HIMSS 2018

Another HIMSS conference is in the books. Amidst the craziness that HIMSS can be, it is always a pleasure to spend time running into friends, collaborators, and former colleagues.  There have been lots of great pieces written about 2018 HIMSS, including by Chrissy Farr and by Lisa Suennen. Here are some of my thoughts and takeaways:

1 – Where’s the Peds?

HIMSS pretty much has a little something for anybody. However, walking the exhibition hall and seeing vendor booths, attending sessions, and talking with colleagues, there was a noticeable under-representation of anything having to do with pediatric care. I’m guessing this has something to do with $$, but I would love to see more attention paid to the specific needs of children, parent caregivers, pediatric care, and children’s hospitals.

2 – Cash and Flash

HIMSS had its usual plethora of vendor swag giveaways, plush carpeted booths, sponsored parties and happy hours, steak dinners, and other signs of the amount of money flowing through the system. One couldn’t help but wonder, if the biggest challenge facing American healthcare is one of cost and value, how could we be spending this much money on HIMSS while telling each other we were there to save money?

Some great tweets on this subject:

Screenshot 2018-03-12 10.20.56Screenshot 2018-03-12 10.20.33

 

3 – Interoperability’s Day Has Arrived

With many thanks to years and years of tireless work by Ken Mandl, Josh Mandel, Aneesh Chopra, Micky Tripathi, Graham Grieve, and so many others, there was a palpable sense that FHIR APIs are crossing from “early adopter” to “mainstream.” CMS announced “Blue Button 2.0,” an API containing four years of Medicare claims data for 53 million beneficiaries that allows individuals to allow third parties to receive that data via API. The VA announced its Lighthouse platform, which gives external developers access to data and tools from the VA in order to more easily build apps to serve the needs of veterans. This is happening.

4 – 2018 HIMSS Word Cloud

AI. Cloud. Interoperability. Security. Provider Burden. API. Connected. Engaged. Consumer. Coordinated…… and Blockchain

4b – My favorite 2018 HIMSS pitch

Started off with the company saying, “even though all our founders come from an AI-background, and all our competitors use AI, we do not use AI in our product.”

5 – From EHR Implementations to Pilots to Mainstream Digital Health

Lots of thought and effort is going into thinking about how to scale innovation and move digital health into the mainstream. How can we create the infrastructure, processes, and tools to try things out, iterate, and scale innovations to get beyond the pilot trap? You can still feel the tension as people try to move past the era of EHR implementations to actually using their EHRs as an underlying platform to achieve care delivery goals like patient engagement, population health, and precision medicine. How can we best use EHRs as a platform on top of which we can integrate novel apps, analytics, and decision support?  To me, solving this at scale is the key question and challenge of the next several years.

 

 

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HealthCare Innovators Podcast: Patient-Generated Health Data

I recently had the opportunity to sit down with Travis Good, MD, MBA, Co-Founder and CEO at Datica to discuss emerging trends in the use of patient-generated health data (PGHD) in healthcare delivery.

Here is a link to the Podcast episode

Thank you to Travis for a fun and engaging conversation and for all of the great work Datica does promoting a vibrant digital health ecosystem!

The Case for a Patient-Centered EHR: My Dad (full post at Medscape.com)

In the 10 years since my father was diagnosed with multiple myeloma, he has accumulated thousands of lab results, hundreds of physician progress notes, and dozens of imaging studies. Because his myeloma has been hard to treat, and perhaps because he is a well-regarded physician in his field, he has accessed the best care available, including fantastic doctors and new therapies available at distant research centers.

Despite the fact that all of his physicians use electronic health records (EHRs), nobody actually has his medical record. It does not exist. Rather, his thousands upon thousands of data points are scattered across the country, with no one health system or physician having unified access to all of it, including my dad.

As a clinical informaticist, I spend a lot of time thinking about interoperability—the extent to which systems are able to exchange data and subsequently present those data such that they can be understood by a user—but nothing prepared me for seeing my dad play the role of his own health data aggregator.

Tracking data over time is a key component of multiple myeloma care. Imaging scans looking for bone lesions and the “light chain” blood tests that measure the myeloma cancer protein are done periodically to assess response to treatments. Each result, depending on its direction, either brings a sigh of relief or a rise in stress and fear along with a shift in treatment regimen. To optimize my dad’s care, his doctors would need to see the full picture: the imaging, labs, and each historical chemotherapy treatment over time.

You can imagine how this ideal interface would look, with a nice, clean graph showing his light chain results, imaging, medications tried (and failed), and the location of his treatment. But no such graph exists. Worse, it cannot exist in our current system because each health system where my father is treated is only responsible for their portion of his overall medical record.

Keep reading full post at Medscape.com (warning: requires Medscape account)

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