Flying Down to HIMSS19: Yes, We Do Know Where this Train Is Headed

Feb. 9, 2019
The clarity that has emerged at the HIMSS Conference in the past several years is a welcome development, in an industry tasked with creating and executing on transformational change

Anyone who might claim to be a “grizzled veteran” of HIMSS—and I would include myself in that category, both because this year’s HIMSS Conference in Orlando will be my twenty-eighth HIMSS, as well as because my beard has grown progressively grayer over the years—would be able to recall what HIMSS Conferences past were like, compared to those of the most recent years.

I’m thinking of the substantive differences in the conference, though of course, there are clear differences even on the most superficial level as well. HIMSS91, the first HIMSS Conference I attended, attracted 1,800 attendees and 164 vendors, when it was held at the San Francisco’s Moscone Center. Meanwhile, HIMSS18, held at the Venetian Sands Convention Center, attracted 41,423 attendees on Monday, March 5. But more substantively, I still remember vividly electronic health record (EHR) vendors boasting in 1991 about building very closed clinical information systems; and I think now, in retrospect, about how scattered the overall atmosphere was, around information technology solutions, and around everything else.

Fast-forward 28 years, and we’re in a completely different policy and operational environment nowadays. As I’ve often noted, the Medicare actuaries continue to project dire healthcare cost increases. Back in February 2017, the actuaries predicted that overall U.S. healthcare expenditures would explode to $5.548 trillion in 2025 from $3.5 trillion in 2017—an increase of at least 57 percent over eight years—and would increase to 19.9 percent of gross domestic product (GDP) by that year. Then last year, the actuaries adjusted that projection very slightly, predicting that we would see 19.7 percent of GDP devoted to healthcare by 2025—but still a breathtaking percentage. In any case, whatever the specific projection details, the overall picture is clear: our U.S. healthcare system is on track to go over a cost cliff within the next decade.

And that cost trajectory is driving the federal, state, and private purchasers and payers of healthcare to in turn drive providers forward to make the U.S. healthcare system as cost-effective as possible. And that in turn is creating an unprecedented level of focus in the industry, driving internal healthcare system reform as never before. And with the focus on the shift from volume to value driving everything forward, healthcare IT leaders have got their work cut out for them—but also, are operating in a landscape that’s clearer than it’s ever been.

The past five years in particular at the HIMSS Conference have seen a kind of alignment of energies that hadn’t existed a decade earlier. In the past few years, instead of seeing dozens of themes highlighted in presentations and speeches, and in vendor booths on the exhibit floor, only a small number of themes are now typical—all of them in some way connected to accountable care, population health management, care management, clinical transformation, and efforts to make the healthcare system more cost-effective and efficient (including revenue cycle management), as well as to secure our data and information technology, all with existing or emerging information technologies (with emerging technologies very much including artificial intelligence and machine learning).

The landscape is also broadening, even as it becomes more focused: more and more, the social determinants of health are becoming a major part of the discussion; and that is clearly a good thing.

All of this is by way of saying that, more than ever before, it’s possible to predict the overall themes that will emerge at HIMSS, in advance, simply because of the healthcare system’s increasingly focused trajectory and forward evolution.

And that is good for HIMSS attendees and for healthcare IT leaders more generally. Still, along with the clarity of the healthcare system’s trajectory comes the other side of the coin: an intense and continuously accelerating pressure on CIOs, CMIOs, and all of their colleagues, to achieve early and robust results, as they help to lead in leveraging healthcare information and other technology in order to rework the core of patient care delivery. Everything about this is complex, and none of it is easy.

But at least we do have a level of clarity that didn’t exist years ago—certainly not 28 years ago, but also, not at the level of clarity we have now.

So it will be fascinating to attend educational sessions, presentations, speeches and town halls this year at HIMSS19, and to visit the exhibit floor, and to engage in discussions with colleagues from all across the industry. And not expecting to be surprised is totally fine—because clarity on the path really is worth a great deal these days, as this train accelerates forward into the future.

So I wish everyone who is attending HIMSS19 a terrifically successful conference; and I look forward to connecting with so many colleagues there, and look forward to the learning, sharing, and discoveries that are inevitable—and welcome—at our industry’s industry-dominant conference. So, Happy HIMSS19 everyone! May we all learn, grow, and prosper.

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