4 main takeaways from HIMSS19

By David Lim and Rebecca Pifer for Healthcare Dive

For one week in sunny Orlando, Florida, more than 43,000 health IT professionals converged in the mammoth Orange Country Convention Center to showcase technological innovations, argue about interoperability, network and pour creativity into their #HealthPolicyValentines tweets.

Health IT’s biggest conference of the year ended Friday. As the industry begins to come down from its annual HIMSS high, here are Healthcare Dive’s top four takeaways from HIMSS19.

Interoperability rules welcome, but long road ahead

HIMSS started with a bang as the Trump administration released its long-awaited proposed interoperability and data blocking rules. They were welcome by many in the industry, with some important caveats.

To start, industry has until April to comment on spots they don’t like. Providers are not happy about discharge notification and administrative burden the rules may inadvertently cause.

“To make a seamless experience in healthcare happen, a lot of different technologies need to come together,” Karen Appelbaum, executive director of enterprise access operations and technology at Providence St. Joseph Health, told Healthcare Dive on the HIMSS exhibition floor. “There’s no one technology that’s going to do everything,” making standardization key.

Concerns that the rules don’t adequately address patient identification and matching came from experts like Ben Moscovitch of Pew Charitable Trusts and Mark LaRow of Verato.

“In other industries, if you mistakenly merge two records, patients and people may not get hurt by it,” Moscovitch said, but in healthcare, errors in linking patients to their correct data can “actually cause direct patient harm.”

That’s something The Office of the National Coordinator for Health IT and Congress continue to look at, ONC’s division director for federal policy and regulatory affairs Michael Lipinski told Healthcare Dive.

Potential EHR vendors farther behind on interoperability between systems could face big hurdles, experts said. While they haven’t been overly vocal so far, be on the lookout for possible objections when they submit feedback to the government on the proposals.

“My PSA is that we want to hear from you,” Elise Sweeney Anthony, executive director of policy at ONC, told a packed conference room Wednesday. “Tell us if it’s too broad, too narrow, or if we hit just the right point.”

And much depends on how the private sector moves forward with implementation.

“The private sector’s now behind the government,” Mike Leavitt, former HHS Secretary under President George W. Bush, said Tuesday at a keynote speech.

Consumers remain the focus — but are they ready for it?

Consumer-centric healthcare. Patient empowerment. Price transparency.

It was hard to avoid the buzzwords zooming around the convention center. One prevailing message from government and private industry alike was a desire to enable patients to play a greater role in their own health.

That’s a major aim of the rule drop this week, HHS Secretary Alex Azar said in his televised keynote address.

“We believe empowering patients with this access will help build an ecosystem of applications that can improve both patient care and population health,” he said, noting that the standardization of APIs and aggregated health info will reduce burden on providers, too.

As an industry, healthcare needs to move away from the tech and toward the “person were meant to serve,” agreed Karen DeSalvo, a former ONC chief.

ONC’s team said it kept this ethos top of mind when crafting the rules.

“We want to have a pro-business, pro-consumer model,” ONC head Don Rucker told reporters. Prominent venture capitalist John Doerr thinks the government succeeded, saying late Wednesday “the winners are clearly the consumers” in the ONC and CMS rules.

But HIMSS’ focus on consumerism wasn’t limited to the public sector.

“Consumerism and empowerment is sort of a two way street,” CVS Health’s chief medical officer Troy Brennan said in a panel on cost transparency. “The part that’s on us is to provide them with the information they need.”

Some health IT professionals question whether the average Joe is ready to handle the reams of data that could be heaped onto them over the next few years.

Rock Health Director of Research Megan Zweig noted consumer abandonment of wearables year over year continues to climb despite an uptick in interest to manage health conditions. And Mayo Clinic’s medical director of applied clinical informatics Karl Poterack raised concern data being collected has limited clinical use.

But Steve Burrill, Deloitte’s healthcare practice national sector leader, was more optimistic, telling Healthcare Dive, “It’s less about their ability to make decisions, because we have not gone through a process yet to educate most Americans what that data means and how they use it.”

Innovation in healthcare tech continues at rapid clip

The 1.1 million square feet of floor space was packed with health IT vendors, consultants, data analytics companies, cloud and AI products surgical demonstrations.

(A complete list of the more than 1,300 exhibitors can be found here.)

Predictably, artificial intelligence was a big draw. Off the floor, a top CMS official teased an upcoming ‘AI challenge’ with a “significant” cash prize for any groups able to streamline the government’s predictive analytics. But on the floor, a seemingly inexhaustible cadre of companies vied for attendees’ attention on their newest AI-enabled tools.

EHR vendor Cerner debuted Chart Assist, a workflow product meant to reduce physician burnout and increase productivity. QuartzClinical launched clinical registry and data warehousing tools the company heralds will fully automate data acquisition, storage and retrieval. Data analytics company Innovaccer showed off an AI-based data activation platform that integrates with more than 300 EHRs, while Change Healthcare tackled claims management.

A new partnership between hospital chain Sutter Health and tech company Ada Health aims to personalize care for Sutter website uses, and Zynx Health unveiled a machine learning system that can retrospectively analyze order utilization to identify where quality outcome interventions are needed.

AI may have been king, but it’s hard to overshadow the cloud. One year after former Google CEO Eric Schmidt advised HIMSS to “run to the cloud, don’t walk,” it seems like health IT vendors took that mandate to heart.

Google Cloud and Amazon Web Services had strong presences on the floor, with booths and crowds often triple the size of their neighbors. Among other competitors, smaller companies like Virtustream and OpenText gained some buzz with their cloud systems: Virtustream Healthcare Cloud and Alloy for Healthcare.

Other notable areas were in voice tech and blockchain.

Mayo Clinic and conversational platform Orbita highlighted their partnership that resulted in Mayo First Aid for Google Assistant and Mayo First Aid Web-based Voice Chat, an expansion on their Alexa skill, which offers integrated voice and text-based interfaces to help consumers talk out their health problems.

Recent market entrant Suki attempted to set itself apart from competitors by crowing its time-saving and efficiency metrics for clinicians.

New blockchain tech explored at HIMSS includes names like Kalibrate Blockchain, which introduced its exclusive licensing program for its FormDrop mobile app, and the collaboration between Boehringer Ingelheim and IBM Canada to lock down healthcare processes like clinical trials.

Some say it’s clear FDA is interested in encouraging medical device and software development with its efforts around the Software Precertification Program pilot.

“They are much more progressive than what we’ve seen in the past, so I would say we’ll see a lot more digital devices and therapeutics that come out,” Gurpreet Singh, U.S. health services leader at PwC told Healthcare Dive.

As chains around data fall away, cybersecurity grows in importance

With interoperability being the biggest theme of HIMSS 2019, one question is how the health industry will prepare its cybersecurity infrastructure as data sharing becomes more prevalent between different health systems, technology companies and EHR vendors.

“Freeing data from locked silos will spur innovation at a pace we have never seen before, supporting future advancements in healthcare through new medications, devices and more personalized treatments,” CMS Administrator Seema Verma said in her keynote address.

But with more medical device cybersecurity advisories are being reported through groups like ICS-CERT year over year, it is clear the health industry will have its hands full as it moves to integrate data from across the healthcare spectrum.

In October, FDA released its draft guidance outlining its thoughts on ways to improve cyber-readiness. The agency is considering recommending industry build a cybersecurity bill of materials and bifurcated tiers of devices based on if a device can directly harm a patient if it is hacked.

“It’s really been a year of documenting good practices and having more things available. I’ve seen so much collaboration occurring between the government and industry and between the hospitals and the medical device manufacturers,” said Margie Zuk, senior principal cybersecurity engineer at the MITRE Corporation.

Suzanne Schwartz, FDA associate director for science and strategic partnerships at its device center, laid out her ideal vision for the future of cybersecurity, saying that five years for now, FDA hopes devices are all updateable, patchable and resilient.

“Everyone has to have a seat at the table and participating in what that looks like and how one accomplishes that systematically and methodically. It’s not going to happen all at once,” Schwartz said. “It’s got to be done in a safe way, in a manner that has risk based and based upon the kinds of devices that are out there.”