Electronic Health Reporter

The cornucopia that is the annual HIMSS conference and tradeshow – healthcare technology’s biggest event – is behind us, but what’s left in the wake is wonderful, inspiring even, if not a bit overwhelming. The reactions to this year’s event have been overwhelmingly positive. Interoperability in the form of data sharing and a ban on patient health information blocking by CMS (through proposed rules released the first day of HIMSS) set the tone.

This was followed by CMS administrator Seema Verma taking a strong tone in all of her presentations at HIMSS, with the media and during her keynote speech. The federal body made it clear that data generated from patient care is, unequivocally, their data. While these themes heavily influenced the show, there were other takeaways.

My personal takeaway from HIMSS is “mind the gap.”

There are many other diverse opinions about what came out at HIMSS19 and the themes that will affect healthcare in the year ahead. For some additional perspective, I turned to healthcare’s thought leaders; people who are a lot smarter than I. Their responses follow. That said, did we miss anything in the following?

Dr. Geeta Nayyar, Femwell Group Health and TopLine MD

After spending a week surrounded by some of the most intellectual and innovative minds globally in healthcare at HIMSS19, I’m even more confident that the shift toward patient engagement mass adoption is well underway and ON FHIR. The new CMS/ONC proposed law around interoperability and penalties for “information blocking,”  are both touchdowns for the quarterback, which remains to be patient engagement. The robust discussions during the pre-conference HIMSS patient engagement program, reflected a move to a consumer-centric approach evidenced by the presence of Amazon, Google and Microsoft at the show. The keynote by Premier’s CEO Susan Devore shared a consumer-centered, provider led vision, “with data flowing seamlessly and being analyzed and effectively leveraged to guide decision making at the point of care.” Collaboration in healthcare is the key to everyone’s success. I was inspired to see her and so many women coming together to support each other in HIT, as Dr. Mom remains the healthcare decision maker in the households, we are all ultimately trying to reach.

Andrew Schall, Modernizing Medicine

Physician burnout continues to be a hot topic coming out of HIMSS19 and many feel that EHR platforms may be a part of the burnout epidemic. There were several sessions that focused on user-centered design at HIMSS this year including one that focused on the iterative approach to software development and user experience. First, I think that the industry is recognizing that one-size-fits doesn’t work for EHRs. Additionally, I believe that improvements will come in large part from the greater involvement of practicing physicians in designing specialty-specific EHR workflows and interfaces. A combination of powerful technology like AI and augmented intelligence, as well as well-designed EHR solutions with an intuitive user interface and user experience, will help ease the physician burden and automate time-consuming and administrative tasks like coding and billing – ultimately reducing burnout.

Shane Whitlatch, FairWarning

HIMSS 2019 showcased the ongoing digital transformation to make healthcare responsive to patients across a continuum of care. Enabling patients to be able to access, use and own their personal health data, while ensuring privacy and security was the central takeaway of this year’s HIMSS.  Notable, critical moves to support this goal included: the Department of Health and Human Services announced proposed rules to enhance interoperability and data access with payor data; ongoing security and privacy efforts to ensure appropriate patient access to their data while mitigating emerging risks from items including medical devices to nation-state attackers; and artificial intelligence and machine learning initiatives to effectively manage the tsunami of data in healthcare while promoting optimal healthcare.

Tripp Peake, LRVHealth

The best part of HIMSS this year was we seemed to get away from a single buzzword.  Healthcare is hard, there’s no silver bullet. The Precision Medicine Summit got into the weeds about how to really roll out a program in a provider system. The AI companies stopped talking about AI for AI sake and were more focused on ROI. Everyone seemed more balanced about VBC: yes, inevitable, but also gradual. Consumerism was probably as close to a central theme as existed. And I continue to be excited about the energy, creativity, and commitment of the entrepreneurs in this market.

Don Woodlock, InterSystems

Anytime you bring 43,000 healthcare professionals together in one location, you will never have a shortage of opinions on the future of the industry. We are at the cusp of a revolution in healthcare, driven by technological advancements. Some key trends we saw at HIMSS19 were, no surprise, around artificial intelligence, where people are trying to enhance predictive risk scoring and improve patient engagement. Additionally, there were profound announcements around mandating application programming interface (APIs) to improve the flow of healthcare data across the ecosystem. As interoperability becomes liquid, it will become the critical component of every healthcare system, driving the industry to new heights.

Paddy Padmanabhan, Damo Consulting

On day one of the conference, the HHS sucked the oxygen out of the room by dropping a proposed 800-page rule on data and interoperability. The rule aims to aggressively expand interoperability by making it mandatory for providers and health plans participating in government programs such as Medicare Advantage, CHIP and others to make patient data available to patients as a condition for business. CMS head Seema Verma and ONC Chief Don Rucker drove the message home repeatedly during the conference.  Indeed, Seema Verma declared it an epic misunderstanding that patient data can belong to anyone other than the patient. A somewhat sobering counterpoint was voiced by Epic Systems CEO Judy Faulkner in a media interview where she suggested that interoperability challenges go well beyond data sharing by EHR vendors. Regardless of where it may fall, interoperability will continue to dominate healthcare IT agenda for some time to come. Related issues around new and emerging data sources, especially social determinants of health, will gain prominence in the coming months.

Erin Benson, LexisNexis Health Care

The proposed rule on interoperability of health information influenced most conversations at HIMSS. In the context of cybersecurity, the rule served as a reminder that it’s just as important to let “good guys” in quickly and seamlessly as it is to prevent unauthorized access. We want to enable value-based care and give patients the ability to manage their own health by having access to their records. We also want to keep costs low and efficiency high by enabling interoperability and giving partners, vendors and employees necessary access to systems. Therefore, a cybersecurity strategy needs to strike a balance between user engagement and data security.

Mike Morgan, Updox

The power of consumerism is really impacting healthcare and the need for patient engagement is alive and well. Providers across the board must look at new technologies and ways to redefine patient engagement to better communicate with patients and partners but do it via channels that are easy for staff and customers to use. New applications, such as telehealth and secure text messaging, have changed how healthcare communicates and consumers are demanding that immediate, convenient engagement.

Vince Vickers, KPMG 

HIMSS19 seemed to have the most decision makers at the conference in five-plus years when a lot of healthcare organizations were still looking at implementing electronic health records. We might be ready for another wave of healthcare IT investment after healthcare organizations digested those investments made in electronic health records. The key is now around optimizing EHRs – interoperability, improving ease of use, enhancing analytics — or dedicating resources to enterprise resource planning (ERP) systems to make themselves more efficient in the back office. We’re also seeing healthcare organizations position themselves to be more consumer-oriented, partly to address new entries from some of the tech companies, such as Google, Amazon, Microsoft, and a multitude of others, that wanted to make a big splash at HIMSS.

Simon Clephan, IGEL

Top of mind at HIMSS19 was the topic of how digital workspaces can improve patient care. Today’s healthcare professionals require faster access to patient data – whether in a clinic, at a kiosk or moving between provider sites in a large health system complex. While this data is necessary to deliver the best care, it must also be secure. One of the best ways to do this is through VDI (Citrix or VMware) where no data is stored locally and with a Linux-based endpoint. Linux on the endpoint is superior to Windows since it’s generally faster and highly resistant to viruses and other malware.

David Niewolny, RTI

HIMSS19 brought validation to the fact that healthcare is beginning to accelerate the adoption of advanced technology. Themes of big data, cloud and AI were prevalent throughout the show floor, the educational sessions and the cocktail hours. And for the first time, it felt real. There were actual products utilizing big data, cloud, edge analytics and AI being shown to solve true clinical and operational problems. Though it will take years to fully realize the benefits of a fully connected healthcare ecosystem, 2019 will be remembered as the year the Internet of Medical Things became real.

Kerry Martin, VitalWare

Hospital charge masters aren’t just for finance anymore. As of January 1, hospitals must post a list of their standard charges in a machine-readable format on their website and update the information at least once a year. A clean charge master is still key to ensuring accurate and full reimbursement, however, it’s also becoming a way to communicate with your patients. CMS is just beginning down this path, and while the new rule might not paint a clear picture of a patient’s out-of-pocket costs, it is the first of what will likely be many more steps focused around consumer price transparency.

Susan M. Reese, DNP, MBA, RN, CPHIMS, Kronos Incorporated

HIMSS19 drove considerable momentum for trending topics like the rise of consumerism in healthcare, and the collaborative nature of technology integrations. On the topic of consumerism, HIMSS19 opened our eyes to how changing models of care delivery and disruptive technologies are evolving the patient experience – a.k.a. the customer experience – by making technology more intuitive and accessible for consumers worldwide. Secondly, integrations emerged as the lifeblood of the healthcare industry, with healthcare technology vendors facing increasing demand for innovative solutions, product extensions, and real-time integrations that can seamlessly connect business applications and fully support natural workflows.

Charles Aunger, Health2047

Security awareness is on the rise in every area of healthcare, not just data. Healthcare organizations that lack the technology and manpower to put the necessary securities in place need to partner with the right organizations in order to keep up. Artificial Intelligence is not a standalone solution. It holds promise for building technologies and tools, but as of now AI’s ROI is found in the back office. Instead of transforming patient care, its current focus is on workforce optimization. The patient and the care team should not be seen as two separate entities. Patients must take a central role in driving their own care.

Chrissa McFarlane, Patientory

This year HiMSS19 was focused more on global health, as well as emerging technologies and its application to health IT. It also had an emphasis on technology, such as artificial intelligence and the rise of the machine, artificial technology and human machine dyad, as well as the value of blockchain and how it’s going to evolve healthcare IT. The value of blockchain realized the need for more collaboration from larger companies that aren’t currently working together and tackling the first phase of supply chain management and moving on that towards a more complex integration (with Private health information) in the next three to five years.

Gary Nelson, Schellman & Company

HIMSS19, like every other year, covers a vast array of healthcare information areas, but the three key takeaways that seemed to span across all facets of healthcare were interoperability, cybersecurity, and blockchain. Whether an attendee was focused on patient care, revenue cycle management, information security or HIE, those three topics seems to take precedent in conversations and general concerns. It was interesting to attend various forums, use case discussions, and sessions to learn that the entire healthcare community had the same shared focuses.

John Beck, NextGen Healthcare

I am encouraged to see HIMSS re-emerging as a high-value platform to showcase both steadfast and emerging HIT capabilities in the post-meaningful use era. At HIMSS 2019, we saw appropriately healthy interest in clinical workflows, usability, mobile, population health, interoperability and automation, as well as real innovation in patient engagement. For healthcare leaders the smoke has cleared, and we see progressive groups preparing to place technology bets.

Alexandre Theoharidis, Acuity Link

At this year’s HIMSS19, conversations with hospitals and health systems continued to reinforce the critical need for healthcare organizations to better streamline their patient flow. This can be achieved by aligning the timing of patient appointments/admissions and discharges with the arrival of the medical transport, in turn resulting in better optimized workflows and ultimately, a clearer view into the movement of patients. The end result is improved patient care and experience accomplished through shortened discharge times due to minimized bottlenecks in patient movement. 

Lucienne M. Ide, M.D., Ph.D., Rimidi

What I noticed was a key takeaway from HIMSS 2019 is that despite advances in interoperability and no shortage of innovation, there is still a lot of friction bringing new technology into healthcare systems. Innovators are looking for more streamlined processes when it comes to solution selection, contracting and security reviews. The EHR battle is over, and there will be little churn at this point. Instead, health systems will be looking to leverage what they’ve already bought for more value. Analytics and user experience will be owned by new entrants who provide visually intuitive, actionable data on the EHR platforms.

Chris Foster, The Sextant Group

HIMSS19 covered a variety of leading topics in healthcare technology, but perhaps the most overwhelming topic was data (lots of it) and how to manage this overwhelming amount of data with analytics and artificial intelligence. Healthcare providers are capturing more data than ever; however, the challenge now becomes how to prioritize this data, ensure it is high quality, and how to utilize it for more enhanced patient care and improved workflows. Artificial intelligence is at its infancy, and while the big picture is appealing, the small and boring details need to be sorted out first.

Lonnie Rae, Medal

One of the biggest takeaways from HIMSS19 was the emphasis on interoperability and need for better access to a patient’s health data. Many EHR providers and health IT vendors – Medal included – announced plans and solutions to help use fragmented patient health data, and present it to healthcare providers in a timely and meaningful way. Moreover, the ONC unveiled its information blocking rule, which aims at boosting interoperability to achieve the same goal. News and conversations at HIMSS made it obvious that there is a need for longitudinal patient records that aggregate data from multiple sources, and give that data purpose.

Rick Halton, Lumeon

Much like population health and patient engagement were buzzwords at past conferences, HIMSS19 was all about AI and blockchain. However, it was difficult to discern use cases, as they seemed ubiquitous and over-used. What I found particularly notable was seeing more traction for and recognition of care pathway management as an approach to streamline care delivery for each patient by breaking down the siloes of fragmented care. This approach offers the benefit of truly measurable outcomes, where buzzwords can still only offer vague promises for transforming care. I’m sure we will see more of this at HIMSS20.

Vidya Murthy, MedCrypt

From the opening remarks around value-based care via transparency, to individual talks where AI strategies were detailed, a willingness to change was thematically consistent. It was heart-warming to see an entire section dedicated to cybersecurity at HIMSS, albeit in the far corner. The challenge I faced as I walked across the rest of the convention is that cybersecurity was positioned as a compliance tool. Many shared cybersecurity concerns but focused on HIPAA/privacy or employee training/awareness. Last week taught me that cybersecurity is not yet perceived as a device-centric patient safety concern by the majority of attendees — a crucial concept that must be adopted to foster the advancement of cybersecurity in healthcare.

Kali Durgampudi, Greenway Health

As the healthcare market continues to shift to value-based care, it’s crucial the industry stays ahead of the complex and evolving regulatory environment while supporting enhanced care for a better patient experience. The need for this balance was evident during HIMSS19. But just how can the industry accomplish this? Through better innovation and interoperability. Delivering state-of-the-art technologies to healthcare providers can help them maintain a thriving practice that offers exceptional patient care. To meet this demand, health IT vendors must be forward thinking, nimble, and capable of delivering innovative and interoperable solutions and services that meet providers’ needs now and in the future.”

Michael Doyle, COTA, Inc. 

Moving away from trends seen in previous years, there was a noticeable shift in the tone of HIMSS19 from EMR vendors stockpiling data to companies working with and finding the value of data within the EMRs. Companies that are positioned to take advantage of data and use it in a meaningful way are poised to grow and make a difference at the point of care. This was emphasized over and over through the featured panels and excitement from attendees around vendors looking to organize and uncover the meaning behind existing data sources.

Sanjeev Agrawal, LeanTaaS

AI/ML continued to be a significant point of emphasis at HIMSS, primarily in service of improving clinical outcomes. For the first time, though, we heard how health systems like MultiCare Health in Tacoma, Washington, and Saint Peter’s University Health System in New Brunswick, New Jersey, have deployed AI/ML-based solutions to improve the operational performance of clinics, operating rooms, and infusion centers. Increasingly, health systems are discovering the power of data-driven, objective measures to challenge long-standing policies and practices like OR block scheduling to improve accessibility, accountability and visibility into their operations.

Sunnie Southern, Onix

As witnessed at HIMSS19, the cloud is gaining significant traction in healthcare, and a one-size”/“one-configuration deployment model isn’t the answer. Healthcare organizations need to create a roadmap to the cloud, including exploring hybrid- or multi-cloud solutions. The most innovative organizations are developing cloud strategies that address their key stakeholders’ needs and align with business objectives and budgets. The most strategic ones are thinking about their data’s value and how they can turn it into insights that inform business today and in the future. This includes investigating the role that advanced analytics like artificial intelligence and machine learning will play in their strategy.

Chris Voigt, Privia Health

Out of everything that I took in, one observation stood out in particular. Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), spoke this year as well as last. In 2018, she remarked that using fax machines for healthcare transactions should be phased out. This year, she called for a wholesale push for interoperability that would give payers and providers instant, accurate and complete access to patients’ electronic health records, often referred to as the “Blue Button” app. This digital revolution would create health records at birth that include every appointment, test, diagnosis and data from the Internet of Healthcare Things devices into a record, which could be blockchain-enabled to ensure accuracy and security. If you ask me, that’s like graduating from a foot-powered Flintstone’s car to a Lamborghini over the course of one year. How did we make such a leap from literally cutting the cable on fax machines to a wholesale, easy-to-use, innovative concept?

Patrick Fenningham, EIR Healthcare

This was the first year I attended HIMSS in about five years. From my perspective the key takeaway was the evolution and strong commercialization of real-time location services, RTLS, in the hospitals. I saw a healthy amount of large and small sized companies diving into this space with some very exciting technology. The industry has finally established a strong connection between technology integrating with infrastructure. Over the last few years the advancements of technology in the healthcare space were app driven but now we are starting to see an inclusion of the physical space and equipment which will only continue to ease clinical workflows and enhance the patient experience.

John Danaher, MD, Elsevier

HIMSS 2019, as always, was an exciting week full of learning, innovation, and sharing new insights technology. Elsevier had a strong presence at the conference this year, between our interactive booth and virtual panel session with a live moderator on-site. During the panel discussion, the ideas of precision medicine, advanced clinical decision support, and clinical pathways were all major topics. Some additional themes I picked up while exploring the convention center are below:

PROPER DATA APPLICATIONS ARE CRUCIAL: By opening up data and increasing interoperability, healthcare professionals will have access to better insights. But providers must truly understand how to apply the right data in the right circumstance and ensure that this knowledge is employed across the continuum of care. Workflow integration is important and order sets must be bespoke for the diagnosis and pathway. This type of interoperability will bring improved precision medicine, and ultimately insight into our decision patterns.

AI HAS UNLIMITED POTENTIAL; COLLABORATION IS KEY: AI is the biggest buzzword in healthcare as many exhibitors presented their latest and greatest solutions designed to take advantage of the endless possibilities. AI and machine learning are rapidly growing and clinical decision support tools are increasingly using these tools to augment care, not replace clinicians. This technology will ultimately improve outcomes and reduce care variability.

ACCESS IS IMPERATIVE: Big data is a recurring theme, as many are calling for an increased amount of data to be unleashed. CMS surprised many with their new policy that allows for greatly increased patient access to EHRs. The next generation electronic health record, in accordance with appropriate clinical decision support, will improve processing methods to ensure the data and information is available for the whole team, including patients and family, so the team can synchronize around the patient’s goals and are plan. There is amazing opportunity here, but extra care must be taken to ensure security and responsible use.

BLOCKCHAIN WILL GET A CHANCE: In an attempt to address rising concerns with data security and patient record accessibility, blockchain will continue to grow as healthcare companies seek new opportunities to implement this technology. In 2019, we will see real-use cases, new and creative applications, and opportunities for blockchain to build trust with consumers.

PATIENT ENGAGEMENT IS CRITICAL FOR PRECISION MEDICINE: We must never forget the human element to truly make the most of data access and AI solutions. Patient engagement leads to better value-based care and reduced costs. CDS tools are essential for this outcome, as they help sequence and interpret care plans made just for the individual. Individualized medicine truly is about the individual.