On the first day of the HIMSS Connected Health Conference, leaders from various healthcare segments came together to push towards a unified goal: to better connect systems and people, and better protect patients' health information.
These feelings were expressed both from the morning's keynote speakers, and again in the form of two industry surveys that representatives from the Chicago-based Healthcare Information and Management Systems Society (HIMSS) discussed at the conference on Nov. 9 at the Gaylord National Resort in National Harbor, Md. (the HIMSS Connected Conference combines the mHealth Summit from previous years with the new Cybersecurity and Population Health Summits, all under the HIMSS umbrella).
H. Stephen Lieber, HIMSS President and CEO, kicked off the conference saying that the program's changes this year are due to a greater recognition of the empowerment of individuals, which he said is the key to new healthcare as we move more towards self-connected care. Lieber specifically mentioned patient-generated health data (PGHD), noting that while it doesn't get a lot of credibility from those who only believe in traditional medicine, it is a valuable source of data—"maybe the best source of real-time clinical data."
A series of other keynotes, spanning about 15 minutes each, were given by Dr. James Mault, M.D., vice president and chief medical officer of Qualcomm Life in San Diego; Judy Murphy, R.N., chief nursing officer and director of global business services at IBM Healthcare; Douglas Wood, M.D., medical director of the Rochester, Minn.-based Mayo Clinic's Center of Innovation, and others. In perhaps the most inspirational moment of the morning, Murphy showed a video clip of a blind runner, who with the help of a mobile health app and geolocation technology, was able to fight his way to push towards an incredible total of 100 miles ran. The clip showed the man face challenges such as bumping into a tree and falling down due to lack of sight—but the technology, mixed with the familiarity of the running route, enabled him to avoid the tree the next time.
While Mayo Clinic's Dr. Wood mentioned how his organization repeatedly ranks as one of the top two systems in the country, he quickly added, "Hospital magazine ratings are less important than changing the way we care for patients. We were looking at it wrong," Wood admitted. "We need to reconsider how we care for people instead of trying to improve our current system. Should we perpetuate the current system or reframe? What if we measured how many times we helped people enjoy life?" he asked. As such, Wood, while talking about Mayo's 270 innovation projects and more than 600 experiments that had 10,000 contact hours with patients, said, "We need to move towards [a system] where we think about people, not patients; and health, not healthcare." Added Qualcomm's Dr. Mault: "Technology is way ahead of our healthcare systems' ability to apply it. It's time to get out of pilot mode and get into connected mode."
Continuing on the notion of a more connected healthcare, a morning session on a HIMSS Connected Health survey looked at the benefits and value of health IT, from the perspectives of a payer and a provider. Although the survey's official results are still pending, Brian Rothman, M.D., associate professor of anesthesiology and medical director of perioperative informatics at Vanderbilt University Medical Center, and Ajoy Kodali, enterprise vice president of IT at Washington, D.C.-based health insurer Humana, touched on how connected health solutions provide industry-wide value.
Specifically, when it comes to patient portals, the longest-standing form of patient engagement technology, Rothman said that now the focus needs to be on how to better motivate patients to keep coming back to the portals for the right reasons. For that, Rothman noted, the key is to rethink how to measure the effectiveness of them. "There is no metric for this if I don't have a chronic disease or need pending lab results. So it's about drawing the patients into the portal when they are people,"he said. "When people become patients, that's when you want to engage them. They have to understand the portals' benefits beforehand so that they are ready when they become patients," he said. Rothman added, "How do we make these portals so they address as many disease states as possible, rather than just contain patient information? You want to have actionable information where they can be driven to an app to improve their health. Portals tend to be more static, and they are more about pulling than pushing right now. It's challenging to make it a one-stop shop for a diverse population," he said.
Furthermore, when it comes to mobile apps and PGHD, Rothman said that a big challenge has been the reliability of the data. What is uniquely different in healthcare, he specified, is being able to find the source. "I can use it and deliver it, but I don't have the source. The source is the greatest challenge. We are relying on data that may not be defined," he said. The problem with unreliable data is that if it gets put into an app that people rely on for guidance, it could actually result in greater time consumption if the information is not correct, Rothman noted. As such, "there are many behavioral issues that go into wearables and apps," he said.
Kodali agreed with Rothman, noting that when it comes to care coordination, "We would like to see the data present in a single form in the electronic medical record (EMR), rather than in multiple places, a comment that drew a laugh from Rothman, the provider, who clearly has the same concern. "Integration is tough; there are too many layers. We need to get ball moving," Kodali said, adding that personalization will be the key moving forward. "How do you personalize it to take it down to that individual level? It's hard to get there," he admitted, but noted "that is where the value will be seen in the long run," particularly for Humana members who are mostly senior citizens and especially need that personalized level of customization.
Key to having a connected healthcare, of course, is having a secure healthcare environment. As such, during an afternoon session on the conference's exhibit floor, Lisa Gallagher, senior director of privacy and security at HIMSS, spoke about the results of the HIMSS 2015 Cybersecurity Survey, released earlier this year. While HIMSS has conducted this survey since 2008, this one specifically wanted to look at: what tools organizations are using to secure the healthcare environment; how organizations assess, prevent and detect cyber threats; what the biggest motivators are; and how to determine which items are the biggest barriers.
The survey found that while 87 percent of provider organizations have made information security more of a business priority in recent years, overall confidence in protecting their systems from threats, particularly insider attacks, remains low.
The survey, which made sure all respondents were responsible for security functions in their organizations in some capacity, asked about capabilities in protecting their organizations against various types of attacks. The responses did not inspire much confidence: only 20 percent of survey participants said they were confident in protecting against malicious insider attacks, while 34 percent expressed faith in protection against phishing attacks. Meanwhile, just 27 percent of respondents said cyber threat intelligence is a technique their organization uses to detect and investigate incidents. For techniques, network monitoring and monitoring system activity logs ranked highest for respondents.
Overall, two-thirds of survey participants reported "significant security incidents," Gallagher said. Most expressed uncertainty and lack of confidence when asked about their organization's level of preparedness. When asked about consequences of security incidents, 62 percent said "limited disruption to their operations," while 21 percent said "loss of data." However, noted Gallagher, certain factors with these responses should be taken under consideration—it's possible the person answering might not know exactly how much data was lost, for example.
Regarding barriers to better security, 64 percent of respondents reported lack of personnel as being the biggest roadblock, followed by lack of resources. What's more, responding to an attendee question, Gallagher said there was no known correlation between size of the organization and ability to protect itself—even the largest and most mature systems get attacked, she said. "This theme is consistent with our previous surveys," Gallagher said. "It's about staffing, processes and tools. Across the board, there is still too much uncertainty. Folks aren't sure or are not confident in their ability to protect data in this current healthcare environment."
