7 health predictions for 2014

Whether we're talking about treatment breakthroughs, medical research, or changes in healthcare policy, it's clear that 2013 was a big year for health news.

So what's coming in 2014? Here are seven predictions from experts across the healthcare spectrum.

1. Continuing Confusion About ObamaCare
Even by the eve of 2015, the dust will still not have settled on who has what kind of coverage under the Affordable Care Act (ACA).

Dr. Mark Smith, president and CEO of the California Healthcare Foundation, polled his colleagues on the issue of ACA's first year.

“Newly insured consumers won’t really know what they’re getting—or what they’re paying, when you factor in out-of-pocket costs, tax credits, and tax reconciliation—until they’ve been enrolled for a year or more and begin to seek and use care,” he told Healthline.

“As with recent events regarding obtaining and keeping coverage, we’ll see stories of great benefit and others of significant hardship," he added. "In a year, it may still be tough to know if collectively we are better off.”

2. Broader Acceptance of Medical Marijuana
Illinois will ring in the new year by establishing a pilot program legalizing marijuana for medicinal use, becoming the 22nd state to make cannabis legal in some form. Dustin Sulak, an osteopath who prescribes medical marijuana in Maine, expects to see the nation continue to embrace the plant for its health benefits.

“Cannabis awareness reaches a tipping point, growing exponentially as the medicine of choice for common medical conditions such as cancer, pain, and anxiety,” he said.

He predicts that more people, including children and the elderly, will openly share success stories, while pharmaceutical companies launch their own cannabis products.

More cities and states will legalize cannabis, while the federal government continues to prohibit it, he predicts. At the same time, more Americans will have access to substance abuse treatment under a provision in the Affordable Care Act.

Read More: 4 Illegal Drugs That Might Be Medicines

3. Better Artificial Body Parts, Thanks to 3D Printing
Dr. Tom Vangsness, author of The New Science of Overcoming Arthritis, told Healthline that new three-dimensional printers will advance the creation of material that mimics human cartilage. He believes that 2014 will bring more innovative new research for the treatment of arthritis, including stem cell and gene therapies and miniature devices that use nanotechnology implanted beneath the skin to stimulate muscles.

Dr. Laura Niklason, a professor of anesthesia and biomedical engineering at Yale University, is a global leader in cellular therapies and bioengineered blood vessels. She founded Humacyte, Inc., which is pursuing the development of vessels grown from human cells on scaffolding. Their aim is to provide arteries that can be taken off the shelf in a hospital and implanted into people when needed. This year, the company will see the results of its first in-human clinical study.

And earlier this month, Dr. Kristjan Ragnarsson of Mount Sinai Hospital in New York City unveiled a bionic body suit that allows a patient paralyzed from the waist down to walk.

See Healthline's Picks for Top Innovations of 2013

4. More Doctor Visits Replaced by Technology
Chip Burns, president of The Asbury Group Integrated Technology, said remote monitoring of everything from blood sugar to sleep will continue to revolutionize medicine. Digital avatars will be at the ready on a smart phone when a patient can't see a doctor.

Almost all of a person's health information will be available and exchanged online. In his recently released white paper “The Guide to the Future of Medicine: 40 Trends Shaping the Future,” Dr. Bertalan Meskó issues a call for preparedness in this new age.

While it will be convenient for many, some patients raise questions about how those without smartphones or Internet access at home will fare.

Amy Gonzales, an assistant professor of telecommunications at Indiana University, is researching that issue.

“My concern is that people without stable digital access are going to increasingly fall through the eHealth cracks," she said. "This is especially a problem since the same people without stable digital access are also the most likely to be sick and need access to healthcare.”

Read More: Getting Care Anywhere via Virtual House Calls

5. HIV Moving Closer to Extinction
There won't likely be a cure for HIV next year, but antiretroviral therapy, or ART, drugs will become even easier to tolerate as the globe inches toward a vaccine.

Joel Gallant, chair of the HIV Medicine Association, said, “Implementation, affordability, and uptake (of ART) remain the greatest challenges to biomedical prevention.”

As for the tens of thousands of people in the U.S. with HIV who don't even know it, Gallant hopes the implementation of the ACA will get more people tested and treated. “Only then will the concept of 'treatment as prevention' start to have a real impact on our epidemic,” he said.

HIV Progress Report: Are We Close to a Cure?

6. The Continued Rise of Personalized Medicine
Patients with chronic conditions like multiple sclerosis will benefit most from treatment regimes tailored to them.

“One of the matters that will need urgent attention in 2014 is the identification of biomarkers to help select the optimal drug to prescribe, with nine approved alternatives, for treatment of relapsing-remitting MS,” said Lawrence Steinman, a neurology professor at the Beckman Center for Molecular Medicine at Stanford University.

As the need for new research grows, the public sector will play a growing role in funding and arranging healthcare, as a debate rages at all levels of government over who should pay for what.

“Look for a few cases, maybe coming from cash-strapped local government entities, where new ground is broken in addressing underlying cost drivers and more clearly defining ... responsibilities,” Smith said.

7. More People Choosing Healthy Habits
The American Medical Association classified obesity as a disease just this year, and the ACA requires most insurers to provide for obesity prevention programs. Add that to mounting evidence about the benefits of vegan diets, and the result will be finding sensible solutions to a deadly problem that often stems from a poor diet.

Nutrition based on genetic testing and the influence of gut bacteria on obesity will get plenty of attention, predicted Lise Gloede, a registered dietitian and certified diabetes instructing in Arlington, Va.

“Hopefully fad diets will take a back seat, but that never seems to happen,” she said.

And the importance of washing one's hands will move to the forefront in healthcare settings as well. With healthcare-acquired infections on the rise, hospitals and medical professionals are scrambling for sanitation satisfaction.

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