Electronic Health Reporter

Guest post by Tom S. Lee, Ph.D., CEO and founder, SA Ignite.

Those making the long trek to and through the annual, arduous health IT connection-fest known as HIMSS are undeniable siblings-in-arms. Each has their own list of “must learns” by which they measure the return on the foot blisters and hurried lunches.

This year, I brought my particular list of themes to track. Although the odds are great that I missed relevant crevices of the show, I believe I gathered a decent quorum of items to share here.  You be the judge.

Theme 1: More Regulatory Guidance from CMS and HHS

The HHS, ONC and CMS brain trust spoke to packed rooms in an illuminating 24-hour span, which crossed multiple themes on my list. On the regulatory front, HHS Secretary Burwell, National Coordinator for HIT DeSalvo, and CMS Acting Administrator Slavitt, all made direct or indirect mention of the MACRA legislation and its constituent parts, the Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs; e.g. Medicare accountable care organizations). MIPS and APMs together redefine how $250 billion per year in Medicare Part B payments will be paid to physicians in value-based, rather than fee-for-service-based, manners. The hub-bub around MIPS, in particular, stems from the fact that it can reward high-performing providers with incentives up to and even beyond 27 percent of Part B payments and penalize low-performing providers up to 9 percent, while also reporting their MIPS performance scores to consumers.

Although CMS was unable to confirm or deny many aspects of the CY2017 MIPS rule currently being drafted, I heard strong clues from CMS and its contractors confirming a Jan. 1, 2017, start of the first MIPS performance year. In addition, CMS officials publicly stated across multiple sessions that the draft CY2017 MIPS rule would be released “within a few months,” “in the spring,” and perhaps as soon as April.

Theme 2: The Rising Importance of the Back-Office Impacts of Value-Based Programs

Over the last nine months, it wasn’t clear how Medicare’s Chronic Care Management (CCM) program was playing out in the field.  CCM rewards primary care providers with a monthly per patient fee for delivering a set of high-quality, chronic care services to patients both within and outside the clinic.  The dollars netted by a practice can be substantial, even eclipsing the incentives earned from complying with meaningful use over the last several years. However, the front-office and back-office tasks needed to support a successful CCM program can be substantial. Whereas after walking 80 percent of the main exhibit hall floor I saw no CCM vendors, I saw in the first-time-exhibitor hall several companies out of ~40 exhibiting focused exclusively on offering outsourced CCM program delivery services. Maybe the CCM model and market are starting to take root.

Theme 3: Interoperability Continues to Play Out

Secretary Burwell announced that EHR vendors serving more than 90 percent of hospital EHRs and the five largest health systems had signed an interoperability pledge to support consumer access to EHR information, refrain from blocking information sharing, and implement interoperability standards. Since the pledge does not yet describe consequences for noncompliance, the bet seemingly is that market pressure and peer pressure alone will accelerate interoperability in meaningful ways.

CMS and ONC announced the launching of an App Discovery Site, or a “FHIR Cloud,” to enable EHR-neutral applications to securely interoperate with EHRs utilizing the emerging FHIR specification. In addition, challenge grant prizes will be awarded to winning consumer and provider-facing applications leveraging FHIR.

Theme 4: Privacy and Security Get Even Hotter

The HHS breach disclosure database reveals that one in three Americans’ healthcare records were breached last year. The recent “ransomware” case in Hollywood, CA, added more fuel to concerns about patient data security. Vendors are responding as I saw in the first-time-exhibitor hall that nearly one quarter of these new-to-HIMSS firms focused on information privacy and security. Secretary Burwell noted progress on the creation of a national cybersecurity task force as mandated by the Cybersecurity Act of 2015.

Theme 5: Healthcare Transparency for Consumers Further Expands

I was not able to find in this year’s exhibit halls any vendors focused on what could be a huge opportunity: optimizing providers’ public reputations shaped by the growing swath of provider performance data being publicly released by CMS and other payers.  Perhaps the healthcare marketing community is paying more attention to this, but marketers will need to rely on their health IT and clinical peers to understand the impacts of the data on consumer perceptions of their providers.

Overall, I left the show feeling that the four days and 15,000+ steps per day were worth what I heard, saw and learned from among the 40,000+ HIMSS attendees. The show viscerally demonstrated the unprecedented levels of activity, excitement and confounding challenges in our chosen field. This stuff makes a difference in people’s lives. Best of luck on your journey towards next year’s re-gathering of the minds.