This past week, Paul Nardone and I attended the HIMSS Connected Health Conference. At the end of the week, we were largely wondering, who was this conference for? Was it targeting providers and healthcare systems looking for solutions? Vendors and start-ups looking to enter the market or grow their business? Payers looking to understand the impact of new technology?
Too much of this conference was vendors and consultants talking to vendors and consultants. With the profusion of healthcare IT conferences during the year, it ought to be possible for a smaller conference to focus, pick a topic, and dig into it in-depth with experienced, meaningful speakers. ‘Technology,’ even ‘Connected Technology’ is just too big a topic, and the result was an event that felt too unfocused to offer enough value to anyone.
- Product integration plays the single largest role in how provider organizations choose a product. The ability for products to seamlessly integrate into EHRs, patient portals, and to present a single user environment trumps any other consideration if baseline functionality is present. Said one representative from an ambulatory outpatient system, “we don’t even look at anything that lives outside where our providers spend their time.”
- Other than vendors and consultants, payers were the single largest group present and talking on the convention floor. Their interests were in remote patient monitoring tech, AI/ML chat, symptom checkers, and population health analytics.
Design is a Core Competency
With multiple panels devoted to application design throughout the conference, Connected Health made it clear that design matters. Physician burnout and work overload are well-established tropes in hIT, but new products that add screens, reports, and dashboards have not helped. Intuitive, clean user interfaces can cut down on time and resources spent in use and in training. It is not a matter of programs simply ‘looking nice;’ design is tied to actual usability and can no longer be overlooked.
Design-focused development implies a broader goal of improvement of existing functionality, instead of developing new functions. Ada Health has leveraged clean, simple design concepts to make use easier for both providers and patients, and the strength of that design was key to their partnership with Sutter Health. Truly user-centric design, recruiting from core user groups of providers and patients to understand their needs both in functionality and usability is an essential tool for anyone looking to break into these crowded, complicated markets.
Are Payers the Biggest RPM Market?
Payers outnumbered providers among the conference attendees and while the provider organizations present were largely looking into specific solutions or product types, the payers were interested in a broad range of potential services and offerings. Remote monitoring, chronic disease management, patient engagement tools, and home care devices were all major topics of discussion among payers. One described it as a “hunt for additional value” they could provide to customers, especially employer plans, along with anything that could reduce costs over their covered populations.
While most provider organizations do not have downside risk in value-based care (VBC) contracts, and some aren’t engaged in VBC at all, payers have a clear value proposition in engaging and monitoring their members to lower risk and reduce utilization. Most vendors at this event appeared to be targeting providers and healthcare organizations almost exclusively but until downside risk becomes the norm in contracting, payers are the more obvious customers for most of these tools in the near term.
Most vendors at this event appeared to be targeting providers and healthcare organizations almost exclusively but until downside risk becomes the norm in contracting, payers are the more obvious customers for most of these tools in the near term.
JARMs and Peak AI
One reason providers may not be attending conferences like Connected Health is that even in the buzzword areas of AI and machine learning, product offerings have become consistently similar. One provider at the conference coined the term JARMs, asking if we really needed to hear about ‘Just Another Readmissions Model.’
Imaging, risk stratification, readmissions probability, and the other major use cases for AI in healthcare have been well accepted, if not well adopted. Their presence in technology is expected, and so new products that offer a variation on those themes isn’t exciting to most in the field, even if it represents an advance. The hype of AI is still that it represents a sea-change in healthcare, and that anyone who does not use it will be left behind.
As use cases propagate and more providers become familiar with these technologies, it has become clear that these are mostly incremental improvements rather than anything groundbreaking. For smaller practices and healthcare organizations with limited budgets and leadership capital, there is no obvious reason to go looking for technology they basically understand and cannot or will not deploy. If the hype is going to stay, vendors of AI/ML technology need to start showing something new.
What Will New Regulation Look Like?
The most valuable content came in the discussions of developing regulations to address data security and privacy. Continued disagreements and attempts to protect walled-off resources of data will result in draconian laws on privacy and data control that will hinder innovation and care. Developments like the MITRE draft Patient Data Use Agreement are good starting points, but leaving these issues up to the market is resulting in major breaches of security and trust. If healthcare wants to have a say in what comes, vendors need to be willing to accept some changes.
Other regulatory areas need to evolve as well, as the impacts of some lower visibility laws are becoming better understood. Telehealth parity laws were intended to spur the use of telehealth and remote monitoring but may have ended up distorting markets and preventing patients from seeing the cost savings telehealth was supposed to produce. New CPT codes for remote monitoring and upcoming changes in telehealth reimbursement from CMS are great to see, but many providers and systems at the conference struggled in understanding the nuances of the changes and how to take advantage of them.
Meanwhile, provider licensing and advanced practitioner roles remain arcane and complex, despite attempts like the Interstate Medical Licensure Compact to simplify them. Hiring, onboarding, and appointing a provider is already a complicated, time-consuming, and expensive process, and considerations of interstate practice through telehealth and home monitoring are rarely considered. Now that many of the technological questions behind these methods of care are being settled, the regulatory and legal environment they will need to exist in will be a major determining factor in whether they can become a part of regular practice.
Paul Nardone contributed to this conference recap.