Advanced Healthcare Technology: What ACO REACH Providers Need to Know About Trends, Challenges and Opportunities 

By Zach Finnel, Senior Vice President of Business Development 

There’s a science-fiction version of healthcare technology that Silicon Valley and others promise in the near future—smart eyeglasses that pull up patient charts, radical research breakthroughs that cure previously unbeatable diseases, nano surgeries that barely leave a scar. That big leap forward is still going to take time to come to fruition. 

In the meantime, providers can adapt to advancing healthcare technologies by understanding the major trends, challenges and opportunities. Here’s what you need to know now. 

Three trends in advanced healthcare technologies ACO REACH providers should know 

1. Continued healthcare digitization and integration in all care models, including ACO REACH 

For years, the healthcare system has worked to digitize health records and workflows and drive integration across the system. But even in 2024, there’s still much work to be done, especially in the transition to value-based care.  

Too many healthcare providers remain siloed on electronic health-management-record islands of their own. As the healthcare industry digitizes records and provider workflows, it creates massive amounts of data. The next frontier will be the integration of disparate data environments from primary care providers, specialists, hospitals and acute-care providers so that everyone has the same information on every patient. This will ideally minimize errors due to polypharmacy or relying on patient narratives alone. 

Remote-monitoring technologies are already unlocking treasure troves of data thanks to the Internet of Things. With care triggers and interventions tied to that data, healthcare providers can be more proactive in managing their patients’ health and well-being. A patient with heart failure who weighs themself daily on a smart scale won’t have to report they are retaining water to their care manager. Their care manager will get the alert and can call to direct them to the appropriate level of care. 

2. Artificial intelligence (AI) in healthcare and ACO REACH 

Healthcare has long leveraged AI to help with predictive analytics and automation. AI will now help providers with diagnostic support, increased personalization and research and development. 

Predictive analytics uses historical patient data to help make predictions about the future. Providers who know how to read and use this data can then make targeted interventions with their most at-risk patients. This is what ilumed does with BrainStream for our ACO REACH providers, which we’ll explain later. 

AI can assist providers with diagnosis through imaging analysis. AI will be able to review hundreds of thousands of X-rays, MRIs and other scans to identify and recognize patterns, helping providers make more accurate diagnoses. 

Providers could also use chatbots to help patients round the clock and direct them to the right type of care for their needs. 

3. Healthcare consolidation across the industry and in ACO REACH 

We’ve seen healthcare consolidation for many years, but the pandemic accelerated the trend of larger practices. As technology becomes more important, providers might have to invest more in new equipment, software systems and staff. With primary care margins already slim, this capital crunch makes consolidation more attractive. 

The push toward value-based-care delivery and the demand for integrated data and coordinated care is another factor driving this trend. When care teams are coordinated across provider types and locations, patients and providers win because everyone has the same view of the patient. A patient discharged from the hospital might not be the best person to tell the story of their condition or treatment. This is why the ACO REACH model is so powerful because it connects providers across the healthcare spectrum. 

Provider challenges with healthcare technology 

Providers face internal and external hurdles to adapting to the next phase of technological progress. To start, you might have to change how you or your staff have worked for years or even decades. Competing against pen and paper is a hard habit to break. In wound care, providers still trace a wound on paper, measure it and then scan it instead of leveraging technology to make the process faster, easier and more efficient. 

Second, there’s so much change happening at a rapid pace. Much of the technology has not been proven in the real world yet. It can feel like too much is being thrown at you at once. You might already give up your lunch breaks; it’s a lot to ask to learn new technologies too. It can feel like adding complexity and difficulty to an already complicated and hard job. 

As a provider, you were trained in medicine, not technology. Learning new skills and having to keep pace with every change while caring for your patients is a lot to ask. When it comes to medicine, you were likely trained in a traditional fee-for-service model of care. Adapting to a new value-based-care model while also changing your systems and workflows can feel like drinking from a fire hose while running on a treadmill. 

There’s all this new tech rolling out, yet the use cases aren’t proven. Early adopters in the dot com era got burned because it took more than 10 years for the promises of the early Internet to play out once tech went mobile first. 

Implementation remains a huge challenge. For you to use technology, it must be seamless, easy and affordable; otherwise, it won’t happen. Your systems need to work together without a hitch. Your operational workflows need to flow from one staff member to another without hiccups. You’ve got to maintain HIPAA compliance and have robust systems to monitor cybersecurity and privacy. You need end-to-end encryption and the ability to de-identify patient data. All of that is a tall order that hasn’t been fulfilled yet, despite all the promises. 

Provider opportunities with healthcare technology 

We see three key areas of opportunity for providers with healthcare technology: 

1. Increased automation to help providers spend less time on busy work and more time with patients. The right automation can help providers spend less time in front of the computer by automating routine or easy tasks. What if instead of trying to type and transcribe your notes during a patient visit, AI listens to the conversation and does it for you? What would that extra eye contact and human connection be worth to you and your patient? 

2. Improved diagnostics to enhance care delivery and make better decisions tailored to every individual patient. Instead of following a playbook for a certain disease, you can create a personalized treatment plan and communicate in the way that’s best for that individual patient, whether it’s a gentle nudge or more tough love. 

3. Advanced chips and data centers will lead to massive processing power. We’ll be able to put data to work in ways we never dreamed of to glean new insights and find the areas that make the biggest and most immediate impacts on population health across the nation. 

Patient challenges with healthcare technology 

One of the biggest challenges for patients with using advanced healthcare technology is access. The digital divide has left millions of Americans behind. They might not have smartphones or reliable Internet access, which leaves them boxed out of the healthcare-technology revolution. They can’t access telehealth or communicate with their providers as easily, let alone use AI to help answer their questions. 

Many patients lack trust in these technologies or are worried about privacy concerns. They don’t want to speak to a computer system; they’d rather speak to their doctor or nurse. They don’t want to be part of a faceless data farm. 

On the flip side, there’s a risk patients become too reliant on AI and skirt human interaction with their healthcare all together. They might have a false sense of confidence that, because they can see their health data, everything is fine when it isn’t. Smart watches, for example, can be a helpful tool, but without the right trigger points and interventions tied to patients’ data, they might not get the care they need. 

Patient opportunities with healthcare technology 

As with providers, we see three main areas of opportunity for patients with advanced healthcare technologies. 

1. Better treatment thanks to more accurate diagnosis and more integrated care teams enabled by technology. When patients have easy access to quality care and have their health providers—primary care provider, specialists, case managers, social workers—all working together, their health outcomes and well-being improve and costs go down. 

2. Enhanced engagement in their health and well-being. For too long, too many patients have had a passive relationship to their healthcare. With advanced healthcare technology, patients can take active roles in their own health and wellness, whether that's through increased remote monitoring, more telehealth access or 24/7 AI chatbots to direct patients to the appropriate level of care. 

3. Increased personalization will mean every patient gets their healthcare needs met their way, whether that’s very hands-on with frequent interactions or through sporadic reminders. Personalization will also make it possible to better consider a patient’s genes, their history, lifestyle and environment more than we do today to make the right interventions at the right time int he right place. 

How ilumed is adapting to advanced healthcare technology for the ACO REACH model 

At ilumed, we’ve used predictive analytics for several years and have developed our own proprietary ACO REACH provider software platform, BrainStream. BrainStream allows us to be more proactive at scale. Rather than perform sick care, which is today's healthcare norm, we can provide true healthcare by targeting the most at-risk patients. 

There aren’t enough hours in the day to call every one of our aligned ACO REACH patients, so we use BrainStream to determine which patient calls are going to make the most impact based on a patient’s claims data, disease progression and the probability of them experiencing an acute event. When we can intervene before an acute event, we have a better shot at reaching positive health outcomes. Here are some proof points: 

• Our patients who accepted care management saw their healthcare costs decrease by 33%. 

• We prevented $2.9 million in spending by proactively enrolling patients in long-term care management. 

While technology enables our team to work smarter in the ACO REACH model, the most important part of what we do cannot be replaced—making human connections. AI helps identify which patients to call, but it’s our people who bring their humanity to each patient to listen with a friendly ear and learn with compassion. This human-to-human connection is the most valuable part of healthcare. To understand what’s going on for a patient, you need to slow down and have an in-depth conversation. No machine is going to replace that. 

We’re also testing AI to help detect ACO REACH claims fraud. Medicare claims continues to be an ongoing problem. While the Centers for Medicare & Medicaid Services (CMS) announced that Accountable Care Organizations (ACOs) would not be impacted by the $2 billion urinary catheter fraud scandal unveiled in early 2024, ilumed understands the risk that fraud has on the ACO REACH model as well as our providers and patients. That’s why we’re examining claims data and training machine learning models to help us flag anomalies and identify trends before they snowball. 

We know that innovation is never done. We will continue to keep our fingers on the pulse of healthcare technology advancements when it comes to clinical, operational and financial aspects of the industry. We’ll continue to balance technological advancements with compassionate, patient-first care. We’ll continue to strive to be a best-in-class ACO REACH entity providers and patients can count on. 

Where the industry and ACO REACH goes from here 

It’s important to remember for all our advancements, we’re still in the first inning of the healthcare technology ballgame. The ninth inning is still a long way off.  

We can’t get where we want to go without testing and experimentation. It’s in the pilot phase that we figure out what we truly need rather than what we thought we needed. Sometimes, the first experiments fail, but often the second experiments succeed. 

Let’s heal healthcare together using advanced technology coupled with compassionate, value-based care. Work with us as an ACO REACH provider.