.

Healthcare Information Technology (HIT) Trends and Predictions for 2022

The world of technology has changed significantly in the past few years and is now able to provide healthcare organizations with a variety of new, innovative healthcare platforms, programs and devices. The organizations recognize these abilities, and 80% of health systems say they plan to increase their spending on health information technology (HIT) over the next five years.

The following are trends that healthcare organizations and technology groups have been working on together in the past few years and will continue to do so in 2022.   

1. Electronic Health Records (EHRs) have finally become a reality across the healthcare industry. EHRs are now in 94% of hospitals and 89.9% of providers’ offices. They allow healthcare professionals to access and review patient records, develop care plans and quickly document notes from anywhere on their secure devices, when located in a cloud-based system. This is much more convenient than working with a paper record that is only available in the office. However, the EHRs are not perfect and the two groups are working together to make them even better.

2. Cyber-attacks, Ransomware, and Data Breaches.  The healthcare industry saw a record number of these in 2021. Organizations are working diligently to protect their systems against attacks, but it is an ongoing battle. It continues to be a major focus for 2022. 

3. Big Data and Analytics. Using AI and predictive analytics on large amounts of real-time and historical hospital data allows us to see relevant data that can be used to make precise, and valuable decisions. It gives clinical and operations staff the data they need to make effective, real-time decisions regarding things such as capacity needs, patient needs and treatments, transitions of care from one setting to another and forecasting and preparing for future demand.   

Another component of Big Data is the need to Integrate Data for Teams. Members of a care team who work for different organizations or in different locations have their own separate data, but that data needs to be shared with members of the team. The technologies to accomplish this (shared networks, the cloud, etc.) are available and the integration is getting better, so it is a priority for 2022.

Use of Unstructured Health Data is also a need for 2022.  The racial and ethnic variations in COVID-19 infection rates identified the need to collect and analyze data from as many sources as possible for public research and drug development activities. Organizations need to get better at obtaining and analyzing the 80% of unstructured healthcare data. This is vital to be able to determine health disparity issues. Artificial Intelligence and machine learning will help reveal the unstructured data and make it easier to store, analyze and share. 

4. Medical Internet of Things (IoT) is growing rapidly. It consists of wearable devices, monitors and other applications that are used to provide remote monitoring and observation of a patient’s health status. They are becoming more affordable and are providing more and more capabilities.

5. Artificial Intelligence (AI) and Machine Learning (ML) create enhanced versions of traditional medical devices that allow physicians to receive the information in a timely manner. During the pandemic, healthcare providers were able to manage crises remotely, using AI and real-time health data assessments. AI and ML have incredible potential to make dramatic changes in healthcare.  

6. Extended Reality (XR) for Clinical Training and Treatment.  XR includes virtual reality (VR), augmented reality (AR) and mixed reality (MR), and they are all expected to grow in 2022. They involve lenses or headsets that alter our perception of the world by placing us in a virtual environment (VR) or overlaying virtual features on real images of the world (AR/MR).

• VR is used to train medical personnel about the human body without putting patients at risk or requiring medical cadavers. It is also used to train social and coping skills to autistic children and for cognitive behavioral therapy (CBT) to allow patients to work through their fears and psychosis in a safe and non-threatening environment.
• AR applications include those that make it easier for healthcare professionals to locate veins when giving injections, let surgeons share what they are seeing in surgery with others, and provide everyone directions to the nearest publicly accessible automated defibrillator unit.

7. Digital Therapeutics are software programs with evidence-based therapeutic interventions that are used to prevent, manage and treat a variety of physical and behavioral conditions. They allow patients to participate in managing their own healthcare goals and foster patient empowerment.

8. IT Start-Ups, Mergers, and Acquisitions will continue to play a major role in healthcare as organizations focus on acquiring technology and innovative products that can change care delivery and reduce overall costs. Healthcare start-ups raised more than $21.3 billion during the first three quarters of 2021, and it was the biggest year ever for health IT company mergers and acquisitions. This is expected to continue for the next few years.

9. Surgical robots assist surgeons in surgery, allowing procedures to be done with minimal invasiveness, reducing recover time and mitigating infection and risk. During the pandemic they work in a variety of other locations, taking on other simple tasks to relieve workers so they could assist with patient care. These tasks included: linen transportation, disinfecting hospital rooms, checking patients for fever, delivering medicine and food, inventory tracking and supply management. Trends are moving toward having robots play a role in supply chain management.  

10. Personalized Healthcare.  Patients are beginning to take a more active part in their healthcare, and personalization is making it easier for them to stay engaged. Examples of these include:

• Physical Health Applications, like wellness-based exercise and nutrition applications, that help patients with diabetes, heart conditions or high blood pressure to manage their conditions.
• Mental Health Applications allow patients to find a therapist and video chat with them. This has become a very helpful tool for patients with behavioral or mental health issues.
• Quality Data Applications collect data and share it with a healthcare team member so they can better understand what type of personalized care the patient needs.
• Tailored Preventative Measures allows AI to collect patient behavioral and risk factors. The patient’s provider then uses the data to create a personalized care plan that may prevent an emergency procedure in the future.
• Healthcare and Gamification uses video-game applications to get people to exercise, eat better and learn to relax, making it more fun and increasing the chance that patients will stay engaged.

NOTE:  The references for the above information came from “27+ Affordable Care Act Statistics and Facts (2021)”. It is very interesting and includes facts about the ACA, its benefits, stats on insured and uninsured individuals in the U.S., and barriers to seeking healthcare.

Conclusion

There are a lot of trends listed for this year, but we have to remember that this year and last were unprecedented. Healthcare (and the entire world) was in a disastrous global emergency caused by COVID-19. The number of articles listing trends and predictions for this year was much larger than normal. All of the 2022 trends will not be worked on by everyone, but they are being worked on. And eventually they will get accomplished. Just look at the list of trends that were finished in the last decade (as described in last month’s article) and you will see that it may take while, but we can accomplish a great deal when we set our minds to it.

COVID-19 gave us a difficult wake-up call. It forced us to create new innovative, creative ideas based on specific, identified needs. With all the challenges that occurred over the past 2 years, the momentum has finally shifted and a new more robust healthcare industry is finally becoming a reality. COVID-19 actually helped push healthcare into the future by decades. We are not there yet, as there is still a lot more to do, but we are much further ahead than we were 2 years ago. We just need to continue on this path and identify how we can improve even more. And we must not forget that as we continue to innovate, we need to remind ourselves that our “new norm” will be “ever-changing.”  No more “status quo” or normalcy.

Healthcare is, and always will be, ripe for disruption, but the COVID-19 pandemic showed the entire healthcare industry (and the world) how unprepared we were for this type of global emergency. It changed healthcare and many other industries as well. It also taught us that we can discard policies, procedures, processes, programs, or workflows that we thought were “sacred” for decades.

The trends and predictions for 2022 point to a future filled with smart actionable data, adaptable automated workflows, innovative AI/ML/VR/AR technologies, efficiency and productivity, reporting based on analytics and big data sources, informed decision-making, health equity, new telehealth processes and transitional care changes.