Healthcare Technology Featured Article

April 15, 2013

Seven Key HIT Takeaways from HIMSS 2013

The Healthcare Information and Management Systems Society (HIMSS) annual conference has been called a cornucopia of interesting and professionally relevant activities and events for a healthcare information technology (HIT) professional. Amid all the activity – countless education sessions, an exhibit hall brimming with innovations and myriad opportunities to generally interact with the HIT universe – the following seven takeaways stood out.

1) Meaningful use (MU) is the “new normal.” MU “took the air out of the room” when it burst on the scene a couple of years ago. However, EHR vendors are now used to the government issuing them requirements (instead of just customers or management) and have a pretty good handle on MU’s stages.      

So where does that leave us? HIT in 2013 will be influenced by new market forces created by:

The increasing rise of value-based care and reimbursement in the public and private sectors and the shift away from fee-for-service.

Consolidation of the provider market owing to retirements in the aging physician workforce, the gobbling up of practices by integrated delivery systems and the laggards finally getting on board with HIT.

Dissatisfied EHR customers, customer position on the adoption curve and the need to maximize revenue from an existing customer base.

New strategic imperatives for population health, patient engagement and medication reconciliation.

2) Making existing EHR solutions better. Now that MU is the “new normal” and EHR adoption is steadfast, it’s now about making existing HIT solutions more valuable. Certainly there will be a move to improve transaction-based EHRs, which enhance data collection on individual patient encounters and improve billing.

In the future, we can expect EHRs with wider data collection, analysis and reporting capabilities. Solutions can be extensions or bolt-on.

EHR usability will also remain a focus in 2013, as MU stage 2 requirements call for user-centered design. These requirements mandate that product managers and developers work closely with end users to create, review and revise specifications and features to ensure their usability – often employing such methods as focus groups.

3) Clash of the titans over data sharing. The success of value-based care and reimbursement depends on data sharing. This point was made loud and clear in a Keynote address by Farzad Mostashari, MD, National Coordinator for Health Information Technology, who juxtaposed the needs for information exchange and large-scale community data repositories with industry resistance. Frustrated by lack of progress, he put everyone on notice that the federal government will be using “every means at its disposal, including policy and payment levers and the bully pulpit, to encourage data sharing and discourage recalcitrance. No one should make a profit hoarding data,” he said.

Why does the government believe it needs to step in? The simple answer is that health systems, payers and providers do not want to share data because of alleged competitive advantage, and the perceived low return on the investment of constructing interfaces. But there are other legitimate information-sharing needs – such as data exchange for public health purposes – that are not being met.

Sometimes considered the “bad guys,” EHRs are just responding to their clients.

4) Population health. Population health is critical to the financial success of emerging value-based payment systems. Conducting prospective, pre-emptive care management for population groups will depend on HIT, interoperability, data and data analysis. It’s already in its formative stages. For individual providers, population health currently means taking action on the outcomes of clinical quality measures that they are calculating for MU for their “population” of patients. 

For integrated delivery networks, population health means rolling up the individual provider data, doing trends analysis and targeting improvements among their network providers, which offer a continuum of care to a specific market or geographic area. Payers and PBMs can roll up that data and take analysis to the next level to identify cost reduction and care improvement opportunities.  

Successful population health down the line requires much more sophisticated and wider-ranging level of data collection on covered populations than most health care organizations have now. But we have a place to start: there is now more discrete, codified data being recorded at the point of care. We just need better tools to mine it more effectively.

5) Patient engagement. Patient engagement is inextricably linked with population health. This concept is simple: patients have a bigger role in care decisions based on consumer-oriented, evidence-based advice. Consumers also have the opportunity to inform the care process by electronically providing information regarding their status and regimens, as well as accessing clinical data. In addition, they’ll be able to take advantage of social support networks and electronic tools that can motivate them more to participate in their care and follow treatment regimens.

As former Apple chief executive officer John Sculley pointed out in an address at an invitation-only event, the consumerization of healthcare holds really big opportunities for innovations.

6) Interoperability. Interoperability has been a hallmark of HIMSS for several years, but this year yielded the biggest and most impressive Interoperability Showcase. It’s important, of course, because if we can get to a point where patients’ comprehensive medical records comprise discrete data captured at the point of care (not claims data), legitimate predictive analyses can be accomplished and proactive care coordination can occur.

Breaking down remaining barriers to interoperability will be one of this year’s biggest challenges.

7) Industry initiatives. Big things can be accomplished once key players decide they’re ready to act. One such example is the newly announced CommonWell Health Alliance, an interoperability initiative of six EHR vendors to connect patient data across competing health data systems. If CommonWell accomplishes two things, it will significantly advance HIT and the quest for interoperability. The first is the creation of a large-scale master patient index (MPI). This has been a long-standing need in healthcare, and will become even more necessary to track patients as they transition across the continuum of care, to identify and manage risk and to match outcomes with payments. However, national MPI development has been stymied over the years by a variety of factors, not the least being resistance by patient privacy advocates. The second CommonWell opportunity is helping to standardize an HL7 data interface implementation guide and squeeze out variations among existing ones. This is a big undertaking that is sorely needed.

With 34,000 attendees in attractive locales, HIMSS is sometimes viewed as a boondoggle by supervisors, those who have never attended or the overwhelmed; in fact, it’s a bellwether event for not just health IT, but healthcare in general.

If these takeaways haven’t shown up in your purview yet, they’re likely to in the not-so-distant future.

Edited by Braden Becker
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