Another HIMSS has come and gone and while the industry decompresses in its wake, it’s important to reflect on the themes and takeaways for the conference.
For one, the theme of the conference has changed over the years. “I think four or five years ago, you’d walk around HIMSS and everything would be about population health and population health became the label for how organizations should be thinking about the industry. I think there’s been a subtle or not-so-subtle change…to value-based care,” Mike Boswood, President and CEO, Truven Health Analytics, IBM Watson, told Healthcare Dive during the conference.
In the past years, the conference's themes have largely focused on interoperability or EHRs and meaningful use. This year we heard a lot about machine learning and artificial intelligence but one topic continued to pop up over and over again that we were frankly a bit surprised by: patient experience. Numerous surveys populated last Monday noting that patients are engaged in their health and technology but that providers could help the effort. A many of tweets also highlighted the conversations that focused on patients:
Patient-centered, dialogue, and use case https://t.co/HBRsnpi4y2— Aisling McDonough (@AislingMcDL) February 22, 2017
@jeffpbyers I seem to be seeing patient experience pop up in every other tweet— Maneesh Juneja (@ManeeshJuneja) February 21, 2017
But while the focus may have shifted to value-based care, the health IT company has in part found itself at a crossroads of sorts. “You guys have to start taking on the established companies here because right now I think this is a bit of a failing industry because it’s not satisfying the customers,” former acting CMS Administrator Andy Slavitt stated during a fireside chat with another former CMS admin, Dr. Mark McClellan. “At least that’s my opinion and I know I’m wrong in many respects but I know I’m also correct in many respects because I talk to thousands and thousand of physicians over the last year and the vast majority of them don’t like the technology they’re using.”
“If that’s true or just partially true, that’s an enormous opportunity,” he added.
Walking onto the HIMSS exhibition showroom floor studded by monolithic booths gives a visual cue that the health IT industry is alive and well. After all, about 42,000 individuals had signed up to attend the event (about 20,000 more than in 2007). Though it is true that many of the legacy health IT systems were built in a time where physicians and patients had different expectations for their health data. Ten years ago, patient data information hoarding could be seen as more acceptable as the fee-for-service model allowed for it to be acceptable. Now, with a push toward value-based care and networked and engaged patients as well as providers, the rules have widely changed to put the patient toward the center of conversations. The idea of value-based care is largely bipartisan, as both Slavitt and McClellan noted in their chat, and will likely continue despite what happens to the ACA. So hospitals need to find new areas of revenue while using their beds less as the shift continues and alternative payment models continue to evolve.
"I think this is a bit of a failing industry because it’s not satisfying the customers."
Former Acting Administrator, CMS
What tech providers and C-suite administrators are looking for in a tool
Many of the C-suite members Healthcare Dive spoke with were looking for technology that actually provides actionable insights. Dr. Mark Briesacher, SVP of Intermountain Medical Group and Medical Staff told Healthcare Dive it's easy to get lost over tools and technology in the analytics space. What Briesacher looks for is how analytics can help both the patient and caregiver. "I see the time a patient or customer spends with a caregiver face-to-face as extraordinarily precious time," he said. "How can analytics make that time worthwhile?"
Patients have goals they want to accomplish in the care setting, whether it's to get back to health or stay healthy, for example. Analytics could help by presenting to both the patient – whose symptoms and health information has been electronically compared to a large, similar patient cohort, in this theoretical situation – and the caregiver the most important, actionable items to accomplish an individual's health goals.
"That’s where I think we need to get to. In terms of where we’re at today, we’re not there," Briesacher said. He stated what analytics can do currently is help automate a physician's common behaviors, such as pulling up common medications they order. The next iteration, he notes, will focus on how to personalize that sacred time for both the patient and the caregiver.
"You have to have an actual outcome" when looking at analytics tools, Dr. Peter Chang, CMIO at Tampa General Hospital and LogicStream customer, told Healthcare Dive. "Analytics are great [but] you can’t just sell analytics from the standpoint of ‘I have this package; just go and use it.’ There needs to be some scalability to it for your organization. I think that’s what is important for us when we’re starting to look at products."
“The key to this is technology that’s going to allow us to create action," Mark Farrow, CIO at Hamilton Health Sciences, a hospital system headquartered in Ontario, Canada, told Healthcare Dive. "We’ve had technology capturing data forever and it doesn’t do anything for us and that’s one of the biggest challenges especially as I walk around some place like HIMSS."
Hamilton Health Services partnered with ThoughtWire and IBM Canada to help mitigate Code Blue alarms within their acute care facilities. The team created a mobile early warning score, integrated with Meditach data, to predict and prevent adverse events. Initial results found a 17% decrease in the number of critical care response team consults requiring ICU admission.
Farrow noted there is also an abundance of tools and technology to choose from. He goes back to the idea that the technology should create action while not interfering with workflow. With the early warning score, nurses walked through workflows to help guide the tool's development. Farrow states nurses love the tool because they see how it can change but not interfere with how they work.
“The key to this is technology that’s going to allow us to create action."
CIO, Hamilton Health Services
Paul Shenenberger, CIO, Summit Health Management, a partner of athenahealth, told Healthcare Dive there's been a shift in health IT over the last five years where IT departments, instead of physicians, are in control of software purchasing decisions for the their organizations. He added that IT departments may not always know what their physicians' needs. Thus, it may help to have an open dialogue between the two parties to help get IT tools that help workflows and operations.
Telemedicine could be a hot item this year
Shenenberger noted he went into HIMSS17 looking over telemedicine solutions. "The more people I talk to the more I realize I'm not the only one in that boat," he said. "I think it's going to rapidly evolve over the next year. For me, I’m looking at consumerization for the next driver of healthcare. As legacy providers, we have no idea what consumerization actually means or what it’s going to mean for our practice. We are very ripe for disruption from the retail market segment. Those interactions are going to be driven by mobile experiences for the patient."
Telemedicine can give patients the ability to access healthcare services for low acuity visits in a setting they want by seeing their physicians virtually. Shenenberger was looking for solutions to business use cases he identified for his organization, including telepsychiatry and engaging higher acuity patients with virtual visits to help curb health costs.
No regret bets
David Betts, principal at Deloitte Consulting, is looking how to help hospitals and health systems improve their cost structure and sees signals in the marketplace that cognitive analytics, not just from a clinical decision support perspective but also from a transaction processing perspective, alongside robotics and process automation can help drive down costs by allowing staff to pivot to high value add activities.
While the industry is in a period of transition under a new presidential administration and there is a bit of uncertainty in the marketplace, Betts says it's exciting to see focus on patient experience and the industry thinking about experience as a designed element, as a differentiating element in a competitive market. Betts notes much of healthcare spend is shoppable (he estimates 53%).
"That’s only going to continue to grow and as personal responsibility increases, the need to differentiate on brand is a different discussion today than it used to be," Betts said. This includes bringing retail market principles to bear, looking at customer segmentation, building strategies to deliver care and maximize lifetime value both in terms of reducing costs and increasing quality. Those are things Betts says he's saw signals of on the show floor as well as in conversations.
"Those are no regret bets today regardless of what happens in Washington or what happens in the states," Betts said. "You got to get costs down, you got to get closer to your customers, you got to drive clinical quality and look for opportunities to partner to collaborate to do that."