The pilgrimage to HIMSS has once again come to pass. While certainly not a spiritual pilgrimage – after all it did take place in Sin City – it is a trek into the depths of healthcare IT (HIT). No other venue in the U.S., brings together such a broad swath of HIT leaders, especially from the vendor community – after all this is a trade show – thus the annual pilgrimage for us is well worth it.
As we have done in years past, Chilmark Research sent a large team to HIMSS to get a sense of where the market is today and where it is headed. To capture Chilmark analysts’ impressions of HIMSS16, I asked them to answer three simple questions:
- What was the biggest surprise for you at HIMSS this year?
- What was the biggest letdown?
- What was the most interesting conversation you had at HIMSS?
Following are their answers – each distinct – that I believe provides a pretty accurate window into the current state of the market and where we are heading. And if you are up to it, would love to get your answers to these three questions in the comments section.
Brian Eastwood: Analyst, Care Mgmt & Engagement
Biggest surprise: Seemingly every vendor at HIMSS was looking for a flagship customer that’s in some kind of risk-based contract. As most healthcare organizations (HCOs) aren’t ready to take on risk beyond the usual low-hanging fruit (30-day readmissions reductions, knee and hip replacement bundled payments), most vendors are still looking. They’ll need to work with their technology partners to find that first customer.
Biggest let-down: Another year, another interoperability pledge encouraged by the government and taken by electronic health record (EHR) vendors that continue to make billions of dollars selling monolithic applications to HCOs that don’t seem to know any better. If vendors want to show a true commitment to interoperability, they will team up for a live onstage demonstration of bidirectional exchange instead of signing another pact.
Most interesting conversation: It was an aside in a conversation with Cliniconex, a Canadian firm that builds automated patient notifications into EHRs – addressing concerns ranging from “Do I need to fast before this appointment?” to “What forms do I need to fill out?” – but I learned that annual physicals north of the border last 60 minutes. That stopped me in my tracks, as that’s about 55 minutes longer than my last physical. That also shows how far the United States has to go to achieve value-based care.
Matt Guldin: Senior Analyst, Care Mgmt
Biggest surprise: Just how much people and vendors were talking about transition management and including post-acute providers (including home health) into the care management process. I’m sure the recent HHS announcement that is finally going to provide some dollars to purchase HIT influenced this just a bit.
Biggest letdown: Lack of clarity on national leadership regarding care plans – This came up time and time again from vendors. They aren’t certain who in DC or nationally is taking charge of this including important work of further defining care plan data standards along with sending and receiving various parts of the care plan. There was also a lot of confusion regarding what is required is actually required in a care plan for CCM coding and what activities related to the care plan are actually permissible to meet the monthly 20 minute requirement for patients.
Most interesting conversation: The risk of ~600 hospitals mostly in rural, isolated areas of closing over the next 3 years that would leave large parts of the US without hospital coverage in a 50 or 100-mile radius; how will these hospitals stay in business and explore alternative operating models to ensure they remain open.
Brian Murphy: Senior Analyst, Clinician Network Mgmt & Interoperability
Biggest surprise: Provider interest in FHIR – education sessions and floor-level vendor presentations were well attended and got lots of questions.
Biggest letdown: Progress on FHIR deliverables – production-level implementations less than expected in light of last year’s stated emphasis by vendors on speeding up adoption.
Most interesting conversation: Talked to someone from IBM about the expectations of millennials about how the healthcare system should work. Clearly, the scheduling and referral process will have to change radically over the next 10-15 years as this cohort consumes more healthcare.
Jody Ranck, Senior Analyst, Analytics & Engagement
Biggest surprise: Finding a vendor that is deep into integrating behavioral psychology into a risk stratification model that translates into actionable intelligence. Also, the number of vendors touting precision medicine despite the relative immaturity of the market.
Biggest letdown: The disjuncture between knowledge that social determinants are a major driver and knowing that they need to integrate this data into risk models/care plans, etc. and relative scarcity of vendors doing it in a major way given that this is perhaps the most important driver of population health outcomes.
Most interesting conversation: Advances at Apervita where they are seeing pharmas paying for provider data and how the Apervita marketplace is used to understand outcomes data better. Very interesting from a risk stratification perspective as well because they are building profiles around different analytics and can see how different algorithms perform for predicting outcomes.
John Moore, Founder
Biggest Surprise: The extreme disparity of booth traffic among vendors at HIMSS. Sure, one is unlikely to see a lot of traffic at booths trying to sell the next COW or any hardware for that matter, but was unprepared for what I saw of tech vendors. In one example, an EHR vendor serving smaller community hospitals and systems did not have a single demo jockey busy. I look over into the adjacent aisle and one of the more modern, cloud-based EHR vendors making a play for acute had every demo jockey fully consumed. Writing is on the wall – those vendors that have not invested to keep their systems current are headed for the dustbin.
Biggest Letdown: You would think that after eight HIMSS I would be use to the hype, but I always walk away shaking my head. In the past it was PHRs, HIEs, PHM, etc., all of which have failed to reach their true potential. This year it was precision medicine. Lots of arm waving, bold statements, etc., but all falling short as to the details of actually how to enable precision medicine. NantHealth has a big vision for such in cancer treatment, but this is not just a shot to our own moon, but that of Saturn’s moon, Titan.
Most Interesting Conversation: Actually same conversations happen in two separate instances. Acute EHR vendor approached by one of the larger ambulatory vendors to develop seamless interoperability between their competing systems. Health systems are really making a push here to get their vendors to play nice and it seems to be working.
BONUS
What I wish I saw more of: Organizations and vendors talking more about the need to create synergistic, symbiotic relationships between payers and providers. Was underwhelmed to say the least but this is an important area that requires far more scrutiny and research, which we plan to personally take on in 2016 and beyond.
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