• by Bruce Carlson
  • February 11 2019
  • EMR


Interoperability? AI? Value-Based Care? What Issue Will Dominate HIMSS 2019?

Interoperability? AI? Value-Based Care? What Issue Will Dominate HIMSS 2019?

The Healthcare Information Management Systems Society’s annual meeting (HIMSS) begins in Orlando, Florida this week.  EHR vendors such as Epic, Cerner, Allscripts, athenahealth and GE Healthcare will demonstrate innovation while attendees meet to talk usability, ROI on innovation, blockchain and interoperability.     Electronic Medical Records (EMR) software, related hardware and services to produce EHRs for patients and providers is a 30+ billion-dollar business  and Kalorama Information will be watching developments at the meeting.  Our report on the EMR Market is located at: https://www.kaloramainformation.com/EMR-Electronic-Medical-Records-Physician-Hospital-EHR-Geographic-Regions-Trends-Issues-11633681/

Push on Interoperability

As in past years, healthcare IT professionals and vendors will be focused on making EMRs of different vendors talk to each other.  "Interoperability Moonshot: Project Gemini," "Sharing Clinical Knowledge as Interoperable SMART on FHIR Applications" and "Interoperability Town Hall: Have we Kept the Patient Focus," as well as a discussion on "Women in Interoperability" are workshops at the meeting. It's hard not to see interop issues as the most important, especially with some buildup in announcements as a result of the recent government showdown.  

The meeting floor will feature a showcase section on interoperability with stages for vendor pitches and use cases.  HIMSS says this is the highest trafficked area of the convention floor.  The Centers for Medicare Services (CMS) will have top staff at this important meeting.     Since announcements last year at HIMSS18, the US Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have been working on a number of initiatives focused on facilitating interoperability and greater patient engagement. Hear from the two agency leads on the progress of this work, as well as other projects they are leading to transform our healthcare system.  Alex Azar II Secretary, Health and Human Services and Seema Verma Administrator will discuss. 

AI on Stage

Yet HIMSS is the premier healthcare IT meeting, and thus artificial intelligence will be a significant focus as well.  Sessions include: "AI Optimism and the Race for Talent," "Synergies Between Man and Machine," "AI and Imaging: Your Data as a Strategic Asset," "Cognitive Computing and Real-World Data in a Breast Cancer Clinic" The show opens with an AI for Healthcare presentation.  Machine Learning & AI for Healthcare brings healthcare IT decision makers together for insights and face-to-face dialog about how hospitals are using AI and Machine Learning to reduce costs, improve care outcomes and more.  Thursday's look at AI in Clinical trials asks Machine Learning and Artificial Intelligence is a rapidly expanding field in many industries. Can AI find better matching patients faster and increase accuracy of protocol feasibility for clinical trials?  

 "While EHRs have helped hospitals create a central repository of their clinical and financial data, extracting accurate, reliable and actionable analytics for right time decision-making is a daunting challenge “  wrote Andy Dé, senior director, Healthcare and Life Sciences, Tableau Software; a HIMSS social media ambassador in a recent blog:https://www.himssconference.org/updates/how-will-convergence-artificial-intelligence-and-analytics-impact-healthcare-and-life-sciences-2019   “Leading healthcare organizations have deployed next-generation analytics platforms to deliver actionable insights integrated into their EHR’s clinical workflows to empower their executives, clinicians and nurses at the POC. In 2019 and beyond, they will bolster this by integrating machine learning and NLP algorithms to enable predictive analytics powered patient risk stratification, proactively identify the most at-risk patients likely to overstay their length of stay and at risk of 30-day re-admissions.”

Given these potential meeting themes interoperability would seem to have a slight edge as it is a requirement of EMR meaningful use, the regulatory standard for EMR users to attest usage that enable them to earn subsidies and avoid penalties.  Providers will need to implement interoperable systems that participate in local health information systems (HIEs) and actively exchange data with hospitals, payers, and other providers in order to qualify for reimbursement. Ambulatory providers must consider the choices carefully in order to collaborate with local hospitals and HIEs that extend CPOE capabilities to local hospital laboratory and radiology facilities. There’s payor funding behind this trend - Interoperable EMRs also create additional efficiencies for providers because they are able to see and exchange data from across the continuum of care for care and disease management activities and improve the quality of care and lower costs by reducing the number of duplicate tests and procedures that are performed because data on past care is not available.   And the recent government shutdown caused a delay - As HIMSS 2019 approaches, healthcare professionals continue to watch for a long-awaited rule on information blocking from the Office of the National Coordinator for Health IT and a new interoperability rule from the Centers for Medicare & Medicaid Services. The 35-day government shutdown impacted their release.

Other Issues

 Of course, it's possible that neither AI nor interoperability will generate the key takeaways from the meeting.  First of all, there are ways AI and interoperability are related; as at least one seminar ("Artificial Intelligence – A Solution for Interoperability?") is discussing, there are proposals to use AI to navigate interoperability differences between vendors.  

For its part, HIMSS outlined up to four trends the association thinks is important to watch In  In the run up to the meeting, the Health Information Management Society made four predictions for 2019.  The report — "2019 Healthcare Trends Forecast: The Beginning of a Consumer-Driven Reformation" — outlines four predictions for the state of healthcare in 2019, based on commentary and analysis from various healthcare experts.   Among those are:  1. Digital health startups will need to demonstrate tangible results and do more than ride the "peak of the hype cycle." 2. Consumer pressure   for greater access to  convenience, choice and, most importantly, cost transparency."  3. Financial and demographic challenges will drive   data-driven care and continuity of care   4. Data-privacy debates will drive policy changes.

The HIMSS document suggests a third option which is value-based care.  Patients increasingly want personalized care, which is driving healthcare providers to turn to value-based care models, a pay for performance model that rewards providers for quality care. Value-based care is one of the trends HIMSS predicts will gain ground in 2019, according to its recently released report, "2019 Healthcare Trends Forecast: The Beginning of a Consumer-Driven Reformation."   Conference speakers like Karen DeSalvo, the national health IT coordinator under the Obama administration, and Terrence O'Malley, a clinician at Massachusetts General Hospital, think patient-centered care and value issues will be an important focus.   Because patients are demanding better service and more transparency, healthcare providers are starting to pursue value-based care models, and that's changing how healthcare services are paid for and delivered.   Insurers, the government and patients are demanding lower costs for services, as well as more transparency into how healthcare spending results in quality care.