Five Takeaways from HIMSS16 in the Sin City

March 7, 2016
Another HIMSS conference has come and gone! Here are my five biggest takeaways from this year's show before I go into health IT hibernation for a few days.

Another HIMSS conference has come and gone, and although Las Vegas doesn't seem like the optimal place for a health IT conference on paper—good God, I saw some strange stuff—there was as much buzz and craze as ever. (To this end, be sure to check out all of HCI's awesome wall-to-wall HIMSS coverage all in one spot right here). With that being said, here are my five biggest takeaways from this year's show before I go into health IT hibernation for a few days.

1) The "Pledge"—It sounds like a movie, but it's as real as ever. On HIMSS' opening evening, Department of Health and Human Services (HHS) Secretary Sylvia Matthews Burwell delivered big news to thousands of audience members, announcing a major federal initiative that has gathered together industry leaders to advance data-sharing, consumer access to healthcare data, and interoperability. The organizations that have signed onto these commitments, per HHS, include the companies that provide 90 percent of electronic health records (EHRs) to U.S. hospitals and the five largest private health systems in the country. This is a big deal on paper with a lot of huge names involved. It's the government's way of essentially saying to stakeholders, "Figure out how to work together to improve the flow of patient data from organization to organization, or you will be held accountable."

But, that leads us to the second part of this process—is there enough accountability tied to the pledge? Does it have enough teeth? I asked several big names in health IT throughout the week, and there were varying answers. Here are a few:

Marc Probst, vice president and CIO of Intermountain Healthcare, one of the provider organizations that signed the pledge, said the pledge isn't enough on its own, and many of the folks who signed it were already committed to these actions, making it more of a formality.

Former Office of the National Coordinator for Health Information Technology (ONC) policy director, Jodi Daniel, said, "It's just a promise. There isn't necessarily a hook other than public awareness and transparency about who has done what," adding that the pledge is both positive and limited.

Judy Murphy, R.N., chief nursing officer and director, Global Business Services, at IBM Healthcare, on the other hand, said the pledge will stick. "Vendors will call each other out," she said.

Rasu Shrestha, M.D., chief innovation officer at UPMC (University of Pittsburgh Medical Center), said the key going forward is for vendors to be incentivized for opening their systems. He said it starts with provider customers and patients asking for access to data. "When there is enough of a demand, vendors will have to comply," Shrestha said. Providers choosing vendors that embrace open APIs (application program interfaces) and HL7's FHIR (Health Level Seven's Fast Healthcare Interoperability Resources) standard will move the needle, he said.

2) FHIR Cloud—There was much buzz circulating throughout the HIMSS show floor this week about the "FHIR Cloud," turning the phrase into a trending Twitter topic. I'm not positive anyone can even describe the FHIR Cloud, but at the very least, some cool images come to mind. Early in the week, ONC did launch an innovation strategy that includes two software app challenges with award prizes totaling $175,000 each: one focused on consumer use and one focused on provider use. Additionally, a competitive funding opportunity of up to $275,000 will support the development of an open resource to make it easier for developers to publish their apps and for providers to discover and compare them. The strategy will leverage the FHIR standard and the use of open standardized APIs. Indeed, FHIR was a hot (no pun intended) point of conversation at HIMSS16. But even as FHIR's expert architects admit, there are still plenty of challenges with it, and the standard alone will not solve healthcare's interoperability problems.

3) Slavitt Backs up Docs—Good for Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt, who said at HIMSS16 that he has gone on the road to try to better understand doctors' frustrations with technology. What did he learn from his interactions? Physicians are hampered by a lack of interoperability, regulatory burdens slow them down, and EHR technology is cumbersome. Not that any of this is new information to those who have been paying attention, but still, it's a welcoming sign that a person in Slavitt's position would be so brutally honest about health IT needing to work better for physicians. "I'm not bashful about where we need to be better and take our game up," Slavitt boldly said during his keynote on March 1. "We need a user-centered approach to designing policy." Part of the idea, he said, is for the upcoming Medicare Access and CHIP Reauthorization Act (MACRA) to represent a cultural shift towards value-based care. It should be noted that so little is currently known about MACRA and physicians certainly need to get educated on the law; but, Slavitt seems committed to making this work for doctors.

4) Payer-Provider Convergence—Our Editor-in-Chief Mark Hagland's blog about payer-provider convergence was a terrific read. Per Hagland, "Ten years ago, it would have been virtually unthinkable to have a provider leader (not to mention a physician executive at an academic health system) and a health plan senior executive, follow one another on a symposium program, and say essentially the same kinds of things—from the provider and payer perspectives of course—about payment incentives and collaboration. And yet these were exactly the kinds of presentations that took place at the Business of Healthcare Symposium on Monday [at HIMSS16]." Put frankly, as the business model of healthcare continues to shift, providers' and payers' goals and interests must become aligned as they look to together improve clinical outcomes and bend the cost curve. Shrestha, of UPMC, a health system which has its own health plan, additionally told me that having that vast knowledge of both sides helps the organization understand where all the pain points are since they are leaving and breathing these challenges on a daily basis. "We're putting our money and our mouth is and we're putting our resources where we believe the future of healthcare is going," Shrestha said.

5) Moving Along on the Population Health Train—The healthcare industry is still immature in its population health management capabilities, but it has evolved in the last year. Thomas R. Graf, M.D., of the consulting firm The Chartis Group, said to Hagland in Las Vegas, "With regard to the population health journey, we as an industry now at least know what we don't know...We're past the first step." For Judy Murphy, the population health movement is "more exciting" to her than anything else going on in healthcare. She said, "I get excited about the idea of getting outside the acute care facilities, really starting to think about the continuum of care, and about managing healthcare throughout, whether you are the healthy or the chronic disease management person." Both Graf and Murphy both noted that current EHR systems are not yet marrying clinical and financial data, and that is a core challenge. Murphy also mentioned how important the engagement piece is to population health. "A lot of people think that population health management is getting the data and running the reports. Reports don't change behavior—for the provider or for the patient," she said.

That's all from me from Las Vegas. Any thoughts on my HIMSS16 takeaways? Anything to add? Let me know in the comment section below or on Twitter at @RajivLeventhal.

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