More than 34,000 health IT enthusiasts converged on New Orleans last week to attend the 2013 HIMSS Conference & Exhibition. As anticipated, the event provided a stage for several industry announcements, technology developments, and educational sessions. The Health IT Outcomes team was there in full force, and the following are my top takeaways from the show.
As expected, interoperability was a focal point of HIMSS13. Perhaps the event’s biggest announcement — the launch of the CommonWell Health Alliance — centered on this crucial topic. Cerner and McKesson publicized plans to make a historic announcement at HIMSS a few weeks prior to the event, and health IT pundits immediately began to speculate that the news would involve interoperability between the two vendor platforms. However, the announcement turned out to be much bigger than initially anticipated — with Allscripts, Athenahealth, RelayHealth, and Greenway Medical Technologies also included in the news.
According to the release, these six vendors will form an independent, not-for-profit organization (CommonWell) in a collaborative effort to achieve data liquidity between systems, in compliance with patient authorizations. The Alliance will define, promote, and certify a national infrastructure with common platforms and policies. It also will ensure that health IT products displaying the Alliance seal are certified to work on the national infrastructure.
The fact that six giants in the EHR space joined together in an effort to further interoperability in a highly fragmented market was big news in and of itself. However, the apparent snub of Epic (an EHR market leader) generated almost as much attention. Leaders of CommonWell made it clear that all EHR vendors have an open invitation to join the Alliance, but Epic’s CEO Judy Faulkner told Bloomberg that her company has not, to date, been asked to participate. Moreover, Faulkner believes the collaboration to be more of an attempt to develop a “competitive weapon” that these organizations can use against Epic rather than a true attempt to achieve universal interoperability.
Interoperability wasn’t just a topic of conversation for exhibiting vendors at HIMSS, it also resonated with many of the providers in attendance. For example, I sat down with Dr. Rasu B. Shrestha, VP of Medical Information Technology at UPMC, at HIMSS where he shared his system’s approach to interoperability with me.
“At UPMC, we have taken a best-of-breed approach to health information system management — or what I like to call ‘controlled chaos,’” says Shrestha. “We have approximately 45 clinical systems in play at UPMC and we work to harmonize the data stored in all of these systems into one common language using tools from dbMotion. We like to think of it as creating a ‘Rosetta Stone’ of health data.”
Shrestha says this common language is instrumental at interconnecting UPMC’s internal systems, but he also stresses the importance of ClinicalConnect — Western Pennsylvania’s public HIE — to make it’s patient data accessible to providers outside of the UPMC network. Shrestha also states that the biggest roadblock to true health data interoperability isn’t a lack of standardization, but the fact that there are too many standards with no harmonization.
“As a result, vendors have a tendency to simply ‘pay homage’ to standards, rather than truly embracing them,” he says. Time will tell if the CommonWell movement helps to change this pattern.
The “must attend” event at HIMSS13 was unquestionably President Bill Clinton’s keynote on Wednesday afternoon. I got to Great Hall A 30-minutes before the former President was scheduled to take the stage, and every seat in the auditorium was already full. I managed to secure a “standing room only” spot inside the Great Hall, while hundreds of other attendees were forced to watch Clinton’s speech from closed-circuit television monitors located outside the auditorium.
Given his reputation as a polished orator and his undeniable passion for U.S. healthcare reform, I was prepared for a rousing keynote from President Clinton. However, (and I’m sure I’m in the decided minority here considering the coverage I’ve already read) I was left underwhelmed by the former President’s speech. I was expecting a targeted lecture outlining the problems currently facing healthcare in the U.S. and clear directives the health IT community could take to improve the system. Instead, I felt the President delivered a vanilla, almost canned, speech more focused on highlighting his accomplishments and preserving his legacy (both politically and with The Clinton Foundation) than on rallying health IT leaders to fix the healthcare problems at hand.
That’s not to say Clinton’s speech didn’t have its moments. For me, the high point of the President’s keynote came when he discussed the need for healthcare price transparency, arguing there is currently no correlation between what people pay and the quality of healthcare they receive. He stressed the importance of health IT in this effort, saying technology would not only be instrumental in cutting costs, but also in empowering patients.
“The whole premise of IT is to manage data, so we know what the heck is going on," Clinton said. “Think about the role of IT to empower people to take a bigger role in healthcare, in being healthy, and [in] simply understanding the system."
While interoperability was clearly a focus of vendors and the HIMSS event staff, I believe most health providers at the show were more interested in how IT could help them better manage risk and improve performance-based outcomes. This year’s event was the first HIMSS where the Affordable Care Act (ACA) is now being looked at by providers as a foregone conclusion. Providers are now accepting the fact that reimbursement models will change from a fee-for-service to a shared-risk model based on patient outcomes. According to industry estimates, providers will need to cut their expenses by 10% to 20% in order to survive under these new models of Medicare reimbursement. As a result, there is now a rush among providers to enhance current IT systems and install new tools to help them maximize reimbursement in this new landscape.
David D. Adams, senior VP and Chief Strategy Officer at Centra Health, stressed the influence this shift in healthcare is having on Centra’s IT strategy at a McKesson media breakfast at HIMSS. “Over the next 5 to 10 years, our focus is on looking for ways to manage premium risk better,” says Adams. “From an IT perspective, this means building an infrastructure geared toward measuring performance, optimizing reimbursement, and facilitating payment distribution.”
Interoperability will be a central component in enabling optimized reimbursement, but providers were also very interested in the role big data, population health management, and performance analytics technologies will play in this effort. These tools are considered to be cornerstones of a sound risk management infrastructure.
“You can’t manage risk without data,” says Philip M. Oravetz, Medical Director of Accountable Care at Ochsner Health System. “Robust data warehouses are crucial to a risk management initiative. Today, we are awash in data at Ochsner, but we need effective analytics to extract actionable information out of that data.”
HIMSS13 clearly illustrated that the healthcare is finally becoming a highly mobile industry. This mobilization trend brings with it a great deal of promise for clinicians and patients, but also a fair share of security headaches for health IT professionals. Mobile innovations were on display at every level at HIMSS — from enhancements to traditional mobile cart solutions to the latest in remote monitoring technology.
For example, Rubbermaid Medical Solutions announced a new mobile nurse workstation, called CareLink, at HIMSS. The workstation includes an integrated 7-inch touchscreen complete with intelligent software that provides users with advanced messaging capabilities and other interactive tools to streamline care delivery and reduce workflow distractions.
Controlling the proliferation of consumer-grade devices into healthcare was also a key focus among vendors and providers alike. BYOD (Bring Your Own Device) solutions and advice were highly sought after at HIMSS as providers aim to address employee demands while keeping corporate assets and patient data safe. IT professionals seem to keep searching for a “magic bullet” technology that will solve all of their BYOD-related challenges, but the sad truth is it doesn’t exist. Instead, providers must secure their BYOD environments using a combination of technologies — including virtualization, encryption, and MDM (mobile device management) tools — that work best for them.
Finally, the next wave of healthcare mobility is allowing providers to assess patient needs outside of the medical office or hospital via remote monitoring devices. For example, AT&T launched a new remote monitoring solution called mPERS (Mobile Personal Emergency Response System) at HIMSS13. This device, geared toward the elderly and disabled, plans to use Machine-to-Machine (M2M) connectivity to link people in distress virtually anywhere, at any time to a professionally staffed monitoring center. Unlike current monitoring systems, which are often confined to a person’s home and require the individual in distress to manually press a button for assistance, the mPERS solution intends to overcome these limitations by automatically triggering a notification to the monitoring center via sensor technology if a user suffers a fall or other mishap.
Like no other conference I’ve attended before, the power of social media was on full display at HIMSS13. The platform of choice was undoubtedly Twitter, likely due to its ability to deliver key pieces of information in 140 characters or less from multiple sources in real-time. From 3/3 through 3/7 (the dates HIMSS was held), nearly 7,000 individuals sent 38,974 tweets using the #HIMSS13 hash tag, generating more than 66 million impressions. As usual, given the size and scope of the show, I was only able to take in a small fraction of what HIMSS13 had to offer. However, through my Twitter stream, I felt I was informed on just about every aspect of HIMSS. I follow hundreds of people on Twitter that attended the event, and if I was interviewing a provider in the press room, it seemed like a dozen folks in my Twitter stream were chiming in about what was going on in an educational session, the exhibit hall, or the Interoperability Pavilion.
While social media was an influential information resource at HIMSS, it was clear that most health providers are still stumped on how to better leverage this networking tool to benefit their organizations and their patients. If providers could learn how to use this medium (safely and securely), then it could prove invaluable in enabling better communication and patient outreach.