With the books closed on HIMSS16, I have been reflecting on the lessons learned from seemingly countless keynotes, education sessions and showcases, an exhibition with 1,200 vendors, and exchanges with just a few of the more than 40,000 attendees.
From my perspective, four themes stood out. Let’s take a look…
1. Patient-generated information will help close the loop on health information flow
The emphasis of new care models is clearly on outcomes: how to measure and ultimately improve them. But most outcome measures are mere proxies. A readmission might suggest a breakdown in coordination of care, but it doesn’t measure the impact on a person. Each of us responds to treatments at a very individual level. If we could capture that experience ourselves, either objectively, as with vital signs, or subjectively, as in “I feel better today than yesterday”, we could contribute valuable and timely information on our own health.
In his keynote, Thomas Goetz, award-winning editor of Wired magazine, asserted that the individual is the most underutilized resource in healthcare. He posed questions around how we can better leverage technology to put ourselves in the driver’s seat of managing our own health information. His Ted Talk provides a look into what that could look like. The dozens of innovative consumer-facing applications on display in the Connected Health Experience showcase suggest that progress in this area is accelerating.
2. The march from EHRs to population health continues
Meaningful use has driven EHR adoption to impressive levels. But what to do with all the information that’s now being captured? Among the most prominent answers: use it to understand and manage health at a population level. Mayo Clinic, the Military Health System, and others presented their approaches to implementing “pop health”. They all share a set of essential objectives:
- Assemble data that allows you to define and understand a population
- Select and standardize measurements – guided by the Triple Aim of health quality, cost, and experience of care
- Stratify the population into segments with similar health profiles and needs
- Proactively manage the health of individuals in these segments to improve both outcomes and overall quality of life
The foundation of population health consists of the information and analytics that make it possible. As new sources of data, such as genomics and patient experience, add to the stream of health information, and advanced analytics help to harness it, we’ll look back at what we’re doing in 2016 as the very beginning.
3. Interoperability is on fire
Presentations in the HL7 booth made it clear that the emerging FIHR (pronounced “fire”) interoperability standard is indeed gaining momentum. The Argonaut project, a rare collaboration of competing vendors and other organizations with diverse interests, promises to make practical HIT interoperability a reality sooner than even the optimists thought possible. Watch the HL7 website for details on major developments coming this spring.
North Shore University Health System gave a thought provoking presentation on how its decision support teams are marrying advanced analytics with clinical workflows. The health system has developed an analytics server, based on open source “R” packages, that works in conjunction with its data warehouse and BI systems. The premise of the approach is that analytics capabilities have the most potential for impact when they provide insights directly at the point of care. That’s only possible if they can be integrated into the systems that clinicians use to deliver care. FIHR and other related developments in interoperability hold the promise to make this type of integration seamless and straightforward to implement.
4. Culture and communication trumps technology
With staggering amounts of health data and sophisticated analytics to help us make sense of it, we’re developing a much clearer picture of the task at hand. But guiding and motivating people to drive the changes necessary to transform healthcare may be a bigger challenge than the technology. There are, however, precedents to show the way. In her keynote at the CHIME CIO Forum, Carey Lohrenz discussed the importance of culture in coping with continual adversity while staying focused on the mission. As the first female U.S. Navy Tomcat fighter pilot, Lt. Lohrenz has a unique perspective and some genuine “street cred”. She described how the Navy’s culture makes it possible for the 5,000 person crew of an aircraft carrier — average age just shy of 20 years old — to cope with a steady stream of unanticipated challenges. The formula: everyone understands what success looks like as well as their role in attaining it. As a combat pilot, you never have complete information, but you need to learn to work with the 80% or less of the picture that you do have. Mistakes and failure are part of the equation. The capacity to learn from them, and communicate openly, needs to be embedded in the culture of an organization if it expects to be able to adapt in a rapidly changing environment.
The importance of culture and the willingness to wade into the unknown was underscored by a talk that Lehigh Valley Health System gave on its data governance journey. After a system-wide EHR implementation, the health system realized that it had more information than it could effectively consume. To help cope, Lehigh Valley implemented an approach to governance that helps align the organization around common metrics and definitions. It has made great strides, but it has taken executive level leadership and a willingness of just about everyone to let go of “how things used to work” in the interest of moving forward. Tenacity and perseverance are critical, but so is patience.
So how do all of us, health providers and individuals alike, take advantage of the progress that’s being made on these fronts? In one of the closing keynotes, Jonah Berger, a marketing whiz and professor at Wharton, provided some insight into how ideas spread. Turns out it’s still mostly by word of mouth, with interesting and compelling stories carrying important ideas along with them. His book “Contagious” includes examples that you’ll likely recognize. Think GEICO with its quirky commercials that always tie in their business proposition: “15 minutes will save you 15%”. Perhaps there’s an equivalent for healthcare!
What are your lessons learned from HIMSS16? Let us know in the comments below.
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