10 trends taking the stage at HIMSS19

Proposed interoperability rules grabbed attention early, but uses of IT to improve care showed progress.

The most significant technology trends creating the buzz in Orlando

The annual conference and exposition for the Healthcare Information and Management Systems Society serves as a barometer to measure the progress information technology among participants in the healthcare industry. The editors of Health Data Management identified the following trends that were gaining the most attention from the approximately 45,000 attendees at this year’s HIMSS event.

ONC, CMS lay down the (proposed) law on data exchange

Federal agencies have a history of releasing bombshells at the start of HIMSS conferences, and HIMSS19 was no exception. The Department of Health and Human Services released proposed rules to improve the interoperability of electronic healthcare records. The proposed rules—issued by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT—had plenty of shock and awe. CMS is proposing requirements that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges must provide enrollees with immediate electronic access to medical claims and other health information electronically by 2020. ONC’s proposed rule would implement provisions of the 21st Century Cures Act that deter and penalize “information blocking.” The proposed rules have generated positive reactions from stakeholder groups.

Don’t worry, be API

With the federal government’s call last week at HIMSS19 for the adoption of standardized application programming interfaces, the industry is now positioned to move towards a healthcare API economy. An ecosystem of third party API-enabled apps, running on smartphones and other mobile devices, is envisioned by the Department of Health and Human Services as dramatically increasing consumer access to their electronic health records and other healthcare data. CMS wants to empower patients to be “consumers of healthcare” armed with data that “brings them into the decisionmaking.” Currently, Americans are “in the dark” due to a lack of pricing and quality information as well as difficulty in accessing medical records, according to Administrator Seema Verma.

FHIR is burning brighter

App developers, health IT vendors, and providers have widely embraced HL7’s FHIR standard to help solve the interoperability challenges confronting the healthcare industry. However, the Office of the National Coordinator for Health IT, for the first time, said at HIMSS19 that it intends to make FHIR a requirement through a proposed rule. “While there are a variety of relevant healthcare standards for connecting labs, images, claims processing systems and other pieces of the provider world, when we look at the app economy and the clear trends in modern computing, one API approach seems to clearly emerge–Health Level Seven’s Fast Healthcare Interoperability Resources standards,” according to National Coordinator for HIT Don Rucker.

Artificial intelligence gets double promoted

The use of computers to aid care continues to advance quickly, and HIMSS19 provided plenty of evidence that the table is being set for wider use of artificial intelligence. For example, Allina Health has developed a data-driven approach for early identification of sepsis, and the initiative also has reduced variations in sepsis care. AI and machine learning are rapidly growing and clinical decision support tools are increasingly using these tools to augment care, not replace clinicians. This technology will ultimately improve outcomes and reduce care variability, contends John Danaher, MD, president of Elsevier’s Clinical Solutions. And IBM Watson Health made a splash, by announcing plans for a 10-year, $50 million investment in research and collaborations with two academic medical centers—Brigham and Women’s Hospital in Boston and Vanderbilt University Medical Center, Nashville, Tenn.

Patient engagement has a ring to it

As the value-based care train picks up steam, provider organizations are realizing they need to get patients more involved in their own care. Sharing data with them is a painful but necessary first step—but more needs to be done. Patients want better communication with clinicians, easier and quicker access to care and easier-to-understand billing statements. These initiatives, and more, require significant support from IT.

Blockchain technology tackling early use cases

Okay, blockchain was the buzz at last year’s HIMSS, and it appears its potential was overhyped. But it’s now being tested for applications that make sense, are relatively simple but can deliver real benefits to the healthcare industry. Several pilot projects using blockchain technology in healthcare are expected to wrap up in 2019, likely to show demonstrable results in commonsense use cases. Those demonstration projects could prove the value of the technology to the healthcare industry is solving vexing information coordination problems, such as ascertaining the accuracy of data in provider directories and facilitating provider credentialing, says David Houlding, principal healthcare lead for Microsoft.

IT gets involved in the opioid crisis

Several healthcare organizations have begun to demonstrate how they are using healthcare IT to enable clinicians to make better decisions on prescribing pain medications and coordinating medication records for patients. For example, the Electronic Health Record Association recently released a new implementation guide for incorporating the CDC’s recommendations for prescribing opioids into EHRs, and at HIMSS19, its members said they are continuing efforts to better use electronic medical records as part of a strategy to improve communication between providers and patients about the risks and benefits of opioid therapy.

Big tech companies make a big splash

You couldn’t miss them on the show floor—Amazon, Google, Microsoft and other consumer-oriented technology companies stated their cases for how they were intersecting with healthcare. Amazon Web Services and the Google Cloud are beginning to round out resources that providers can access and use “as a service.” And Apple also made a splash, announcing that the Veterans Administration would give veterans the ability to access their personal medical data on their iPhones, thanks to Apple’s Health Records feature.

What to do with data after you get a bunch of it

To cope with mounting financial pressures and shifts in reimbursement priorities, healthcare organizations are looking for ways to use the data they’ve aggregated from their clinical systems to make better decisions. The use of analytics is among the information technologies being used to churn information out of massive amounts of data that provider organizations now have. For example, analytics, workflow and physician education is aiding sepsis care at Allina Health—the organization, which operates 12 hospitals and 90 clinics in Minnesota and Wisconsin, is reporting an 18 percent drop in mortality for most sepsis patients and a 30 percent drop for the most severe cases, saving lives. As another example, Mercy Health in Springfield, Mo., is using data analytics to better understand the costs of its procedures and what affects them.

Security still a showstopper in IT

While massive breaches haven’t occurred in recent years, there has been a steady stream of breaches in recent months, and provider organizations worry about the fact that hackers are fine-tuning their methods to increase their effectiveness. Cyberattacks still weigh heavily on security executives’ minds—according to HIMSS’ annual survey, released at the conference, show that provider organizations see cybersecurity, privacy and security risks as among their top information technology challenges in 2019.

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