Tuesday, March 1, 2011

HIMSS2011 Recap: It?s All About Integration

The 50th HIMSS meeting held in Orlando, FL, drew more than 30,000 attendees, with large representations from outside the USA. For example, the Dutch arrived with a group of 250 people, which is quite a large contingent considering they have 140 hospitals, this is almost two for each institution. 

The Netherlands is somewhat an exception in healthcare however, especially compared with the US. A recent survey by the Organization for Economic Cooperation and Development of seven countries, published in Nov 2009 compared the quality of healthcare in Australia, Canada, Germany, New Zealand, the UK, the USA and the Netherlands. The results showed, not surprisingly, that the USA was rock bottom in most of the categories, and dead last overall. Perhaps more surprising was that the Netherlands ranked number one. I suspect that this is due at least in part to the high penetration of healthcare IT throughout the Dutch healthcare system. Most primary care physicians already have an electronic health record system, something we in the USA are just starting to implement. 

Electronic records were definitely at the forefront of the HIMSS conference this year. A quick glance of the program showed that at least 10 percent of the presentations have the word "meaningful use" in the title. If you than add the terms of DSS, EHR, and EMR, you can probably add another 10 percent. 

At the same time there were many examples of technology integration, and at a higher level than ever imagined. Radio frequency identification (RFID) technology, for example, now allows for tracking of patients, supplies, and providers. Medical devices are being integrated directly with the patient EMR, home based solutions are capturing information such as glucose levels, cardiac rhythms from heart patients and also basic vital signs. EMR-to-EMR communication was shown, and demonstrated the need for much greater integration in the future. A poll during one of the presentations that I attended asked for the number of disparate systems that a hospital has to manage. A typical hospital has on the average 150 systems for managing the different departments and applications; in this audience there was one CIO who has 350 systems to manage. Imagine the amount of traffic that is going on among these systems. The backbone of the communication interchange is still HL7 Version 2. There were some early adopters who tried to implement the HL7 version 3 messaging but due to its verbosity, failed miserably. 

The good news was that a poll also showed that the majority of the audience had a certified EMR in their facilities, a sign that institutions are catching up fast. There are some requirements in the meaningful use specifications, however, that have impacted data collection. For example, ethnicity is now required, which has raised quite a few questions from patients according to many in the audience. 

Another “buzz word” at this year's conference is the “cloud” used in the context of archiving and/or computing. This is not just a healthcare IT trend, as the national CTO, Aneesh Chopra noted during his presentation. He said that the US government would use this technology for more than 20 percent of its operations in the near future. It is interesting that the “cloud archiving” practice has been around for at least 10-15 years, albeit under a different term, i.e. ASP or SSP whereby institutions archive their images off-site with a provider. The advantage is that this provides a built-in redundancy and disaster recovery solution. Many institutions, especially provider networks, provide their own “cloud,” or as in Canada where cloud computing was implemented on province systems a few years ago. 

With regard to vendor news, it was interesting to see that Microsoft finally seemed to make a commitment, at least from a marketing perspective, to the healthcare IT segment as they were now an anchor exhibitor and had a good-size booth. They also announced a major collaboration with Philips using the Microsoft platform. 

Lastly, it was also interesting to see how little emphasis there was on imaging. The imaging vendors had relatively small booths, and to be fair, the word PACS was nowhere to be found in any of the talks and presentations, indicating that this is certainly not a priority for most CIO’s. 

In conclusion, the show was well worth attending. The presentations were good, although some were overrated, especially the big events with the luminary speakers. Otherwise, it was big, flashy (quite a few sport cars in the booths), fun and pleasant in sunny Florida. Next year will be in Las Vegas, and it is expected that this will boost the attendance with easier access to West Coast attendees; however, we will see whether the Vegas gambling and entertainment scene will draw more than the Florida tourist attractions. 

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