“Health care is among the most-targeted industries for cyberattacks — and for good reason,” the authors write. “Vast amounts of highly valuable data, coupled with less mature cybersecurity programs than other industries, makes health care a prime target for cybersecurity attacks.”

Despite increasing financial investment and prioritization of cybersecurity at health systems, executives did not express robust confidence in their organization's IT recovery and business continuity plans after an attack or breach, according to the report. Seven out of 10 respondents report being “somewhat confident” in their recovery and continuity plans; only 20 percent say they are “very confident.”

“Many health systems have implemented network segmentation to prevent full access to the organization's network if a breach were to occur,” the authors write. “With a greater emphasis on connectivity and data access, as well as the increased adoption of connected devices through the Internet of Things, health systems are designing their network architecture to allow for the greatest amount of connectivity while ensuring security.”

Other key findings regarding cybersecurity include:

• 87 percent of respondents expect cybersecurity spending to increase in 2019, with nearly half expecting an increase of greater than 5 percent,
• Phishing and spear-phishing cited as most common types of cyberattacks in previous 12 months, and 62 percent of respondents name “staff” as greatest point of cybersecurity weakness.

Telemedicine

Another top of mind topic for 2019 is telehealth. While currently telehealth represents a low percentage of total care delivery at all responding health systems, executives unanimously anticipate growth in the next three years as reimbursement increases and consumer demand picks up.

Lack of reimbursement is the most significant barrier to adopting greater telehealth services among health systems, as less than a third of costs for delivering care via telehealth is reimbursed for a majority of respondents. However, executives expect the majority of funding for telehealth to come from commercial and government payers within the next three years.

“While most health systems have not calculated an ROI for their telehealth services, many consider developing the patient connections and the associated potential downstream revenue as a proxy ROI,” the authors write. “Additionally, telehealth can be viewed as a cost saving initiative as these services can help prevent unnecessary visits or admissions, freeing up physician time to manage patients with more serious conditions.”

Other key findings regarding telehealth include:

• When considering a telehealth technology system, health systems' top priorities include integration with the clinical workflow (67 percent of respondents) and ease of patient triage and virtual follow-up (57 percent). Lower priorities for technology features are high-quality video chat, secure messaging and chatbot capabilities.
• As many health systems use their own physicians to deliver telehealth services, solutions that make care delivery seamless for providers and encourage physician adoption are highly valued. Due to this focus, in 2017 the majority (71 percent) of health systems reported clinicians are supportive of telehealth services.

Interoperability

Interoperability is another hot topic for 2019, as hospitals and health systems pursue value-based care, consumerism, and other initiatives that require broad sets of data from disparate IT systems, according to the report.

“Health system leaders are increasingly realizing that standing up their electronic health record systems was only a first step on the path to data-driven health care,” the authors write. “The government's Meaningful Use requirements forced health systems to go digital — but it was only a start. To drive meaningful change and promote value, health data should be freed from proprietary IT systems, easily downloaded by patients, and put to work in any number of applications.”

A lack of interoperability has made it more difficult for health systems to address certain key priorities, most commonly improved efficiency/cost reduction, and advanced analytics, according to the report. Additionally, executives report challenges addressing care gap closure, longitudinal patient data and integration with non-owned partners.

Other key findings regarding interoperability include:

• 61 percent of respondents say the use of a major EHR system is not stifling digital innovation at their health system. However, in qualitative interviews, several executives say an EHR is limiting their ability to innovate by locking them into a single vendor's products.
• 70 percent of informatics executives are “somewhat concerned” about Big Tech companies, such as Apple, Amazon, and Google, entering the health care space. Ten percent are very concerned and 17 percent are not worried at all.

A majority of health care data is expected to be stored in on-premises data centers (20 percent) or hybrid/private cloud (60 percent) in the next three years. Ten percent say they anticipate storing health data in a public cloud.

“Health systems also see significant opportunity with the entry of new consumer-focused players into health care,” the authors write. “Areas such as supply chain, pharmacy, data analytics, and consumerism could benefit significantly from solutions offered by outsiders. Health system executives say they recognized they would be forced to think more creatively to solve problems and redesign care delivery as 'Big Tech' companies disrupt the current model.”