More than 40,000 people attended HIMSS in Orlando, Fla., the week of Feb. 20. The single dominant theme may have very well been the fact that there wasn't one.
We asked several attendees and vendors this question: What issues did you expect or see receive more attention at HIMSS17 compared to last year? Here's what we heard. (Responses are lightly edited for length and clarity.)
John Kravitz, CIO and Interim Chief Data Officer, Geisinger Health System (Danville, Pa.).: "I think population health involving advanced analytics has increased over the last year. Also, the interoperability of diverse platforms to support the analytic process to support the population health initiatives. Genomics is becoming a hot topic this year as well, especially as genome sequencing is beginning to identify risks to patients that save their lives. The integration of genomics into the provider workflow as this information becomes available is an item that a lot of providers are wrestling to accomplish successfully."
Suzanne Travis, Vice President of Regulatory Strategy at McKesson Technology Solutions (Alpharetta, Ga.): "I think cybersecurity will still receive a lot of attention. It did last year and is still top of mind this year. I also do think the shift from volume to value and value-based care and wondering what pace of change is going to be under the new administration — that will probably be a focus as well."
Dan Michelson, CEO of Strata Decision Technology (Chicago): "We're seeing huge need for clinical and financial data together. There is enormous attention around cost accounting right now, and there is a huge trend around financial planning as well. Look at either long-range planning or budgeting not on an annual basis but on a continuous basis. The impact on your financials is not an annual thing anymore."
Bill Miller, CEO of OptumInsight (Eden Prairie, Minn.): "The policy pendulum and where it might end up is on everybody's mind. I think most of us — in a very pleasant way, at least my own anecdotal evidence — are steaming right ahead and working on reducing costs, improving quality and fundamentally improving the patient experience regardless of the administration."
Vince Panozzo, Head of Enterprise Health Solutions for Outcome Health (Chicago): "Population plus personalization — meeting population health objectives while also providing a personalized experience for the patient. The other thing I've really noticed is more focus on the caregiver than there has been in the past. Caregivers have been so impacted by large-scale IT rollouts that they feel drained by that. There is now refocus on how we can improve caregiver experience so they have more time with patients, better patient experience and aren't burned out."
Neal Singh, CEO of Caradigm (Seattle): "A lot of customers are coming to us and talking about MACRA and bundled payments. It's interesting because the way some customers have put it as, 'I don't know where to start.' This is not only about technology, but about the education that goes with it as well."
Paul Black, CEO of Allscripts (Chicago). "I expected and saw the spotlight on the transformation of Big Data into more meaningful, usable analytics. For the past few years, we have experienced an increasing focus on the use of devices and assistants, and this year we saw real advances with the use of bots, algorithms, devices and virtual assistants. Plus, tools to operationalize both value-based care and payments; and to improve patient engagement and experience are now in the mainstream.
Additionally, not enough people in the industry are talking about the gap that exists between genomic data and clinical systems/EHRs. Precision medicine can empower providers to apply genomic insights within their clinical workflow to save lives, improve outcomes and reduce costs. The technology and know-how are available today to put the power of precision medicine into the hands of physicians, and enable organizations to make faster diagnostic decisions, identify the best treatments and significantly improve patient care across the board."
Ed McCallister, Senior Vice President and CIO of UPMC (Pittsburgh): "The cloud — healthcare is probably one of the more resistant industries to cloud computing. UPMC is on the journey of a new hybrid cloud approach. We recently did a request for proposal for a data center, whereas 3 to 4 years ago we would have built the data center. Now we've partnered for it. By the end of 2017 we will retire 1,000 servers as we move to the data center. Over 5 years we will probably reduce 50 percent of our footprint at the on-premise data center because of our use of the cloud."
Francis "FX" X. Campion, MD, CMO, Ayasdi (Palo Alto, Calif.): "I think its population health. …Up to now, we've thought about our diabetes registry, our heart failure registry and we know that pretty simple tools — the patient lists and registries that are required for EHRs through the meaningful use program — are pretty prevalent. But we also know that patients don't just come with diabetes or just [chronic kidney disease] or just heart failure. These patients tend to be comorbid. … The big underlying theme really is value-based care at the population level, and all the populations of interest — not just the traditional diabetes and heart failure patients."
Jeff Chester, Senior Vice President and Chief Revenue Officer, Availity (Jacksonville, Fla.): "Everyone is still talking about population health and I really don't think anybody has yet to figure out what it is and who the winners are going to be. Because of that, it continues to be a hot topic. I also think two things that are going to stay, regardless of what happens with the ACA, are high deductible plans and this move to value-based care. How do we manage patient responsibility — it's up significantly over the last five years — and what tools do we need to actually make value-based care a good thing, not a bad thing? I'm also hearing more health plans at HIMSS than I have historically."
Adam Klass, Chief Technology Officer, Vigilanz (Minneapolis): "I think last year was a lot around interoperability. That seemed to really be the focus, and I think this year is going to be more around cybersecurity."
Ian McCrae, CEO, Orion Health (Auckland, New Zealand). "It's around precision medicine — getting more and more data, joined together with the normal medical record and the phenotypic data, but also making sense of it with machine learning."
Tina Foster, Vice President of Business Advisor Services, RelayHealth (Atlanta). "The common word is data. You can look at almost every person's sign, signage, kiosk or pamphlets, and it's data. For so long the industry has focused on getting wired and having the right technology. … It's created this tremendous surplus of data [and] we're not even mining a fraction of its potential. So now you are beginning to see people say, 'How do we harness the data?' And from my perspective, its not only harnessing the data, but it's liberating the data so now we can use it for intelligence to drive change."
Hemant Goel, President, Spok (Eden Prairie, Minn.): "Two areas. One is security. There's a lot of discussion about security and privacy. The second thing is population health. It was there last year, but this year it seems to have a little bit more focus and structure, as opposed to just being a buzzword. People seem to have a better idea of what it is they want out of population health."
Andrew Mellin, MD, CMO, Spok (Springfield, Va.) : "This precision medicine concept; you are starting to see more presentations, more discussion. It's emerging and early, but this concept of precision medicine is something a lot of people think is going to very dramatically change."
Paul Bradley, Chief Data Scientist, Zirmed (Chicago): "There's always a lot of talk about data and how data is leveraged. I think what we're going to hear more this year at HIMSS is leveraging that data to make that transition from fee-for-service to performance-based reimbursement, and how you can leverage these historic patterns and trends to make that jump and have a safety-net in place and feel comfortable about where you are going to be on the other side of things. I do also think there is still a lot of talk around revenue cycle and making things work in the current contracts, and in general, dealing with data. I do believe we are starting to see an emergence around more patient-centric engagement and how you can make the patient feel empowered and help them make the right choices regarding their care, and data definitely can play a role in that."
James Golden, PhD, Senior Managing Director of Healthcare Advisory and Healthcare IT Practice, PricewaterhouseCoopers (Hartford, Conn.): "There's a lot about AI this year, not only on the vendor floor, but in some of the talks that we're hearing, and a lot of the questions that we're getting. … But AI as a theme is very interesting. Some of that comes from all the things that are happening in the news, but I think folks in healthcare are realizing here is an opportunity to make use of all the interesting data that we've been building over the past few years."
Mick Coady, Principal, PwC (Houston): "Cyber[security] never goes away. … This year's focus — it kind of triggered a little bit last year — would be the med device problem. There's been some guidance brought out this year with the FDA on what they want you to do; how they want you to manage it. But the providers are — I'll take it back to an analogy — it's like being in 1997 approaching Y2K. They are holding off on how they are approaching this. Rudimentary things that we used to do in the old days around Y2K — no inventory, or the inventory is nonexistent, or they are trying to build it to even just to find out where they stand and mapping out where their vulnerabilities would be on the network. … This seems to be the hotter of the topics this year than what we've had in the past."
Jennifer Esposito, General Manager, Health and Life Sciences, Intel (Santa Clara, Calif.): "We've seen a lot more discussion and noise — not in a negative way — around artificial intelligence and analytics, and how all of that can be used to accelerate healthcare in a variety of ways. We heard a little bit about it last year; it seems to be the key story we are hearing now."
Aaron Miri, CIO, Imprivata (Lexington, Mass.): "Last year's HIMSS was really about interoperability. There were a number of booths around HL7, making sure that people understood what FHIR is, understanding how systems can be interoperable. This year, you are seeing a lot more focus on cybersecurity. You have the cybersecurity summit that HIMSS put together. You are starting to see people look more inwardly at efficiency. How can I gain more revenue capture? How can I really begin to understand what's happening within my four walls? I think that trend will continue."
Heather Staples Lavoie, Chief Strategy Officer, Geneia (Harrisburg, Pa.): "For us, people are definitely looking for analytics that help support their value-based arrangements. When they are looking for performance analytics, they are looking for something that's robust and isn't focused in a narrow area. They want to see utilization information, quality information. They want to see gaps in care, they want to see gaps in coding, they want to see missing and suspect codes. As opposed to a couple years ago and even last year, they thought about population health, and maybe two sentences deeper than that. Now they are much more sophisticated in terms of what they need."
David Freeman, General Manager of Information Ventures for Quest Diagnostics (Madison, N.J.). "At last year's HIMSS, discussions about value-based care solutions were largely conceptual and future focused. At HIMSS17, concrete solutions are now available, though some gaps in capabilities remain."
Bridget Duffy, MD, CMO, Vocera (San Jose, Calif.): "I am seeing the issue raised around physician-nurse burnout, and how technology contributes or can solve for that. I think that's new in the discussion. Historically it's just focused on improving operational performance or efficiency, and I think there's a broadening awareness of the fact that technology has to ease the burden of being a caregiver."
Todd Rothenhaus, MD, CMO, athenahealth (Watertown, Mass.): "Patient engagement. Patient activation. eHealth. … It's not about predicting who might develop problems. It's about taking the list of people with problems. The one who cost you the most last year that didn't die. You don't need a prediction machine; you just need to take action. Getting care management teams stood up, getting care collaboration tools between providers and getting patient engagement tools."
Andrew Adams, Principal, Ernst & Young (New York): "One issue that we are seeing a lot in the market and starting to see here at HIMSS is robotic process automation, artificial intelligence and that finally making its way into the healthcare space. Particularly for providers, there is just a ton of opportunity, whether it's in revenue cycle or back office functions."
David Dimond, Global Healthcare Chief Technology Officer, Dell EMC (Hopkinton, Mass.): "Security transformation. There is a full-day breakout session on blockchain, which is based on the idea of bitcoin. If you are going to get your patient involved in care and understanding their treatment and really making decisions, they are entitled to their patient data. This is a way to safely have patients access data, have a generalized ledger that physicians can opt into, and as part of that they can look through the chain, see new data and make comments and things like that. That's an advanced 'wish-we-could-be-there' kind of use case. That and I think the ransomware scenarios. … Ransomware can become a patient safety issue. If someone gets in and places an order or changes a medical device that's dispensing drugs in the ICU, that's a new level of ransomware that will just rock the industry."
Dan Trott, Senior Healthcare Strategist/Business Development Manager, Dell EMC: "The consumerization of healthcare. The degree to which wearables and remote monitoring devices are being tied together to access tools like smartphones to be able to facilitate meeting the requirements that we're being given by the new generation of healthcare people. The millennials will very shortly be the largest healthcare users we've ever seen and they are so tied to being able to have instant access to data. So how is healthcare going to both be able to deliver that data to them — whether it's data about themselves, data about their accessibility into healthcare, who they are going to see, when they are going to see, and how they are going to see them — and lastly, how is that going to be a secure transaction?"
Brian Kalis, Managing Director of Digital Health and Innovation, Accenture (Minneapolis): "Relative to the research we did, we've seen cybersecurity as a big area of focus of the dialogue, as well as increasing patient engagement and advanced analytics, like artificial intelligence.
Frances Dare, Managing Director, Health & Public Service, Accenture (Irving, Texas): "Cybersecurity, clearly No. 1."
Dave Dyell, President and CEO, Jellyfish Health (Panama City, Fla.): "I would say patient access has been surprising to me; to see how many folks now are starting to really focus on the way that patients are coming into the intake process."
Randy Parker, Founder and Chief Business Development Officer, MDLive (Sunrise, Fla.): "At prior HIMSS, there were many companies here who were bringing products and services that would never be able to be monetized or scaled. And I see at this year's HIMSS more focus toward products and services that absolutely are available and could be used today."
Henry DePhillips, CMO of Teladoc (Lewisville, Texas and Purchase, N.Y.): "Telemedicine has more or less been a quiet, on-the-rise capability the last few years. But as of 2016 telemedicine has really become mainstream, and as a result the provider organizations are seeing the value to their hospitals and health systems sort of extending their care reach through telemedicine technology. I was in a session that was 10 rows deep of people, standing room only. When asked, 'How many people have had a telemedicine encounter,' 5 percent of hands went up. When asked, 'How many of you would be open to doing it,' 75 percent of hands went up. It's time for and providers are ready to extend their care reach."
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