Dive Brief:

• Cybersecurity, telehealth and health IT disruptors are front and center in health system leaders' minds as they look ahead to 2019, a new Center for Connected Medicine report finds.
• In a survey of C-suite executives at nearly 40 U.S. health systems, 87% said they expect to increase spending on cybersecurity, while none plan to cut spending.
• Execs are also bullish about telehealth reimbursement as a component of value-based care, with more than 60% of respondents believing government and commercial payers will fund the bulk of virtual care services by 2022. For 2019, though, most telehealth will be funded through internal means and patient payments, according to the survey, which was conducted by the Health Management Academy in partnership with CCM.

Dive Insight:

Health organizations recognize the threats and importance of cybersecurity and interoperability and are investing in these areas. They're also noting the importance of virtual care, though regulatory and reimbursement barriers remain. 

Just 20% of respondents reported feeling "very confident" about their organization's IT recovery and business continuity plans, while 70% said they are "somewhat confident." Of those expecting to increase cybersecurity spending in 2019, nearly half anticipate increases greater than 5%.

Employee education is seen as the greatest challenge to cybersecurity, with 62% of respondents seeing staff as the major weak spot. The most common threats are phishing and spear-phishing attacks.

While leaders are optimistic about telehealth, barriers remain — among them lack of reimbursement, restrictive regulations and cost of the technology. A small number of respondents (10%) also cited loss of revenue as a potential hurdle to adoption.

The top two priorities for telehealth are integration with the clinical workflow (67%) and ease of patient triage and virtual follow-up (57%).

Interoperability is also top of mind for C-suite officers, with nearly half of respondents saying lack of interoperability has made it hard to improve efficiencies, reduce costs and optimize use of data analytics. More than a third (36%) said use of a major EHR system "somewhat" or "significantly" stifles innovation at their organization. 

Healthcare leaders' antennae are also trained on potential market disruptors like Apple, Amazon and Google. According to the survey, 70% of respondents are "somewhat concerned" and 10% are "very concerned" about the transformative impact of big tech companies to provide a better patent experience and force greater price transparency.

"The biggest threat is if these companies get between us and the end consume. If there is a platform regulated by someone other than us — that makes us nervous," one CEO said. "There are many places where some of these platforms and conveniences can and will likely succeed — we haven’t been good in this space."

Not everyone is apprehensive about the Big Tech effect. Some leaders see it pushing health systems to think outside the box about new forms of care delivery and cost solutions, and see opportunities for partnerships to increase efficiencies and improve patient care. 

Meanwhile, surprisingly few health systems are moving to the cloud to store healthcare data. Eight in 10 respondents expect to store a majority of data in brick-and-mortar data centers or a hybrid or private cloud in the next three years. Just 10% anticipate moving storage to a public cloud. 

What areas of health IT will be rocking healthcare five years from now? Survey respondents' top five picks are AI/precision medicine, consumer technology, genomics, AI/imaging and diagnostics and telemedicine. Cybersecurity was sixth.