HIMSS14: As Vast and Chaotic as Ever

The best thing about an event like this is the exposure to new ideas and new people. The most interesting discovery was the sheer number of places that provide HC services outside of traditional acute and ambulatory care (e.g., doctors’ offices, surgery centers, and hospitals). From the perspective of the big medical centers and frustrated ambulatory docs, it looks like just one big provider consolidation, but the other side of the coin is just as rich.All this HCO M&A is clearing the field for a whole new raft of alternative healthcare providers.  These non-traditional providers need technology to enable their new business models and the big-HIT vendors are not nearly nimble or cost effective enough to provide it. This creates some interesting opportunities for those who can meet this unmet market need, though not without challenges. There are a number of varying models being deployed and the market has yet to choose which one is viable for the long-run.

I was somewhat disappointed, but not surprised, to see no single EHR vendor that really completely changed the paradigm of how we currently do clinical data capture and how clinicians access, view and use the data. What I call EHR 2.0. Sad really.  But there are people trying, and different from my last HIMSS two years ago, a large number of attendees know we need a radical rethinking of the EHR model. In fact, thanks to not hanging out too long with the Big-half-dozen EHR vendors, I’d say the need for radical change was expressed in well over half my conversations.

If there was anything shocking in retrospect it is the number of smallish EHR vendors just now reinventing the wheel — click-happy-itis redux. Seriously, why bother. These guys also do not tell straight stories on just how far along their products are developed. A lot of marketing and tee-shirts depicting stuff that is just not there. In the software business we talk about vaporware (software that does not exist), promise-ware (products or enhancements promised but not even in design), and slideware (product descriptions, features, functions, benefits, and “screen shots” only found in PowerPoints). This conference introduced me to tee-shirt-ware — products that only exist on vendor employee t-shirts.

The best news was that this was the first venue where one could easily find folks that understand that we have to work on the cost side of the provider ledger. Activity-based costing is no longer a dirty word. At HFMA last summer there was almost no one focusing on cost management, which still amazes me. You can’t improve what you don’t measure.

Best in Show once again for me was Surgical Information Systems Analytics. I am not one to heap praise on vendors very often, but SIS just blows me away with their analytic approach and how they display the data. I still have some work to do to understand how the data is gathered, but the application is where we all need to go. It is the best thing I have seen to date that is focusing on lowering the price we pay for healthcare and increasing the quality, by far — at least for work done in the OR.