Top 10 trends to watch in the health care world, and the fastest-growing areas of medicine

1. Heart and cancer care

"We have more cardiologists than we've ever had on staff at the hospital," says Tiffany Jenkins, marketing director at Poplar Bluff Regional Medical Center. "The baby boomers are getting older, and we don't have the healthiest people in our area or region, so we're going to see those trends continue with heart attacks and heart disease."

Steven C. Bjelich, president and CEO of Saint Francis Medical Center, notes that cardiovascular disease and cancer are the No. 1 and No. 2 causes of death in America, for both men and women. Saint Francis will target treatment for these diseases with its Heart Hospital and Cancer Institute, scheduled to open in July 2011.

2. Geriatrics and orthopedics

Because of advances in orthopedic technology, Jason Schrumpf, president of Missouri Delta Medical Center in Sikeston, Mo., says artificial joints last longer and patients are having them put in at an earlier age. "They used to replace joints at around age 65 to 70. Now they are doing it in their early 50s. These advances also mean there are fewer complications associated with joint replacements," says Schrumpf. "People don't want to be in chronic pain, so they are more willing to have these procedures at a younger age so they can return to a more active lifestyle."

Missouri Delta Medical Center has hired a gerontologist, is expanding its primary care physician base and will open a new orthopedic center -- with two orthopedic surgeons -- in summer 2011.

3. Outpatient procedures

"Another thing we've seen growing is outpatient procedures," says Jenkins. Patients are looking for minimally-invasive procedures with faster recovery time, and sinusitis surgeries are among the most sought-after. "Sinusitis is something a lot of people suffer from, but there has not been a good treatment option that people don't see as severely painful or with a longer recovery," says Jenkins. "We have options now to make it a lot easier and with faster recovery."

4. Rising number of patients seeking care

"A lot folks have put off necessary medical care, and what we have seen is that overall volumes have been going back up in last six months or so," says Greg Hudson, vice president of strategic planning and marketing for SoutheastHEALTH. "The economy will come back -- it always does -- and as the economy improves, the more people will feel positive about it ... and will utilize more health care services."

Hudson expects a "huge influx" of patients from the aging baby boomer population, especially in the areas of cardiology, neurosciences and orthopedics.

Bjelich also notes the imminent rise in baby boomer patients -- 76 million baby boomers will turn 65 in 2011, placing a "significant strain on the health care system," he says. As health care becomes more accessible and convenient (see No. 5 and No. 7), Bjelich expects medical providers to see an even greater patient volume, driving the need for more physicians to care for those patients.

5. Convenient care

To address the growing need for nonemergency room care after regular business hours, Missouri Southern Healthcare recently opened "The Clinic at Wal-Mart," says Amy Ellinghouse, director of marketing for the hospital. The clinic, located in the Dexter, Mo., Wal-Mart store, is open Monday through Saturday from 10 a.m. to 10 p.m. and Sundays from noon to 6 p.m. "We are hoping that by offering the extended-hours walk-in clinic, more people will be able to utilize this option, rather than expensive emergency department care," says Ellinghouse.

Meanwhile, Doctors Express immediate care clinic opened in Cape Girardeau in July, and Southeast Hospital and Saint Francis Medical Center each have walk-in clinics adjacent to their emergency departments. Saint Francis also operates the Immediate Convenient Care clinic on North Kingshighway in Cape Girardeau.

6. Focus on wellness and disease prevention

"Improving the health of Americans represents a major challenge," says Bjelich. "By some estimates, nearly half of our total national health expenditures are spent on treating heart disease, cancer, diabetes (three of the top five leading causes of death in the U.S.) and poor lifestyle choices, such as smoking, sedentary behavior and overeating." Many employers, including Saint Francis, are working to reduce employee illnesses -- and health care costs -- through preventive care programs and employee education, he says.

"Patient education and disease management are taking center stage as insurers look to bend the cost curve," adds Schrumpf. Missouri Delta Medical Center is addressing preventive health by expanding its primary care physician base and offering health education programs to employees and the community.

7. Payment reform and patient safety

Hudson says the federal government is now reviewing the concept of "bundled payments" between hospitals and physicians, and allowing health care providers to form accountable care organizations. He also sees a movement toward more patient safety through integrating information technology, such as electronic medical records.

"The federal government and the private payers are looking for ways to work with health care providers to provide safer and higher quality care within a reasonable cost to the country and the employers," Hudson explains. "Another key driver is the aging of the baby boomers. As we age, we require many more health care services than we did when we were young. With the millions of citizens turing 65 in the coming decade, the health care industry has to become better stewards of our economy's resources."

Schrumpf sees change in these areas as well, for both patients and health care providers.

"Consumers will increasingly have greater access to data that will allow them to shop for their health care based on quality and price," he says. "Health care providers will be challenged to manage patients in a cost-effective manner due to reclining reimbursements."

8. Medical technology

Hudson and Bjelich agree that medical technology is an ever-expanding area of modern health care.

"New and emerging technologies have changed patterns of care and sites where care is provided," says Bjelich. "Improvements in anesthesia and the development of minimally invasive procedures have improved recovery times from a few weeks to a few days. This trend is likely to continue."

9. Growing demand for nurses

"Nursing in general is one of the greatest areas of need. They're predicting huge shortages by 2020," says Dr. Marcia Hobbs, chair of the Department of Nursing at Southeast Missouri State University. Because the average age of a nurse is 47, there will be a huge need for nurses to replace them as they retire. One of the greatest shortage areas is in faculty to train new nurses, says Hobbs. And while her nursing students at Southeast are interested in health care areas across the board, Hobbs identifies two areas in particular need of nurses.

"Psychiatric mental health is a shortage area. I think new graduates aren't typically as attracted to that because they're not adrenaline-type practicing areas," says Hobbs. "Another shortage area is in gerontology. We all know the population is getting older. With younger, newer nurses, gerontology doesn't have as much attraction as emergency or intensive care."

10. Health care systems

Hudson sees a trend toward hospitals consolidating or partnering with other health care institutions: "The expense of providing the most up-to-date information technology; recruitment and possible employment of physicians; the ongoing needs for capital improvements in our existing facilities; and keeping up-to-date on clinical technology is leading hospitals to become health care systems."

In November, Southeast partnered with Ripley County Memorial Hospital to become a two-hospital health care system, says Hudson, and Southeast will continue to work with hospitals throughout Southeast Missouri, Southern Illinois, northwest Kentucky and Tennessee and northeast Arkansas. Saint Francis also partners with local physicians, and some physician partners visit with referring physicians as far as 100 miles away from the medical center, says Bjelich.