We, the editors of Healthcare Informatics, will be joining, very shortly, an anticipated 40,000 people at the Orange County Convention Center in Orlando, Florida for the HIMSS17 Conference and Exhibition, sponsored by the Chicago-based Healthcare Information and Management Systems Society. The sheer size of the HIMSS Conference has grown steadily in the past two decades, as the 1993 event, held in San Diego, drew 4,000 attendees, according to a review of HIMSS history. Last year’s HIMSS conference drew a total of close to 41,000 attendees. Going into HIMSS17 in Orlando, we are anticipating it will be bigger than ever, and as frenetic with activity as ever. As veteran conference attendees well know, once the conference begins, it becomes a sprint to pack as much networking and education into five days as possible all the while trying to navigate between point A and point B through crowded hallways. Over five days, HIMSS17 will feature 300 educational sessions and 1,200 exhibitors, and, keep in mind, last year’s exhibit space occupied over 1.3 million square feet of space. Additionally, HIMSS is projecting an attendance of 45,000.
While the volume and sheer size of the HIMSS Conference have steadily grown, more importantly, in the last two decades, healthcare IT issues have become central issues for U.S. healthcare. The healthcare industry is already tipping into transformational change—change that is already occurring at many patient care organizations, with the shift to alternative payment models (APMs) and delivery system reform. And, it has become clear to many healthcare leaders that health IT will be absolutely essential to any shift away from volume to value. Additionally, with a new Administration in the White House, it seems almost certain that more changes are to come with regard to federal healthcare policy. As in year’s past, this year’s HIMSS conference promises to provide fascinating insights and perspectives and ongoing innovations that are helping to shape this industry at this crucial inflection point in healthcare. And, there are sure to be some surprises at HIMSS, as well. With this in mind, we interviewed healthcare IT leaders to gain their insights into what to expect at HIMSS17, to provide you, our readers, with a HIMSS Survival Guide that can serve as a forecast for this year’s conference.
What will be the biggest buzzwords and “buzz concepts” this year?
Charles E. “Chuck” Christian, vice president, technology and engagement, Indiana Health Information Exchange, Indianapolis, IN:
Other than FHIR [Fast Healthcare Interoperability Resources], I think you’ll see several iterations around “blockchain.” I’d had more than one conversation with several folks on the topic. It’s more about what we can do with the technology, can it apply to healthcare and how might it apply. I’m unsure if there is really a revenue model for it yet, but one can never tell.
Joseph Scopelliti, IT director, data management, Geisinger Health System, Danville, PA:
I’ve got to believe that security’s going to be very big this year, and everybody’s concerned about breaches. And of course, analytics is going to be huge, too. And also, with the change of administration in Washington, that’s going to be big.
Vince Vickers, KPMG’s healthcare technology leader:
I believe there have been the same topics for the last two years and I think we’re going to see a shift this year. We’ll see more interest in machine learning, and I think that’s going to be a hot topic. I think we’re going to see more discussion around efficiency from an operational standpoint around software bots and process automation. There’s a number of startups that I see are going to be there around data and ownership of that data, and patient access to their data using new technologies like blockchain. Looking through the exhibitors, I believe there’s like nine or 10 blockchain-related vendors that are going to be at HIMSS, so that’s going to be an interesting topic. Additionally, we saw a significant number of high profile breaches from a cybersecurity perspective in 2016 and that is not going away. As that’s becoming a bigger challenge, I suspect cybersecurity is going to be a big topic as well. I think we’re going to see and hear a lot about patient access and patient experience. Regardless of what happens with the Affordable Care Act (ACA), I think the consumerization of healthcare is going to continue to be a hot topic, and that includes mobile technologies and anything around the patient experience.
Gregg Mohrmann, partner, The Chartis Group:
Where we kind of see things going is IT elevating itself to the enterprise strategy level, and really tying the IT strategies to the business strategy. Ten key topics, in no particular order: electronic health record (EHR) value realization; business informatics, paired with finance and administrative systems; innovation and digital health; continuing to align IT and its value to the enterprise strategy; precision medicine and genomics; convergence of performance improvement and analytics to drive value; the new administration and implications; integrated care management—population health on steroids; what I would call one-stop-shop access centers, not just call centers—for patients and consumers; and clinically integrated networks, which ties to interoperability and common EHRs. Those are the top ten trends we see.
Gregg Mohrmann
As far as what the vendors will pitch, there’s going to be a lot of analytics of all forms. How do analytics platforms do more for you in terms of driving data along with different EHRs? The other piece of that is integrated care coordination, extended outside the hospital walls, to social work, SNIFs, etc., using apps to drive actions and activities of all of those working outside the hospital walls. The third thing will be telehealth and digital health, and tying those into the systems, and new ways of getting to your consumers, anything from even teleconsults, how you tie in the home, the workplace, etc., from a technology perspective. I think there’s going to be a bit on precision medicine and genomics. Now, I think the spin on that will be on how traditional vendors deal with it in terms of the storage (tons of data) and the analytics; and also, how traditional vendors will incorporate precision medicine not only into the analytics, but also the workflow. And the whole clinical trials management piece, we see a lot of that coming in. If you could target people from a precision medicine perspective, into clinical trials and into the post-acute care setting. And the big 50 healthcare institutions are doing precision medicine. So how that all ties together, so having that functionality across those.
Will we see a significant promotion by clinical IT vendors of FHIR-enabled/FHIR-supported apps on the exhibit floor?
Charles E. “Chuck” Christian, vice president, technology and engagement, Indiana Health Information Exchange, Indianapolis, IN:
I’m thinking that the majority of the EHR vendors’ booths will be on FHIR (pun intended). It is all the buzz and there appears to be a solid push from the ONC [the Office of the National Coordinator for Health Information Technology] and others in D.C. to provide a level of access to the data for the patients. However, there are those that are concerned about the legal ramifications, which may or may not be well founded; we need lots of attorney discussion on this one.
Charles E. "Chuck" Christian
Joseph Scopelliti, IT director, data management, Geisinger Health System, Danville, PA:
As far as FHIR-based apps—I’ve got to believe that there will be more of that.
How is the vendor market shifting to the changes we will be seeing in health IT policy, and how much conversation will there be around these topics at HIMSS?
Leslie Kriegstein, vice president of congressional affairs, the College of Healthcare Information Management Executives (CHIME):
Even with the change in administration, we can very much anticipate that the shift to alternative payment models (APMs) and delivery system reform—ushered in by IT systems—is here to stay. I would expect that the conversation around the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and around APMs to continue to rise in prominence. Looking at our membership, the traditional hospital/doctor boundary is blurry, and so many of our CIOs are concerned about MACRA and ACI [Advancing Care Information, a new performance category under MIPS] as well as the traditional Meaningful Use, so those conversations are here to stay, will expand and definitely not shrink. Given the fact that MACRA was such a bipartisan proposal when it came to Congress, I would anticipate that of all the reform programs, that program will stick around and be of interest to policy makers. I think this is definitely the long-term policy planning that our members and vendors are planning for. Understanding providers’ technology needs going forward is at the top of vendors’ lists.
For 21st Century Cures, there is still very much that is up in the air, because the new federal advisory committee hasn’t been formed yet, and we don’t know who the head of ONC will be. Although there were some details in the statute regarding the functionalities about what vendors will be reporting on, a lot of that will still have to be flushed out when the leadership is identified. It’s definitely on vendors’ radars, and will increasingly be on providers’ radars. I do think that the fact that the information blocking components go into effect very quickly will be on the top of the priority list. Some of the other components, though—the usability, interoperability, security reporting, and the new EHR reporting program that Cures creates—is less of an immediate priority due to the uncertainty around it right now.
Regarding policy developments at HIMSS this year, there are a few things that are still hanging in the balance, and I know the current administration is trying to “clear the decks,” but there is nothing that is at the top of the list that we’re expecting. With this transition, with so many folks being in interim positions, and the civil service versus political appointees still being identified, and the fact that nothing is pending like the Stage 3 final rule, and still being a few months away from any kind of next iteration of rulemaking on the MACRA front, it will be quieter than in years past. Local HIMSS folks are not expecting the new HHS Secretary or CMS Administrator to be there this year. So I don’t expect [policy] to be as prevalent as in years past.
Bradley Howard, M.D., executive medical director, consulting at The Advisory Board Company:
That’s a difficult question, to be honest. From scanning the HIMSS agenda, there are many sessions around moving from volume to value, including a keynote address around risk sharing. Also, cybersecurity is much more emphasized than before. I think the vendor floor will be crowded with booths focused on risk capture, and the big EHR vendors have been talking about their capabilities in this space. This aligns with MACRA very well in my opinion. Keep in mind, the HIMSS request for presentations went out during the early summer and that is driving the agenda, which was finalized prior to the presidential elections. So I suspect the hottest topic of conversation will be what happens to Obamacare, the Trump administration, and how will Medicaid and Medicare be affected. I suspect more than half of speakers will mention the uncertainty that remains.
Bradley Howard, M.D.
As a consultant/provider, what might particularly draw you to a vendor’s booth at HIMSS?
Leslie Kriegstein, vice president of congressional affairs, CHIME:
For the most part, our members go in with a clear expectation if they are looking for a product. So they do less general wandering and more of finding what they’re looking for.
Kevin Coloton, executive vice president, consulting, The Advisory Board Company:
At HIMSS, vendors that offer tactical activities and defined outcomes are going to be the ones that are most attractive to attendees. Consultants and providers who can demonstrate tactical activities and have defined outcomes for those investments are going to be the ones who are most interesting to talk to. We’ve seen that in our work, so clearly defined ROI solutions is the name of the game in 2017.
People are interested in how [others] solve the problem. So it’s not just about the final statistics/numbers, [but they] would love to know the equation. There is so much noise and marketing hype; everyone does HER optimization, but no one defines what they think it is. We do great outcomes—here’s the input we do to get them.
Kevin Coloton
All of the changes in policy are getting more oriented to results, and collaboration between various parties. That’s why there’s momentum around data interoperability and vendor platforms to have better information sharing—collaborating with other vendors that will impact care.
What are you hoping to see or learn at HIMSS this year?
Vince Vickers
Vince Vickers, KPMG’s healthcare technology leader:
Coming off the election, and with the discussions about repeal and replace of the ACA and variations of what could come out of that, it will be interesting to spend some time with people and understand how that impacts their coming year relative to their spending in the IT space, whether they are going to slow down a little bit or if they are going to speed up. I suspect that the sustained, fundamental priorities and interests that CIOs have will likely not change, but I’ll be interested to see if the market starts to freeze a little bit. Hopefully that’s not the case, and people keep moving forward. I don’t suspect trends in priorities will have changed and I’m hopeful that people are not slowing down their efforts, simply because the underlying issues that healthcare is faced with, regardless of what happens with ACA, are the same. Healthcare organizations need to be become efficient and find ways to take out cost. With HIMSS being four weeks after the inauguration, I just wonder, at that point, would that have created more certainty, or more uncertainty?
What will the ongoing consolidation of the vendor space, especially of the clinical IT vendor space, look like, on the exhibit floor, this year?
Vince Vickers, KPMG’s healthcare technology leader:
The exhibit floor, in general, is becoming an interesting animal. Each of the last few years, there’s been one of those big vendors who hasn’t even shown up on the exhibit floor. They have said, effectively, that is not the best return on my investment, we are known in the marketplace and HIMSS has become a large event where the decision-makers are not on the floor. And so, why put hundreds of thousands of dollars into that space. That doesn’t mean that those big vendors don’t have some type of presence there, but not necessarily on the vendor floor. So it’ll be interesting to see if that trend has changed one way or the other. In terms of vendor consolidation, I think we’ll see what we’ve seen in the last few years. As companies acquire smaller organizations, they have brand presence so you use HIMSS as your coming-out party. Here’s who we acquired and you put both logos and both brands out there and use this as an opportunity to tell attendees about why 1 + 1 = 3. That’s what I’ve seen traditionally at HIMSS and I expect we’ll see something similar this year. Overall, I don’t think that consolidation, in total, reduces the number of vendors showing and I don’t think that reduces the number of people attending, as I think the market is continuing to grow, but some of the signage and names may change a little bit.
Should we anticipate any surprises at HIMSS this year?
Gregg Mohrmann, partner, The Chartis Group:
I think we’re going to start seeing some vendors announcing some unique partnerships, because a lot of these things that come together result in combinations that provide better solutions. And I don’t know if we’re going to see any of those partnerships or not, but if you want to continue to evolve in the market, which all the vendors do, I think you’ll see some unique ventures and partnerships. And going along with that, we may see some non-traditional players come into the market, like some of the pharmaceutical manufacturers and some of the medical device companies. It will be interesting— those are some of the things I’ll be looking for. To summarize, and per the 10 topics I mentioned, I think that IT executives really need to strengthen their knowledge of these topics and then educate their fellow C-suite executives. And you’ll need new roles in your IT department, as with precision medicine, for example; and it changes the way you do things; and third, I don’t think you can build an IT plan without pursuing an integrated approach around these individual items.
