Waving Goodbye to the Windy City: Five HIMSS15 Takeaways

(Sips venti iced coffee and gains perspective)...

Ehhh who am I kidding, it's DEFINITELY the five longest days of the year. Specifically, the 48-hour span from Monday to Wednesday filled with meetings, receptions, dinners, breakfasts, meetings and more meetings this year made me wonder when my legs were going to stop feeling like jello. But alas, the conference is now over and we can all take time to reflect. HIMSS never disappoints when it comes to "buzz," as you would expect when 43,000+ health IT minds gather in one place, and while it's always difficult to narrow it down to just a few things, here are my five big takeaways from HIMSS15 in Chicago: 

1) A new chapter is about to be written in the book of health IT. No matter who you talked to, which education sessions you sat in on or which keynote you attended, one theme became apparent throughout HIMSS this year: the adoption of electronic health record (EHR) technology, and the meaningful use of it, is simply not enough going forward. Literally every conversation I had at least touched on value-based care and interoperability. Federal leaders made this clearer than ever in two sessions. First, in her press briefing on April 14, Karen DeSalvo, M.D., National Coordinator for Health IT, continued to push a more interoperable healthcare, one that utilizes tools beyond the EHR. "The EHR is one of major drivers to advance care, but the world has evolved and advanced, and now the ecosystem is much broader than EHRs. To provide person-centered care, you need a model that's beyond episodic visits, and we need to make certain that we're allowing technology to evolve. EHRs only tell one part of story," DeSalvo said. 

What's more, during a separate keynote on April 16, the final one at HIMSS15, Andy Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), told attendees, "We are moving to a place where it’s not about adoption of technology, but where, when you are walking the halls of a clinic, are patients feeling the improvement, and are caregivers feeling the improved productivity?" Undoubtedly, both Slavitt and DeSalvo were as serious as they were bold, pointing to the goals the federal government has set out in the next several years aimed to advance interoperability and patient-centered care. 

Also noteworthy from the federal officials was a sentiment that seemed to suggest looking beyond the meaningful use program, a policy mandate that always sparks debate amongst healthcare professionals, many of whom think that the processes and specifications of the program are unjust. This from HCI Editor-in-Chief Mark Hagland's recap of Slavitt's and DeSalvo's April 16 keynote: "She [DeSalvo] made it clear that the Office of the National Coordinator for Health IT (ONC) was, while continuing to ensure that the meaningful use program under the HITECH (Health Information Technology for Economic and Clinical health) Act evolved forward successfully, already looking far beyond the conclusion of that program towards a future of collaboration with healthcare provider leaders." That's not to say that meaningful is over by any means (though many providers would certainly applaud that), but it does suggest that the direction from the feds is different and broader than it was just a few years ago. 

To this end, as if enough wasn't going on this week in the world of health IT, word broke on the evening of Wednesday, April 15 that the Sustainable Growth Rate (SGR) repeal bill passed in the Senate and would soon be signed by President Obama. Inside this bill is a sweeping change to how physicians will be paid. Blair Childs, senior vice president of public affairs at Premier Inc., put it best when he told HCI that "this law, coupled with another recent announcement of HHS’ goal to shift up to 50 percent of Medicare payments from fee-for-service to alternative payments by 2018 could not make the realities any more clear: advanced payment and value-based care models can no longer be thought of as fads. In fact, they are the new normal." Indeed, provider organizations have so far praised the repeal bill and seem to be very on board with patient care being about quality, not quantity.

2)  Have no fear, patient engagement is still alive. There was concern/disappointment early on at HIMSS that the notion of patient engagement was getting "devalued." This feeling was in reaction to CMS' proposed Stage 2 modifications to the view, download, transmit (VDT) patient engagement measure. Last week in its proposed meaningful use changes, CMS recommended dropping the number of patients required to VDT their health information from 5 percent to a single person. During the patient engagement symposium on Sunday, Farzad Mostashari, M.D. the former National Coordinator for Health IT, spoke out against the proposal, even proposing a day where one million patients asked for their health records to prove that this measure shouldn't be gutted. DeSalvo and others responded by maintaining their commitment to patient engagement during ONC's press briefing. 

While it seems a bit odd that the Stage 2 VDT measure was dropped substantially, only to jump back up to 25 percent for Stage 3, it's important to remember that nothing is official. These are only proposals, and I think people can get a little too wrapped up into numbers and percentages. I'm not defending the drastic reduction of the requirement by any means, but there are other ways to engage patients beyond just the VDT measure. Everything the feds seem to push revolves around a patient-centered healthcare, so I highly doubt they are "gutting" this concept. What's more, the HIMSS15 leadership survey proved that patient engagement and satisfaction are on the top of CIOs' agendas. Let's wait and see how it all plays out before speaking about patient engagement as a thing of the past. 

3)  mHealth and telemedicine continue to grow. The 4th annual HIMSS mobile technology survey revealed that more than 90 percent of survey respondents are utilizing mobile devices within their organizations to engage patients in their healthcare.The data also found that mHealth technologies are impacting two huge areas healthcare—cost savings and patient care. And to this end, the way patient care is being delivered is changing as well. No longer is healthcare confined to the four walls of a hospital or clinical office. As Jim Utterback, IT practice leader at Witt/Kieffer, an executive search firm specializing in healthcare and IT recruitment, told me, "It's all about telemedicine, patient-centered care, wearables, anything you can do to reduce costs. It was no accident that the opening speaker at HIMSS this year was the president of Walgreens. Here's a company that was never a healthcare competitor, but now they are absolutely are, as is CVS. They are all competing for patients." Indeed, the HIMSS mobile survey found that the use of telemedicine and remote monitoring have yielded a positive impact for healthcare organizations. Docs, it's all about population health, data and analytics now, and because of that, you need to be able to care for your patients in non-traditional settings. 

4) Leadership and collaboration are needed now more than ever. I know, this is a cliche one, but it's really true. We're entering an unprecedented time in healthcare with huge changes coming up. It's critical to have leadership and engagement from the top, as without this structure, success will be very difficult to attain. In our conversation. Utterback told me that some organizations are even going outside of healthcare to help them adapt to the changes that are upon the industry. This makes sense, as other sectors have had success in areas that healthcare has struggled with, such as interoperability and privacy/security. Further, as HCI Senior Editor Gabe Perna blogged, care collaboration has become increasingly vital for effective population management,  “Physicians, we can’t do this alone," said James Whitfill, M.D. CMO at Scottsdale Health Partners in Phoenix. "All of the information coming forward to us, we have to be able to leverage it and coordinate with our colleagues, between specialists and primary care physicians. The reality is the physician can’t be the lone quarterback. You have to be part of team with care coordinators, pharmacists, and other folks,” said Whitfill. 

5) HIMSS needs to change its Wednesday afternoon keynote strategy. Just like everyone else, I get excited to hear ex-presidents speak. Not many people can say they have. But this year, George W. Bush literally said nothing about health IT. While I appreciated his candor and humor, it just wasn't relevant. For all the money that HIMSS spends on its speakers, perhaps get someone who can speak about healthcare rather than cold furniture, foreign policy, and painting?

As always, feel free to leave comments or follow me on Twitter. Would love to hear other people's takeaways. Safe travels, everyone!