Healthcare Technology Featured Article

May 07, 2015

HIMSS15: On FHIR and 6 Other Key Takeaways

Poet Carl Sandburg called Chicago “The City of the Big Shoulders.” Its big shoulders were definitely needed for the 2015 meeting of the Healthcare Information and Management Systems Society (HIMSS). The annual event is where every thought leader, power broker, executive, and shaker and mover in the growing and increasingly important category of health information technology converge to move the industry forward. This year’s conference was the largest yet, with a record-setting 1,300 exhibits and 43,000-plus attendees.      

It was also the most thought-provoking. Here are the seven key takeaways from this year’s meeting.

1.  FHIR. The biggest buzzword at the meeting was FHIR (Fast Health Interoperability Resources). It’s among the newest in HL7’s family of standards, and everyone is excited about its simplicity and potential, especially because it will facilitate the exploding use of application program interfaces (APIs) developed in response to meaningful use (MU) stage 3 and other drivers. FHIR is a modern Web services approach used by Yahoo, Facebook and Google, among others. It is data-centric, which makes it easier for systems to exchange discrete pieces of information. This contrasts with the document-centric approach of C-CDA (Consolidated Clinical Document Architecture), in which the exchange of entire documents is required. FHIR also allows access to smaller or “granular” data elements that are not included in some clinical documents. The ability to isolate and exchange well-defined pieces of patient and clinical data has been a pressing need. While FHIR’s potential is exciting, the jury is still out as to whether it will catch fire (pun intended) or flame out.

2.  Interoperability. Interoperability has been highlighted at HIMSS the past several years. It took on added importance and buzz this year because of recently announced efforts by the Office of the National Coordinator for Health Technology (ONC) to address the perceived need for truly interoperable health care. Ironically, it was hard to find a lack of interoperability among the HIMSS15 vendors. Everyone seemed to be showcasing how easily their products connected to the health information technology (healthIT) ecosystem.

3.  EHRS. In past years, electronic health record (EHR) vendors hyped the “next big thing.” There seemed to be a dearth of that this year. Instead, vendors emphasized existing products that are improved and easier to use. Process improvement was much in evidence. We suspect that vendors this year are reacting to providers who’ve said they are frustrated with their EHRs to the point of replacing them and considering opting out of MU.

4.  Population health. The importance of data analytics was reinforced in the focus on population health at HIMSS15. The 26th Annual HIMSS Leadership Survey, which was unveiled at the meeting, highlights the importance of healthIT-driven population health management, patient engagement and strategic planning to improve care quality and delivery. The survey shows strong executive support for adoption and use of healthIT infrastructure, such as clinical analytics. The move toward better data and analytics was typified by the collaboration by NextGen and Milliman to license new technologies that offer risk analysis and predictive modeling, which will facilitate population health management and collaborative care initiatives. Milliman will be in charge of stratification and analysis of Medicare patient data, the exchange of health data among providers and patient risk scoring. NextGen will be responsible for managing EHR work flow and addressing collaborative care management processes. This is a great example of how the results of data analysis and modeling are being made actionable within the physician’s EHR work flow.

5.  Patient engagement.  With the related requirements under MU stage 3, it’s no longer a matter of when patient engagement will happen but how to expand it. Personal health records were barely represented and have been relegated to “yesterday’s news.” Portals — “the” solution from last year — are evolving to a “portal of portals,” consolidating access to multiple sites in a single view, driven by the recognition that patients won’t log in to multiple Web sites to access data from each of their physicians. They will consolidate data obtained from wearables, monitoring devices and other innovations, expanding consumer involvement. However, this raises the question of what a clinician finds valuable versus what is “noise.” What was missing was how to motivate patients to become — and stay — engaged. Research shows that use of health and wellness technologies tends to drop and stay off after an initial surge. Humana President and CEO Bruce Broussard clearly had some solutions for that from a payer standpoint. We think it’s this kind of collaboration among health care stakeholders that will lead to the answer of the question of how to keep patients motivated to become true participants in their health care.

6.  Medication management. Pharmacy traditionally has been underrepresented at HIMSS but is now coming into its own, if this year is any indication. There were sessions about ePrescribing (such as how it’s progressing in Europe) and medication management (such as a patient-centered pharmacy home for the chronically ill). However, what really brought home the rise of medication management at HIMSS was the first-ever pharmacy-related keynote by Alex W. Gourlay, Walgreen’s president and executive vice president of its Boots Alliance. The world’s biggest drug retailer, Walgreens has more than 8,200 stores in the U.S. alone and 4,500 more that are branded as Boots in Europe. Gourlay talked about Walgreens’ traditional line of business but then provided a twist: Walgreens’ movement to technology-driven care management. He shared his vision of how the company will use various technologies, such as mobile video calls with doctors to teleprescribe antibiotics and the medication reminder app Walgreens developed for the Apple Watch, among other things. This definitely signals a change in the world of medication management and will create related opportunities in the world of healthIT.   

7.  Size matters.  HIMSS is one of the country’s largest meetings of any type. Its size is both a blessing and a curse. On one hand, just about everybody in the healthIT world is there, making networking and building of business relationships efficient. It is truly one-stop shopping, which creates value for the investment of time and resources it takes to be there. On the other hand, the size of the meeting makes it impossible to see all the exhibits and attend very many sessions. Moreover, HIMSS really needs to think about the education sessions that were sparsely attended because of competing opportunities, for sure, but perhaps also because they require proposals to be submitted so many months before the event, making many of the sessions irrelevant when the meeting occurs. By the way: the calls for 2016 closed on May 1 for educational sessions and will close on June 15 for other proposals.

All in all, HIMSS15 was a valuable — if exhausting — meeting. See you next year in Las Vegas.

Edited by Dominick Sorrentino
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