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Visited HIMSS in Orlando yesterday and here's the highlights:

• McKesson's $3.8M booth dwarfed the exhibits like a high-tech cathedral

• Epic's homey setting was replete with Prairie-home companion furniture

• Siemen's high-tech lighting effects soared (no pun intended)

• GE has more square footage than recently-acquired products…

• Cerner's monster booth was rumored to be not coming back next year!?

• Microsoft was swarmed with Microserfs trying to spell Azyxxii in Thai …

There were 26,000 attendees: about 25,900 vendor reps & consultants, chasing about 100 CIOs. At an average of $3K each for airfare and a week of out-of-pocket, plus an average of $100K per booth for the 900+ vendors, now you know why health care costs are 20% of our GNP and Medicare reimbursement is being cut. Wonder what all those dollars invested into actual R & D might accomplish?

At HIMSS this week there was much buzz about Google's entry into the electronic health record arena. Google plans to supply a password-protected service that would store health records on Google computers with a directory that lets users import doctors' records and their personal drug history and test results. Although Google will permit sharing of information between providers, control of all information will rest in the patient's hands. Google has initiated a pilot program at the Cleveland Clinic.

At HIMSS the Google booth was not on the main aisle. It was not giving away iPods or videogames - no free beer, pens, or trinkets. Still, it was so crowded that it took patience to make it to the front of the line. At this early stage Google claims that this service will be advertisement-free. Yeah, right. How colossal is that loophole? I hate to be cynical, but the consumer of healthcare is a ripe target for advertising. You only have to watch the commercials during the evening news to get a sense of how vulnerable we are presumed to be to direct advertising. At times it seems that not only are drugs being pushed, but diseases and conditions as well. Even now, when I make a generic Google search I trigger targeted ads for advertisers in my local area. I don't blame Google - that's their business and it is a profitable model.

Our inaction as a profession to create an electronic personal health record and the halfhearted support from our government has left a vacuum that private industry could not ignore.

A private practitioner can not help but worry what a patient will do when they notice a laboratory value that is out of the normal range. While the result might be clinically and statistically insignificant, I predict it will prompt a patient to make Google searches that will not be advertisement free. Such a search will, without a doubt, alarm a patient by raising the specter of terrible disease states which in nearly all cases will be irrelevant.

Our education system is recognized as being weak in the sciences. Most students have only superficial exposure to the biosciences and virtually no attention is paid to teaching Americans about their body in health and in illness. This naïveté is at the center of our vulnerability to manipulation.

One could argue that we will finally put personal medical information into the hands of patients who are clearly the rightful owners. But still, one must ask if we have altruistically begun the process of patient engagement in their own care or have we opened the doors to their exploitation.

What is the difference between unethical and ethical advertising? Unethical advertising uses falsehoods to deceive the public; ethical advertising uses truth to deceive the public.

Vilhjalmur Stefansson (1879 - 1962), “Discovery”, 1964

After five event-filled days at HIMSS — one spent in preconference workshops and four spent speed-walking from booth to booth attempting to make all my meetings — I was understandably exhausted and looking very much forward to being back home in the Garden State. Everything was looking up. I checked out of the hotel, enjoyed a virtually traffic-free ride to Orlando Airport, and was even able to book an earlier flight, trading the 6:15 p.m. take-off for the 2:50 p.m. departure. Then, once we got into the air, the pilot announced that we'd be landing in N.J. early. Talk about the luck of the Irish! I could almost taste the Guinness and Sheppard's pie (yes, I actually like Irish cuisine) that I'd soon enjoy in celebration of a successful trip.

Unfortunately, my luck would soon run out.

While we were “cruising at high altitude,” the pilot announced that there was a holding pattern at Newark Airport that was going to delay our arrival by a half-hour. The half-hour soon turned into an hour and a half, which posed an additional problem. Our plane didn't have enough fuel to circle over Newark “indefinitely.” As a result, we would have to stop at an unnamed destination to refuel. After about an hour, we landed in Baltimore — first we were told it was going to be Washington, D.C., but it turns out Baltimore was the intended spot — where we were given tiny little bags of pretzels while we sat on the runway waiting for an update.

Fortunately, the gentleman seated next to me was able to access information about the flight using his Blackberry (he happened to be an exhibitor at HIMSS). Those lucky enough to be seated near him knew long before the pilot's announcement when we'd be taking off, giving us peace of mind that was desperately needed.Soon, we were back in the air for what amounted to be the shortest flight — well, the shortest leg of a flight — that I'd ever taken. It was great to be back home.

And I have to say, I really learned quite a bit during my first trip to HIMSS. But the lesson that seems to resonate the most — particularly in light of the adventurous returning flight — is that while luck is “all well and grand,” as my Grandfather used to say, sometimes what you really need is technology.

We are well past the days where HIT doesn't get attention outside of the data center. These days, HIT gets lots of attention outside the walls of our Hospitals and Physician's offices. In the past few years we've even gotten focus and budget dollars from the Department of the Health and Human Services, a mention in several State of the Union addresses.

While the topic of HIT has made a long journey from the data center in the hospital basement to the Halls of the US Congress, it is clear to me, as of this week, the topic of HIT is not on the minds of the consumer. Do you know how I know? Disney is building a new “House of the Future” that doesn't appear to address telemedicine. This is a house where the refrigerator can tell you what items you need for a recipe and where every surface is a Microsoft Surface, yet… no mention of remote care. The house of the future will surely have some connection to the healthcare provider, someone tell Mickey.

While Mickey might be an odd barometer of consumer expectations, consumers undeniably have low expectations for things like better control of their personal health information, the ability to shop around, self-service convenience, and other benefits information technology can make reality. Consumers can drive change in healthcare. As IT Leaders, maybe it's important to make sure our neighbors know what HIT can do for them, and not just our Executives, Clinicians, and Legislators.