Major Challenges Facing the Healthcare Industry Today

Getting your Trinity Audio player ready...

Overview

Medical inflation. Skyrocketing administrative expenses. The enormous upfront capital investment required to embrace new technologies. These are just a few of the factors contributing to increasing healthcare costs around the world.

According to one recent study, healthcare spending in the United States alone grew 4.1% in 2022, hitting a massive $4.5 trillion. That’s an increase from the $3.7 trillion total that we saw just a few years prior, in 2019.

However, rising costs and their impact on patients, providers, and the healthcare system overall are just some of the pressing challenges facing the sector. By making an effort to better understand the challenges in healthcare as they exist today, you can begin to get a sense of what tomorrow might look like – and what we all collectively need to do to address it.

The healthcare industry is currently grappling with several significant challenges.

1. Access to Healthcare 

Healthcare access issues are by far one of the biggest issues facing our society today – not only in terms of the well-being of patients, but in terms of how effectively providers can do their jobs as well.

Healthcare equity is essential because the healthier we are as a society, the more productive we are. People lead more fulfilling lives and last longer. They perform better at work and contribute to overall growth and prosperity. Healthcare issues have always existed, but especially when it comes to things like income inequality, this gap needs to be filled as soon as possible moving forward.

2. Workforce Shortages

In healthcare today, widespread shortage of the healthcare workforce is a significant issue. This is a current healthcare issue that has slowly been getting worse over the last decade. It’s actually a problem that many industries are facing, with the trucking industry and information technology being two prominent examples.

It’s not just that there aren’t enough physicians around to treat patients. It’s that we lack people in certain specialties – particularly in those that focus on more preventative healthcare as opposed to reactive topics. There are also skills gaps and labor shortages for nurses and even allied health workers.

Healthcare workforce shortages not only exacerbate  healthcare access issues, but they also lead to provider burnout as well. These staffing challenges also make it difficult for virtually anyone to run a successful practice. If you don’t have enough employees, the volume of work you’re able to accomplish doesn’t just suffer. The quality of that work suffers, too. That’s especially bad when, in this case, “work” involves offering lifesaving care to people.

3. Data Security and Privacy Concerns 

One major example of the types of patient care challenges organizations face has to do with data security in healthcare. Truly, the digitization of the industry has become something of a double-edged sword. On the one hand, the fact that more data is available than literally ever before is making it easier for organizations to be efficient. It’s making it possible for healthcare professionals to generate better care outcomes for patients. It’s creating an environment where communication and collaboration among teams is more efficient than ever.

It’s also coming at a time when the average cost of a data breach hit $4.88 million this year.

It’s difficult for small businesses in particular to safeguard patient data and maintain privacy while the total number of cyber threats and data breaches is exploding all around them. But that’s what has to happen. Not only is there an enormous amount of financial risk that comes along with a successful data breach, but there are also regulatory consequences as well. This, coupled with the trust you will certainly lose in your patients, means that you need to start taking this all very seriously.

4. Integration of Health Technology

Technologies like Electronic Health Records (EHR) and telemedicine undoubtedly make a practice more efficient and lead to higher-quality outcomes. Adopting them into your existing infrastructure and getting your patients to buy into them can be easier said than done.

Healthcare technology challenges include not only the initial cost of such technology but challenges related to getting it all to work together as well. For your investment to pay off and to achieve desired outcomes, everything needs to act as a cohesive whole – not individual silos.

5. Quality of Care and Patient Safety 

One of the long-term problems with the healthcare system comes by way of maintaining high standards of care while also ensuring patient safety as treatment environments become more and more complex.

Nobody is arguing that an EHR system isn’t beneficial. However, if it isn’t used properly, it can introduce brand new risks into an environment – like data entry errors or system outages that could impact your ability to provide for patients.

6. Regulatory and Policy Changes 

Healthcare policy challenges like HIPAA can change wildly and, unfortunately, the providers themselves have the burden of staying one step ahead. If your EHR system does not meet compliance, guess what – your practice doesn’t, either.

These regulations (in their current state) will influence the design and functionality of any technology you deploy like an EHR. You wind up making decisions based not on what is best for your patients, but on what will NOT get you fined or otherwise penalized.

7. Occupational Burnout 

Occupational burnout is a real threat in any industry, but it’s especially prevalent in healthcare. It’s something that we observed during COVID-19 when countless professionals simply left the field. If there aren’t enough skilled workers or providers who lack adequate training, it will lead to an overall decline in the quality of health for our entire society.

8. Move to Value-Based Care 

Today, the healthcare industry operates on a system that sees providers charge by the service. If they perform surgery, they get paid for it – end of story. The outcome is largely inconsequential.

There is a movement, however, to transition more towards value-based care. The theory is that this will help reduce costs because providers won’t be recommending procedures and medications that people don’t actually need. Healthcare outcomes will improve as a result.

Switching from one to the other isn’t as easy as flipping a light switch, however. It will likely take a hybrid approach, at least for some length of time, for the best results.

The endlessly challenging demands brought on by the COVID-19 pandemic set the evolution of the modern healthcare environment in motion. Patient surges, staffing shortages, and the need for rapidly changing procedures all came together to inspire change at every level. Beyond that, government regulations and big tech innovations complicated matters further.

So, while treating your patients remains paramount, the modern healthcare environment now demands so much more from your medical practice. Physicians have to step beyond the basic caregiver role to truly exceed their patient’s expectations. They’re now tasked with being tech experts, cybersecurity heroes, financial gurus, patient experience marvels, and so much more – they really cannot do it alone.

Your policies, certifications, and procedures must evolve with time and with changes in government compliance. Otherwise, current healthcare issues could impact the patient experience, the efficiency of your operations, and your bottom line. To enact all the right changes, you must first explore all the biggest challenges physicians face today. To help you out, here’s a look at nine major challenges in healthcare to overcome — and all the leading solutions.

9. Cybersecurity Threats

Your patients trust you to securely hold onto all their most personal data, including personally identifiable info, medical records, and payment methods. Unfortunately, the rising risk of cybersecurity attacks endangers all that data – and the reputation of your healthcare center.

In 2021, the rate of cyberattacks against healthcare centers tripled. Nearly 50 million people had their protected healthcare data breached as a result, resulting in costly shutdowns and the erosion of patients’ trust.

Yet, to this day, almost half of all devices used in healthcare settings remain vulnerable to cybersecurity threats. But it doesn’t have to be that way.

You can help protect your patients’ data by taking these measures: 

• Upgrade your systems, services, and processes to stay ahead of threats
• Use an electronic health record platform designed with security in mind
• Train your staff to maintain a culture of cybersecurity
• Focus On Business Associate Agreements
• Pay attention to Access Rights
• Have reasonable safeguards, policies, and procedures in place

10. Telehealth Implementation

As evidenced by its rapid growth in 2020, telehealth was key in providing patient care while managing the risk of COVID-19 transmission. In response, virtual visits peaked in April 2020 at 78 times higher than their prior rate.

Since that initial jump, telehealth visits have stabilized at 38 times higher than pre-pandemic levels, showing their popularity with patients. And that’s a great thing. The improved accessibility to healthcare makes it easier for physicians to help patients manage their conditions. Plus, the virtual visits allow you to handcraft the ideal patient experience every time.

More than 75% of patients show interest in telehealth, yet utilization rates remain in the 50% range.

To close the gap, you just need to: 

• Raise patient awareness about the ability to get virtual care
• Set up intuitive EHR systems with telehealth functionality
• Provide support to patients in learning how to use your system

“As we continue this shift to telemedicine, new issues and risks unravel that need to be addressed, particularly in regard to information security and privacy, and ongoing work is needed to ensure that our technology infrastructure provides an environment for safe and effective care delivery.”

Journal of the American Medical Informatics Association

11. Invoicing and Payments

With all its medical jargon, complex coverage rules, and ever-changing approaches, the healthcare billing world doesn’t make much sense to patients. Over 70% of patients find both the insurance explanation of benefits and their portion of the bills wholly confusing.

On top of that, medical bill management portals rarely align with your patients’ payment preferences. Late or altogether missing payments then occur as patients fail to find a way to manage their bills. Your revenue cycle management abilities decline in response, leaving you trying to find a way to keep your clinic afloat.

To overcome this issue, you could:  

• Align your approach with patient expectations, starting with easy-to-understand medical bills
• Set up a user-friendly online patient portal offering many different payment options
• Make it easy to create payment plans without having to make time-consuming phone calls

12. Price Transparency Mandate 

In response to patient complaints about surprise billing issues, the Centers for Medicare & Medicaid Services created the Hospital Price Transparency mandate. Although enacted in early 2021, only 5% of hospitals have achieved full compliance. Worse yet, more than 50% still don’t publish the rates negotiated with insurance companies.

Patients remain completely in the dark about their healthcare costs – and many are not standing for it. While the mandate only affects hospitals, healthcare centers of all sizes, including solo practices, are feeling hurt as a result. In the coming years, you can expect to see patients looking into the price of your healthcare services before deciding where to get care.

To better service your patients, consider: 

• Publish your typical rates for many services for cost comparison purposes
• Offer to provide estimates for large procedures and other potentially costly services
• Give your patients multiple payment options to consider, including the ability to pay over time

13. IT Healthcare Investments

Alongside the push for healthcare pricing transparency, patients want healthcare centers to eliminate wasteful spending. With up to 25% of health spending deemed wasteful, there’s the potential for big savings over the years. Although the waste factors are numerous, administrative complexity, poor care coordination, and low-value care add up to a stunning $444 billion in excess spending every year.

IT healthcare investments, like Electronic Health Record software, can help minimize excess spending at every level of the healthcare world, including small private practices. As you employ key tech software for your clinic, operational costs decrease, especially at the administrative level. In response to patient actions, the software can automatically handle many of your key day-to-day management tasks, including scheduling, care coordination, and billing.

To minimize excess spending at your clinic:  

• Adopt EHR solutions with a patient portal, automatic billing, and telehealth services
• Train your staff on how to best use electronic health records in their day-to-day lives
• Help patients use all the different services found in the portal instead of calling your clinic

14. Patient Experience

A positive patient experience is a must if you want to boost care outcomes, retention rates, and profitability. When given favorable care experiences, your patients are more likely to adhere to medical advice. Better healthcare outcomes follow, boosting patient retention rates and lowering malpractice risk.

But what does an excellent patient experience look like? Oftentimes, it all starts with self-service systems, like EHR software with online patient portals. Through these systems, your patients can conveniently make appointments, speak with healthcare professionals, and manage their bills. The software helps streamline your physicians’ workflows as well, so they can provide timely services while expertly coordinating care.

To handcraft the perfect patient experience:  

• Put all the right tech systems in place, and then train your staff and patients on their use
• Examine all the workflows for each physician and staff member to remove redundancies
• Collect and go over patient reviews to find new ways to improve their experience at your clinic

15. Effective Payment Models 

In the past, healthcare centers solely relied on the fee-for-service payment model for reimbursement. If you’re using that model, your profitability largely depends on getting more patients through the doors and completing key procedures. Within that model, your physicians are not incentivized to promote preventative care and work within a coordinated care team.

In recent years, the value-based payment model has started to take hold instead. This model largely aligns reimbursement rates with patient outcomes. Although only 15% of physicians have made the switch, the results speak for themselves. Patients seeing physicians using the value-based model get a higher quality of care, including better management of all their chronic conditions.

To overcome this challenge: 

• Reflect on whether your current payment model best supports your patients’ needs
• Consider switching to a value-based payment model to incentivize higher-quality care
• Test the results by collecting key metrics on your patients’ care quality and outcomes

16. Healthcare Regulatory Changes

The COVID-19 pandemic brought forth many seemingly temporary regulatory changes in the healthcare world. Regulations on telehealth services were lifted, for example, which improved healthcare accessibility but left questions about future regulation.

Through that process, regulators set their sights on further emphasizing innovation across the healthcare sector. Existing standards will undoubtedly change as a result, especially when it comes to improving healthcare accessibility, affordability, and quality. So, you’re going to need to stay on your toes to keep up with the ongoing regulatory changes in the coming years.

To keep your healthcare center aligned with HIPAA rules, Medicare reporting, and so much more: 

• Check for government updates and training
• If possible, keep a compliance officer to guide you through the changes
• Review the approach quarterly and revise it as needed to stay compliant
• Subscribe to industry blogs and newsletters, for regulatory updates
• Attend conferences, seminars, and events

17. Healthcare Staffing Shortages 

Healthcare staffing shortages started in earnest during the pandemic and they’re not likely to end any time soon. A recent study by the Association of American Medical Colleges forecasts a shortage of up to 104,900 physicians by 2030.

As your physicians retire at rapid rates, your patient population will continue to age and grow. Their healthcare demands will steadily outpace the number of primary care and specialty providers as that occurs. Keeping up with the increasing demand will likely become one of the biggest challenges physicians face while serving their patient populations.

You can help them best handle the demands by: 

• Adopt customizable technology, including online patient portals with telehealth functionality
• Help your physicians understand how to use the systems to better manage their patients’ needs
• Build retention strategies
• Encourage patients to use telehealth services for key conditions easily managed remotely

18. Too Little Patient-Provider Time 

Finally, one of the major challenges facing the healthcare industry has to do with a lack of patient/provider time. Every other challenge on this list takes a fair amount of time to understand, let alone adequately address. Every minute spent on worrying about interoperability or compliance is a minute not spent with patients.

Not only can this significantly impact the quality of the patient experience in the short-term, it diminishes the quality of care in the long-term. A delicate balance must be strict to maximize patient engagement and care quality in the future.

Here are a few more obstacles the healthcare industry must overcome:

• Regulatory & AI Challenges

• Health Equity & Access Disparities

• Mental Health Crisis

• Rising Costs & Financial Pressures

• Technology & Data Overload

• Climate Change & Environmental Impact

What Can Be Done to Help You Overcome Challenges in Healthcare?

Although change can prove difficult, you must address all the challenges one by one. For the best results, consider taking a holistic approach to overcoming current healthcare issues by setting up a fully-integrated EHR solution.

With EHR software in place, you instantly upgrade your cybersecurity, care approach, payment models, and so much more. Customizable workflows promise to keep physician burnout at bay while improving the patient experience across the board.

To get started, you’ll need to set up a demo to see if cloud-based EHR software will work for you. Through that process, you can explore all the ways the EHR system can help your healthcare facility keep up with industry changes.  To get more information about some of the challenges facing the healthcare industry and what you can do to start preparing for them, or to get answers to any other important questions that you might have, please don’t delay - contact the PrognoCIS team today.