Thursday, September 10, 2015

What's new from HIMSS ASIAPAC15

There was a pretty good size exhibition
hall and it was well attended
The HIMSS ASIA Pacific was held Sept. 6 to Sept. 10 in Singapore this year and, despite a good attendance (1,700 professionals), most of the attendees were local, which might not have been such a surprise if you looked at the speaker roster as most of the speakers were from the local region as well. 

In my opinion, it would have been better to call it HIMSS Singapore, as it would have reflected the venue more accurately. The good news is that I learned quite a bit about the initiatives and challenges in Singapore, which basically come down to the fact that there are going to be too many elderly people too soon to be supported by too few workers, which will require a smarter approach to how they conduct their business. Hence the term “Smart Nation” was introduced by the Singapore government as of last year, which includes smart transportation, infrastructure, and homes, but foremost smart healthcare. However, even though the incentive for implementing digital technologies in healthcare is different than in the US and other countries, the objective is identical, i.e. doing things smarter and therefore more efficiently, safely and effectively, and we can use the same solutions.

Singapore still has a long way to go with regard to electronic health record implementations they are about five years behind where the US is right now. In addition, with regard to imaging (PACS) implementations, they are about 2-3 years behind. They have home grown EMR systems that are not interoperable, and they are just starting to think about enterprise image archiving using Vendor Neutral Archiving. The standards-based approach to healthcare IT implementation using IHE is still not well understood and/or appreciated. The good news is that they can learn from implementations in the US as well as countries that have advanced health care IT implementations such as Canada, the UK and other western countries, and use the lessons learned to jump-start their implementations, which will very likely start happening in the next one to three years, which would be expected if they are serious about “smart healthcare.”

There were three major takeaways from the conference. I learned about the potentially disruptive  impact of wearables, the use of demographic and social overlays onto the clinical data, and the use of “Big data” in a cognitive manner.

First wearables – When people think about wearables, you might think about the Apple Watch and other devices you can wear and measure the number of steps, hours of sleep, and even pulse. But the sensors are now getting very thin and can be incorporated into clothes or other wearables and measure additional physiological parameters such as glucose level. This information can be uploaded into a personal health record and a healthcare practitioner can monitor that data and potentially intervene if needed. With most people now having smartphones, they can be connected in real time and allow for monitoring 24/7. The impact of this could be huge, despite the “big brother” connotation. Sometimes, having a “big brother” watching over you could be a lifesaver or, at a minimum, prevent unnecessary ER or doctor visits. And if a visit is necessary, it could very well be done remotely in many cases.

The second potential disruptive innovation is the use of demographic data and overlaying that over clinical information from the EMR. For example, overlaying the number of re-admissions, diabetes patients, or people with any other condition that might be socially or culturally related on top of a map showing the geographical distribution of the patients can give clues as how to address such health issues. This means that patients are not being treated as individuals anymore but in their social and cultural context. Let’s say that a specific area has a high incidence of diabetes, you might want to do an educational session in the community center about nutrition in that region.

The third thing I learned has to do with the use of “big data.” While the reality hasn’t lived up to the hype so far, there are applications that use big data effectively in a cognitive manner to assist physicians making treatment decisions. A good example is the IBM Watson application, which is used by major cancer centers to assist in the treatment of oncology patients. The patient condition and characteristics which are in the EMR are compared with a database of thousands similar cases and tens of thousands of published articles to come up with a suggested treatment plan. You might think that patients do not always fit the statistics, but then the next step is to take into account the genomics data to come up with a truly personalized treatment. The power of this process is to use the intelligence of the IBM Watson, which runs in the cloud.

So, in conclusion, the HIMSS ASIAPAC15 had some insights to offer and learning experiences and it was good to know what is going on in Singapore. However, it is definitely a regional meeting, and there were a lot of vendor-sponsored presentations that talked about products rather than new technologies. So as an educational event, you might be better off to travel to the HiMSS Annual Conference & Exhibition in Las Vegas, Feb. 29 – March 4, 2016.