The Quest For Evidence At HIMSS14

By Ken Congdon

“Evidence needs to drive change and progress in healthcare — not ideology or beliefs.”

This was the rallying cry issued by former First Lady, Secretary Of State, and Senator Hillary Rodham Clinton during her powerful keynote address at the HIMSS14 Annual Conference and Exhibition last week — and her message captured the spirit of this year’s event perfectly. More than 38,000 people packed Orlando’s Orange County Convention Center in search of the latest health IT education and technology. Many of these attendees were leading minds at provider organizations seeking ways to aggregate, analyze, and act upon the electronic health data they’ve been collecting over the past several years. Not coincidentally, many of the 1,233 vendors exhibiting at HIMSS14 showcased solutions that promised to help providers do precisely that.

Interoperability, business intelligence, data analytics, and population health management were among the hot topics at HIMSS14 and there are countless reasons why. However, perhaps the biggest driver is the move toward value-based reimbursement. Providers are finally accepting the fact that the fee-for-service model is as good as dead, and the future financial success of their facilities will be directly tied to their ability to achieve, maintain, and report positive patient outcomes. Doing this effectively requires accurate and actionable data.

“Data is critical to maximizing value-based reimbursement, but it can be overwhelming,” said Dr. Christopher Stanley, VP of Care Management at Catholic Health Initiatives during a value-based reimbursement panel discussion hosted by McKesson. “The challenge is turning that data into information and knowledge that can drive performance and improve care.”

For many, technology will be essential in helping providers make sense (and revenue) out of the massive data stores they have accumulated. The key is to ensure every IT investment enhances the overall efficiency and transparency of data-driven processes.

“Providers need to be more pragmatic in an era of value-based reimbursement,” says Larry Yuhasz, Director of Strategy and Business Development at Truven Health Analytics. “Every IT investment they make must have an ROI roadmap. Revenue will be driven by meeting key patient outcome criteria and through effective care coordination. Business intelligence tools can give providers the visibility to know if they are on the right track.”

The demand for actionable data is so overwhelming it’s actually impacting health providers at an organizational level. “I think the role of the hospital CIO is changing in light of this new breed of data,” says Gene Thomas, VP and CIO of Memorial Hospital in Gulfport, MS. “My job used to be very network and systems focused. Now, I’m charged with providing clinicians with the best information to improve outcomes.”

Terry Boch, SVP of Sales and Marketing at Wellcentive also sees the transformative effect data demands are having on healthcare providers. “We’ve seen an accelerated rate of buying behavior around population health management solutions,” she says. “And the buyers aren’t just CIOs or CMIOs anymore. Many provider organizations are creating new job titles and departments that are dedicated to maximizing data visibility and value. For example, CHRISTUS Health now has a SVP of Population Health Management on its staff.”

HIMSS14 even provided a glimpse of what the future may hold as providers move down the path of evidence-based medicine. The conference provided attendees with the opportunity to tour nearby Nemours Children’s Hospital, part of Lake Nona Medical City — a 600-acre cluster dedicated to biomedical science and research. The hospital opened its doors in October 2012 and was built from the ground-up to be a “hospital of tomorrow,” meaning it incorporates an evidence-based design focused on improving outcomes. Nemours is one of the few HIMSS Analytics Stage 7 Hospitals in the country and features a robust fiber optic network as its technology backbone, a centralized Epic EHR, a patient portal, and a Clinical Logistics Command Center (CLCC). The CLCC provides Nemours employees with real-time visibility into patient conditions by aggregating and displaying data from a variety of sources including patient bedside monitors, the EHR, and mobile alert systems.

The fiber network that provides the communications foundation for Nemours also extends into the residential communities at Lake Nona, providing physicians who live in the development with lossless access to health data (including medical images) from home. Furthermore, fiber-wired homes provide a seamless way for Lake Nona residents to transmit personal wellness data (e.g. weight, blood-pressure, glucose levels captured from remote monitoring devices) back to Nemours.

OTHER HIMSS14 OBSERVATIONS

• Patient engagement was another hot buzzword at HIMSS14. Countless vendors on the exhibit floor marketed themselves as patient engagement experts. However, it was difficult to distinguish the valuable solutions from the noise. The market seems ripe with mixed messages, confusing positioning, and suspect offerings. Furthermore, true examples of “patient engagement in action” were scarce from what I could see at HIMSS14.  Once again, it seems like many vendors are trying to capitalize on the desire of health providers to “check the Meaningful Use box.” Providers need to carefully map out their patient engagement strategy prior to evaluating solution providers to ensure they select a partner that can help them achieve their ultimate goals as opposed to investing in useless technology.
   
• HIMSS14 proved that the healthcare industry is becoming increasingly mobile. Paul McRae, Director of Business Development at Airwatch, put it best when he said, “There is no way to avoid the mobilization of the clinician.” It’s true — clinicians are demanding mobile technology (e.g. tablets, smartphones, etc.) to access and input patient data at the point of care or while on the go. For them, it all comes down to convenience and productivity. However, for IT, proper mobile security is the priority. HIMSS14 featured solutions that could satisfy both ends of this equation. The mobile trend didn’t just focus on mobilizing the clinician within the four walls of a facility. It extended to include concepts, strategies, and technologies that fundamentally change the patient encounter — essentially moving it outside the hospital or doctor’s office. Telemedicine and remote patient monitoring technologies and use cases were prevalent at the conference.
   
• The mobility trend is actually one way to address a larger issue that was tackled at HIMSS14 — the erosion of clinical workflows. The EHR movement has placed an increasing documentation burden on clinicians and, in many instances, has altered the way physicians interact with patients. Moreover, much of the EHR technology on the market was not designed with preservation of clinical workflows in mind. All too often, this combination has resulted in decreased productivity and unhappy doctors. Beyond mobile solutions, HIMSS14 featured template and voice-driven technologies focused on allowing clinicians to get their noses out of a computer and back to what they actually went to medical school for — treating patients. According to Thomas Pacek, VP and CIO of Inspira Health Network, “80% of a clinician’s work should be focused on tasks that require a medical license to complete. Everything else should be a function of other staff or technology.”
   
• HIMSS14 was a hotbed of social media activity. There were several official and unofficial social media meet-ups and “tweetups” at the event including the #HITsm community tweetup, The Walking Gallery tweetup, and the New Media Meetup. Also, for the first time this year, HIMSS selected 13 individuals to serve as Social Media Ambassadors for the event. These folks were chosen based on their health IT expertise and their prolific use of social media as a tool to communicate and educate. Social Media Ambassadors were provided with a free registration to the conference in exchange for chronicling their HIMSS14 experiences and learnings using the #HIMSS14 hashtag via their chosen social media channels. Their involvement had a definite impact on the social media buzz surrounding the conference. From February 23-27 (the five main days of the conference) more than 75,000 tweets were sent containing the #HIMSS14 hashtag and several Social Media Ambassadors (@MandiBPro, @wareFLO, @ahier, @Brad_Justus) were among the most prolific tweeters.
   
• The HIMSS14 audience proved to be champions of the wellness initiative in healthcare. I was amazed how many attendees were tracking their steps taken and calories burned with wearable activity monitors. Exhibiting vendors got into the act too, awarding fitness trackers such as Fitbits and Pebble watches as prizes at their booths. Much of this activity was undoubtedly spurred by the HIMSS14 Wellness Challenge that awarded prizes to registered contestants that logged the most steps. However, a large portion of the HIMSS crowd made a concerted effort to stay fit on their own accord. For example, a group of health IT social media regulars organized an unofficial HIMSS 5K run while in Orlando. Participants gathered at 5 AM on Monday morning (2/24) to run a course they mapped out prior to arrival.