The Digital Health Revolution and HIMSS
A digital health revolution is underway. Technology, regulation and consumer demand has led to the rise of a more intelligent, patient centric and secure healthcare system. Clinicians, entrepreneurs and healthcare advocates are using technology and digital products to not only provide care in new and better ways, but also help consumers avoid becoming patients in the first place. This transformation was evident at the Health Information and Management Systems Society (HIMSS) conference, a flag ship event in the healthcare calendar.
Intelligent Healthcare
The keynote by IBM CEO Ginny Rometty set the tone for the conference. The continuing shift to value based care and the rollout of meaningful use provisions have pushed providers to capture an enormous amount of information about patients and interactions over the last few years. Stage 3, which emphasizes outcomes, has accelerated this trend. With the merit based incentive payment system under MACRA in its first performance year, CMS offered a primer at HIMSS adding to the urgency.
Both healthcare infrastructure and healthcare intelligence are vital to achieving the vision of value based care. On the infrastructure side, interoperability continues to be an important issue as providers, EHR companies and application vendors try to work with each other to collect and store data. However, healthcare has its own unique language and ontology. Platforms that can make this ontology available to practitioners, vendors and patients will be critical to understanding healthcare data and gaining insights from it. Otherwise, AI itself will be pretty dumb.
On the intelligence side, HIMSS featured a number of analytics shops including IBM watson. Ginni Rometty declared that “Artificial Intelligence and Cognitive Computing are mainstream and here”. The “here” part was evident at the conference with a number of providers and vendors highlighting how they have adopted technology to deliver better care. Dr. Rasu Shrestha from UPMC discussed how AI can alleviate physician workloads. Geisinger officials talked about delivering greater patient and provider engagement. Smartphones, wearables, medical devices, apps, hospital operations, public , telemedicine and EHR systems themselves are all generating enormous amounts of valuable data. Solutions that leverage technologies like AI and ML to understand and act on this data will be the key to delivering smarter healthcare.
Patient Centered Healthcare
Patient experience was a major theme at HIMSS. Almost 1/3 of all workers are enrolled in a high-deductible health plan with significant out of pocket expenses. Consequently, patients expect and demand the experience they receive from consumer products and are more willing to try digital products. Secondly, patients are more involved in their care. As seen below, nearly 70% of adults track a health indicator and a third did research online.
As a result, patients are making decisions by themselves and sometimes without the doctor’s input. This trend has enormous implications for various healthcare program such as population health where people are often put into categories based on indicators like medical conditions, lab results, age and billing information. However, clinical care only accounts for a small percentage of the impact on outcomes. Psychological, behavioral and environmental factors play a much larger role. To achieve the goals of value based care, treatments and interactions should also take these factors into account and have to personalized to each individual patient. Providers, vendors and even large corporations are increasingly moving in this direction.
Historically, people have been trained to be passive recipients of healthcare and it is in everyone’s interest to change that. Developing preventative programs, ensuring medication adherence, helping manage patient costs, building a support network, and addressing caregiver needs are all programs that have to be tailored to the needs of each person. Patient-centered and patient-specific care is the future.
Secure Healthcare
Security was once again an important topic of discussion at HIMSS. The health and human services website has a running list of breaches that total over 171 million records over 8 years. Unfortunately, healthcare data is a very attractive prize and the industry will continue to be a major target.
A number of CISOs shared their views on attacks and the measures being taken to defend hospitals and patients. Daniel Nigrin from Boston Children’s Hospital, for example, described a DDOS attack and the value of being aggressive, but also having a plan to operate with limited internet access. Don Lindsey from Tallahassee Memorial Healthcare highlighted the privacy and security risks that social media can introduce.
IoT security and medical device security also featured prominently in conference workshops. 87% of healthcare organizations are projected to adopt IoT technology by 2019 and tools are needed to properly monitor and maintain this infrastructure. Medical devices with wireless connectivity and remote monitoring can pose huge security challenges and government regulators have focused heavily on protecting these devices.
Startups that can address or at least diminish the security problems in healthcare will generate a lot of value. However, as seen above, healthcare organizations are already buying a variety of tools. More technology will certainly help, but it is important to realize that better management and the training of the human workforce will also go a long way in mitigating some of the threats.