Wednesday, April 22, 2015

What’s new at HIMSS2015?

It was quite busy, especially on Monday
The largest Healthcare IT conference in the world was held in the windy city of Chicago this year. Fortunately, the weather was not too bad, except for an early rain shower, which still allowed the close to 40,000 participants to enjoy a comfortable evening stroll on the “magnificent mile,” i.e. Michigan Avenue.

The overriding theme of HIMSS 2015 was interoperability, and the picture is actually not that pretty. After having spent more than  $28 billion on incentives to implement electronic health records, the US government is discovering that information silos still exist, making exchanging information among EMR’s, and between EMR’s and Health Information Exchanges (HIE’s) or other institutions persistently troublesome.

Vendors advertise that they provide connectivity but when it comes to implementation, they are either dragging their feet and/or charging a premium to provide this capability. As a matter of fact, not only is the Office of the National Coordinator (ONC) getting very concerned, even the FTC (Federal Trade Commission) is getting involved as it now sees "potential threats to competition from high switching costs, data lock-in, and misguided standard-setting activities."

The concern about interoperability was widely shared by attendees, based on the turnouts for relevant talks during the show, for example, the presentation by officials from ONC about the recently published interoperability roadmap for 2015 drew more than 500 people, filling up the room to the max. It will likely require increasing pressure from ONC to get vendors to act and open up their systems to allow for interoperability at little or no extra cost.

The interoperability showcase booth
was bigger and busier than ever

The quest for interoperability was also addressed at the Interoperability Showcase, which demonstrated several use cases that were defined using the IHE (Integrating the Healthcare Enterprise) profile definitions. This area was bigger and busier than ever, showcasing 17 scenarios. The increasing emphasis of interoperability in the Meaningful Use stage 2 and 3 requirements probably also have something to do with it.

Dedicated area to security
Part of the HIMSS exhibition was dedicated to the so-called Cyber Security command center demonstrating how to deal with the increasing threat by hackers who are after personal information stored in electronic health records. As evidenced by the recent Anthem security breach whereby more than 80 million records were stolen, healthcare is the next main target for hackers now that financial institutions are harder to get into. Knowing that a record containing personal information such as social security number, birthday, etc. goes for $5 to $10 on the black market, you can do the math on how much a data breach at Anthem would have profited the hackers. Many vendors showed their solutions to thwart potential intruders. Note that the best way to start is to do a security risk analysis/audit, which is actually required by HIPAA regulations anyway.

Lots of innovative heakthcare IT toys
telerehab using gaming console
There also was an innovation pavilion dedicated to new IT solutions, which potentially could have a major impact. One of the gadgets I liked the most was using a Kinect box (i.e. consumer gaming console) for tele-rehabilitation. The box will track body movements, similar to the tracking used in a video game of golf or baseball, but in this case it is used to assist people in physical therapy. There is even a special sock provided that has sensors and can track gait, foot pressure, etc. and send it using blue-tooth to a receiver. A person will do his daily exercises, which can be tracked and displayed on the TV screen, following an instructor. This will allow many to do their exercises and rehabilitation in their homes instead of having to visit or stay at a rehab center.

drug cap talking with your phone
Talking about sensors, another cool gadget that was demonstrated is an intelligent drug dispenser. It either counts when the cap is removed or, even better, now there is a version that sends that information to a smart app, which can than update a personal health record to register that a person took the medication. This technology could help with compliance and potentially prevent unnecessary medical interventions due to a patient not taking his or her drugs.

One of the fun parts of the show are the many giveaways. This year vendors were not as
my favorite give-away: Vespa
extravagant as they were a few years ago when they were raffling off cars (I remember even a BMW being a prize), but there were prizes ranging from iPads and iWatches all away up to jet skis, and, my personal favorite: a Vespa scooter. I guess it was nostalgia as this was my primary means of transportation when I was in college, which seems eons ago.

In conclusion, plenty of novel new technologies, gadgets and toys, but coming back to the main issue of interoperability, there is still a lot of improvements to be made by vendors. Hopefully ONC (and possibly the FTC) will do due diligence and coerce vendors into opening up their systems and making the connection between EMR’s a reality.