Identity sits at the heart of healthcare innovation. We now realize how outdated and expensive the traditional methods of validating identity are.

The first experiment we ran back in 2016 was focused on physician identity. After many iterations and failures, Professional Credentials Exchange was born. The superpower of ProCredEx is the ability to exchange primary source verified credentials.

Credentialing is an identity problem. Solving it is a gateway to redefining what “credentialing” really means. Using the exchange framework, we can explore opportunities to answer other questions. Why should “credentials” focus solely on education, employment history, and licensing status when there’s so much more we need to share and understand in the modern world. If we are freed from the shackles of “credentialing,” why not then move from simple identity to a more robust concept of “reputation” that is aligned with the modern, value-based world? Why not use the exchange to create additional value, improve access, and decrease the burden on physicians and administrators?

It’s not just physician identity where change is needed. In 2021, Hashed Health and our partners are interested in applying these same concepts to the identity and reputation of products, companies, patients, and other areas of healthcare and life sciences. Solving issues of identity is a gateway to a long tail of powerful opportunities.

How much can or should be done remotely? This time last year, telehealth was a “trend to watch.” Then the market tipped like nothing we’ve ever seen before.

"There are generations where nothing happens. There are decades where nothing happens. And there are weeks when decades happen. And that's exactly what we've gone through." – Roy Schoenberg, Amwell for Healthcare Dive

In 2021, telehealth will find some balance, resulting in the fusion of virtual care with traditional encounters. Some services (especially pediatrics, family medicine, psychiatry, and mental health) will likely see higher rates of virtual visits, while others may pivot back to majority in-person visits. Some clinical trials (especially oncology, infectious diseases, immunology, and women’s health) will likely become more decentralized, while others may remain traditional.

At Hashed Health we see great opportunity in the decentralization of health. Healthcare will continue to grow more borderless… expanding the geographical reach and scale of care teams and businesses. We will continue exploring the recontouring of buy-side and sell-side healthcare networks and how they transact. Payers will mature the reimbursement landscape for their services and will grow their use of telemedicine as providers of certain services and managers of certain processes. Life sciences companies will gravitate towards telehealth and telemonitoring in support of lower-cost virtual trials. HHS and the FDA will strengthen the health surveillance control tower through “at anywhere” reporting of lab and testing data.

“The remedy to the cost crisis does not require medical science breakthroughs or new governmental regulation. It simply requires a new way to accurately measure costs and compare them with outcomes.” Michael Porter, "The Big Idea: How to Solve the Cost Crisis in Healthcare" Harvard Business Review 2010 (that’s right… 11 years ago!)

For years we have heard Porter-inspired talk about value from the podium, but changing how people are paid and how costs are measured is difficult work. But now the slow pace of transformation may have reached a tipping point.

This year’s crisis has highlighted the need for providers and payers to work together to reduce systemic costs and stabilize reimbursement rates while maximizing outcomes and improving the patient experience. Those leaders who have been implementing value-based care were generally in a better position during the crisis because they were not married to a reimbursement model that requires in-person office visits and centralized care. The care management tools used by value-focused providers are more capable of delivering care to underserved populations who struggle for access in the fee for service world. Value-focused and risk-focused providers tend to be more proactive and preventative.

In 2021 everyone’s talking about the ability to take risk. The rewards are great if you have data you can trust and the tools to act on what that data is saying.

Supply chains have suffered from years of underinvestment and siloed processes. The supply chain seems somewhat ignored in healthcare’s leadership and entrepreneurial circles, even though supply chain spending represents around a third of the total operating expenses at US hospitals ($36 billion for medical and surgical supplies alone).

So it’s probably no surprise that the technology world did not seem ready in 2020 to relieve the pressure for supply chains in the same ways it has for telehealth and value-based health.

We expect 2021 to be different. It starts with data. A well-functioning supply chain depends on the exchange of tactical, strategic, and marketing information that enables intelligent planning, reduces administrative burden, and provides feedback on quality. As we re-emerge from this crisis, supply chain leaders and health system leaders will have to drive to do better and become more resilient. Let's hope that translates to the modernization of our supply chain infrastructure that promises a more resilient future.

The limitations of our analog, siloed health systems have been exposed by the crisis, which means digital health solutions will be hot in 2021, especially if they can leverage a modern tech stack that is optimized for interoperability and value. Digital health solutions were hot in 2020 ($14B invested across 440 deals according to Rock Health, up from $7.4B in 2019). In 2021, platforms that create a shared source of truth across an ecosystem will be critical to solving the hairy foundational problems that can’t be solved by any single company on its own. And we are increasingly recognizing that solving our cost and quality issues requires collaboration across networks.

Virtual healthcare requires technology that is optimized for virtual-first services, value-based payments, and patient-centered care. For virtual care to thrive, we must introduce new business models for supporting functions like provider identity (credentialing, directories), care coordination, and value-based payments. The use of sensors, remote monitoring tools, wearables, and other connected devices are enablers of an “always-on” triage system.

The majority of our health is a result of what happens in the real world outside the clinical setting. The combination of real-world data and traditional clinical and business data is a critical enabler for next-generation solutions. Innovative solutions (ex. Signal Stream) establish a chronological shared source of truth for business, clinical, and real-world data. This new data layer creates a development platform for a variety of clinically-integrated business workflows and programable financial solutions.

For value-based care and the ability to take risk, it’s all about the ability to acquire, share and trust a combination of clinical, business, and real-world data in as near real-time as possible. Real-time data combined with artificial intelligence and machine learning can improve consumer engagement, manage population health, improve drug development and facilitate pro-active patient engagement.

Distributed ledger technologies (and derivatives thereof) are a part of the stack that introduce trust and powers transparency. These new systems allow us to fuse the clinical data layer, the business data layer, and the banking layer into a new chronological, clinically integrated fintech rail that can free us from our addiction to poorly designed payment and incentivization structures.

Similarly in Supply Chain, we expect to see a focus on moving from systems of record to systems of collaboration.

Our $3T healthcare system needs smart innovations by entrepreneurs and enterprises now more than ever. The industry is changing before our eyes. 2021 represents an incredible opportunity to introduce modern digital technologies that fuse in-person health and telemedicine, introduce new healthcare fintech and revenue cycle solutions, decentralize clinical trials, and replace administrative burden with always-on multiparty business process automation. We live in a world where each month seems like a year of digital transformation and we expect 2021 will be a year when a decade’s worth of important new health tech companies are born.

Like many other trends, the trend of investors moving upstream to the inception of startups is accelerating. The rise of the Venture Studio model espoused by organizations such as GSSN, Enhance, and Hashed Health helps entrepreneurs and enterprises across the country and the world de-risk the startup process with a modern go-to-market approach. In a world where 80-90% of startups fail, the iterative approach of the studio brings resources to the beginning of the process so that critical issues related to team, fit, funding, business model, and timing are discovered early.

Figure 1- http://gan-7000682.hs-sites.com/disrupting-venture-landscape-white-paper

“Disruptive investment strategies and models are hard to come by and it is even more rare to be an early investor in an asset class or strategy before they’re overcrowded; if venture capital is an important part of your existing portfolio then venture studios deserve serious consideration. -Douglas Beyer, Radianx Capital, source Disrupting the Venture Landscape, Global Startup Studio Network