4 CMO Predictions for Healthcare in 2024

Physician leaders will need to respond quickly to opportunities and challenges this year.

In 2024, healthcare will be buffeted by a wave of change, a pair of chief medical officers says.

Healthcare organizations are facing a slew of challenges. Those challenges include workforce shortages that are straining the ranks of physicians and nurses and economic woes that threaten the operations of health systems, hospitals, and physician practices.

1. Recovery and restructuring

For healthcare in general, 2024 will be a year of recovery and rapid restructuring, says Donald Yealy, MD, chief medical officer, senior vice president of the health services division, and chair of emergency medicine at University of Pittsburgh Medical Center (UPMC).

"We have a need to refill and restructure the workforce," he says. "We have a constellation of factors that is making the delivery of healthcare a bigger challenge in the middle of a terrible financial environment. It's not like change never had to happen before, but the timing of change in 2024 needs to be much quicker."

The need for recovery and restructuring is related to the recent threats linked to the coronavirus pandemic, workforce issues, and financial stressors, Yealy says.

"Recovery and restructuring are necessary because continuing to deliver care the same way we have over the past three decades is not the solution to our problems," he says. "The healthcare providers who figure out how to give patients what they need in the manner that they need it as efficiently and effectively as possible will be the ones who dominate healthcare moving forward. We don't have a decade to figure this out. That is why 2024 is a key year for recovery and restructuring efforts."

Restructuring is needed at all levels of healthcare, Yealy says.

"At the individual level, it is a matter of who delivers particular kinds of care and how they deliver it," he says. "The traditional model has had highly trained people doing most of the tasks, such as physicians and nurses. We still need to have a workforce that depends on the primacy of physicians, nurses, pharmacists, and other experts, but we cannot depend solely on them. We need to involve more people and different tools. Artificial intelligence is not going to replace the interaction between a patient who needs care and a physician and a nurse, but it can augment that interaction."

"At the institutional level, whether you are talking about a single hospital or a collection of hospitals in a health system, we are going to have to exist differently to make sure we can respond to patient needs as they change," Yealy says. "A hospital or clinic cannot provide everything to everybody, so we are going to have to restructure the way healthcare is delivered. Over the past 100 years, restructuring in healthcare has occurred at a gradual pace. Now, it is going to happen much more quickly."

Highly trained professionals will remain the backbone of healthcare delivery, but other healthcare workers, including professionals with new titles that have not been utilized in the past, will come to the forefront in 2024, he says. There will be a redeployment of highly skilled healthcare workers as well as a reliance on healthcare workers who can help conduct tasks that do not require highly skilled individuals.

"For example, when a patient comes back for a repeat visit after a care episode or a procedure, an advanced practice provider or a patient care technician could initially assess the patient and gather all the basic information," Yealy says. "Then a physician could focus on the follow-up or the new needs of the patient."

In 2024, healthcare organizations will face a "rocky path," he says.

"Many healthcare providers are not going to be able to adapt quickly enough," Yealy says. "There is going to be an inability to execute on ideas. For many years, you could have a leisurely pace of change in healthcare and do quite well. In 2024, we are going to need to be quicker in responding to opportunities. Some individual providers, hospitals, and health systems are likely to fail."

2. Increased reliance on technology

In 2024, healthcare providers will move more aggressively to adopt and expand technology, says Nathaen Weitzel, MD, associate chief medical officer at University of Colorado Health (UC Health).

"In the perioperative space, there will be a reliance on an improved use of technology such as predictive analytics and AI to refine how we approach the operating room schedule," he says. "We need to optimize our schedules so that we are maximizing the time we have for nursing and anesthesia providers. Technology offers the opportunity to help us balance our resources as appropriately and ideally as we possibly can."

Over the past few years there has been a move toward increased use of robotics in surgery, and that trend will accelerate this year, Weitzel says.

"As we are getting more experience with robotics, we are seeing that patient outcomes are improving and patient length of stay is decreasing," he says. "So, in 2024, we will see more health systems and hospitals increasing the appropriate use of robotics in surgery."

3. More surgeries with patients going home the same day

UC Health is focusing on patient care pathways to select patients who are appropriate for same-day surgery, an option that the organization might not have considered before, Weitzel says.

"We are doing a lot of same-day joint replacements and same-day bariatric surgery," he says. "In 2024, we will be practicing a balancing act, where we will be looking for patients who can safely be taken care of with good outcomes and going home the same day as surgery. They can recover in the comfort of their own home, which frees up bed space for patients who are sicker and having more complex surgeries."

4. Seizing on opportunities to increase efficiency

Driven by workforce shortages, healthcare organizations will be seeking ways to increase efficiency this year, Weitzel says.

"In 2024, we should see an improvement in efficiency to help address the workforce challenge," he says. "In the perioperative space, we have been seeing 10-hour days being stretched into 12-hour days. That extra two hours per day adds up over time, and people start to get exhausted when they are asked to work extra hours. In 2024, we will be looking at the way cases are scheduled, and the way patients are handled. AI has the potential to improve efficiency in the scheduling of surgery and making it work with our level of staffing."

Improving efficiency is the short-term solution to the workforce challenges, Weitzel says, adding healthcare providers cannot significantly increase the number of physicians and nurses in one year.

"There are opportunities to improve efficiency from top to bottom in the patient stay," he says. "You must combine your operating room schedule with your bed capacity. You need to optimize where patients are going after surgery. You need to improve how the post-operative stay is choreographed."

"You need to analyze what type of floor patients are on after surgery and what type of expertise you need on those floors," Weitzel continues. "For example, you do not want to have a hip replacement patient on the same floor as oncology patients who have had complex surgeries for cancer. Those recoveries are different."

Efficiency can be improved throughout surgical episodes of care, Weitzel says.

"You need to streamline patient care, so that patients from the pre-operative phase to the operative phase to the post-operative phase are scheduled appropriately at each stage," he says. "You can cut out inefficiencies, look at the milestones for each day of care, and eliminate gaps in care."