Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are:
Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the dire health economics in the U.S….and opportunities for driving waste out of the American health system. Hillary Clinton’s keynote, too, spoke to embracing evidence-based processes into American health care, incorporating what we know we know to be true, and de-politicizing the process of health innovation. The U.S. is now on the road toward paying for value-based care.
Patients via infomated patient engagement are the blockbuster drug that can help all three pillars of The Triple Aim. The formation of the Personal Connected Health Alliance, between HIMSS, the mHealth Summit, and the Continua Health Alliance (which represents mobile and wireless health companies (such as major telecomms and platforms like Intel and Qualcomm) signals that “mHealth” is morphing into overall health information systems. Think of how “e-business” is now just part of doing “business.” That’s what is happening to “m,” which speaks to how Matthew Holt (@boltyboy), co-Founder of Health 2.0, has talked about “un-platforms” for several years. Furthermore, HIMSS grew the patient message in the 2014 meeting by allocating precious (and beautiful) exhibitor floor space to the Connected Patient Learning Gallery, featuring 4 kiosks of interactive learning: health management, wellness social & behavioral, financial health, and home health.
Electronic Health Records adoption isn’t the end-game: deeply using EHRs is. We are in danger of providers chasing incentive payments and ticking off boxes for Meaningful Use without being mindful of the more strategic opportunities that EHRs afford. Many health providers simply treat the EHR as a digital-paper record without exploiting the opportunity to change and optimize workflows, and develop team-based care that’s enabled through the EHR and collaborative platforms for sharing care responsibilities across different clinician types — and also virtually bringing patients and caregivers on the care team.
Pharmacies are getting increasingly tied in to the healthcare ecosystem, with health IT systems inter-operating with other traditionally siloed health databases. CVS Caremark joined the CommonWell Health Alliance, and five major pharmacy chains are committing to Blue Button to enable patients to more easily access their personal health information. CVS MinuteClinic is transitioning to the EpicCare EMR, and Walgreens is working with UCSF Medical Center to manage prescriptions and share electronic patient records.
Making meaning out of emerging data sets and flows is now possible, and necessary. Big data and data analytics are popular flavors in 2014. That’s not popularity-for-popularity’s sake. Now that peoples’ health data are getting digitized past a tipping point in community medical practice, we must move on to taking advantage of data liquidity and understanding what the numbers mean for higher-risk individuals (e.g., identifying and anticipating patients before they enter trouble zones, like moving from pre-diabetes to developing Type 2 diabetes , or preventing a patient from being re-admitted to the hospital).
Great design is still missing from health IT. But several education sessions spoke to design, such as Azul7’s meet-up talking about empathy and human-centered design — especially important for health applications. More on Azul7’s approach can be found here. Another lens on this is Juhan Sonin’s work in user-centered design for health at MIT. The more retail health care becomes for consumers, patients, and caregivers, the more design must play a role from the earliest conceptions of health IT tools. Currently, design-thinking is largely an after-thought in health IT development.
Healthcare is happening everywhere…and increasingly outside of the hospital. Telehealth is proving cost-effective in a variety of settings across many medical conditions and patient types, from wellness to managing patients with congestive heart failure at home. Alere’s HomeLink remote health monitoring solution received FDA market clearance in January 2014, following WellDoc’s FDA clearance for prescribing the BlueStar patient self-management program. Telehealth has finally reached the post-pilot program stage with real business models for programs targeting heart disease, medication adherence, intensive care in the home, and access to specialty clinicians.
The synthesis: Taken together, these takeaways point to mainstream hospitals and physicians beginning to embrace — beginning to — value-based care. The CIO is thinking more like the CFO – and vice-versa – as The Triple Aim becomes the operational mantra. The Chief Medical Information Officer (CMIO) will be a key player for health providers to provide a bridge and evangelist for making sense out of the increasingly-liquid data coming available through EHRs. Those providers who don’t start to make sense out of the data to drive population health that enables them to take on risk in payment paradigms will be left behind.
Furthermore, as more care moves outside of the hospital walls to the home, health providers will need to advance their information technology expertise and relationships to care providers in the community – especially pharmacies, the new IT-enabled home care teams, schools, grocery stores, and to patients and caregivers who must take on more self-care duties. The Connected Patient is the new-new thing.