About 43,000 attendees were traversing the floors of the recent conference and exhibition annually held by the Healthcare Information and Management Systems Society. At educational sessions and on the floor of the exhibition, several key trends emerged, giving insight to some of the leading trends that will pace the healthcare industry in the coming year. Here are some of the most significant IT industry themes to watch this coming year, as selected by the editors of Health Data Management.
Cognitive computing/artificial intelligence
A central theme of last week’s HIMSS17 conference in Orlando was cognitive computing, self-learning systems that use data mining, pattern recognition and natural language processing to mimic the way the human brain works. IBM President and CEO Ginni Rometty declared during her opening keynote that healthcare has officially entered a cognitive era, which she believes will transform medicine.
Big Blue has made a significant wager in this arena with Watson Health, the first commercially available cognitive computing capability delivered through the cloud, to provide actionable insights from large amounts of unstructured data.
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Cybersecurity continues to be a major concern for healthcare organizations that are trying to protect their health data, particularly from a rising number of ransomware attacks.
However, hostage-focused cyber attacks will diversify—for example, organizations are likely to see medical devices targeted by this kind of the file-encrypting malware, says Marty Edwards, director of the Department of Homeland Security’s Industrial Control Systems Cyber Emergency Response Team. “It’s only a matter of time before we see some sort of significant type of events that involve patient safety that are cyber enabled,” said Edwards at HIMSS17.
Value-based care opportunities
The shift to value-based care reimbursement appears inevitable, and healthcare organizations may be able to use the shift to exercise a fundamental change in how clinical records systems function. Since EHRs no longer will be depended upon for charge capture, records systems can focus on better enabling clinicians to streamline care delivery, potentially reducing the need for heavy levels of documentation records systems now require.
“To redesign these systems, we need to go from the bottom up, not the top down,” said James Barr, MD, vice president of clinical intelligence at Atlantic Health System. “To impact change, we need broader strokes of the value-based payment model. This is expensive to do, when we have to develop the data skills.”
While most providers now have EHRs in place, new technologies and evolving market dynamics have injected some uncertainty into how future systems will operate. Blockchain technology was one of the buzzwords at HIMSS17, although existing EHR vendors say the technology is still new and untested within healthcare, and it’s not yet clear how it will fit into existing approaches of both providers and vendors.
Some presenters questioned how changes in the market will impact technology in the industry. For example, while the market is being dominated by major vendors now, Eric Topol, MD, recently said he anticipates radical change ahead, saying “I don’t see Epic, Allscripts or Cerner in existence in another decade,” a theme expanded upon by Joel Selanikio, MD, who predicts healthcare will morph from an emphasis on institutional care to empowering consumers to become active participants in maintaining their health; current vendors need to change or risk irrelevance, he contends.
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New security approaches
Lean methodologies have long been used in healthcare, typically to lower patient wait times, shorten lengths of stay in hospitals and to reduce medical errors. But now, Lean process improvement programs are being employed to help tie information security to two enterprise levels—the information systems and the organization’s strategy, says Mitch Parker, chief information security officer at Indiana University Health.
Telehealth and virtual care
Recent surveys have found that consumers are more open to receiving health services remotely, using telemedicine and other forms of virtual care. And under new reimbursement methodologies, healthcare organizations have more incentives to provide care in the least expensive form possible. Sessions at HIMSS covered how telemedicine also expands the reach of care in rural areas and other underserved geographies of the country.
Population health and IT
Population health management is a fast-growing capability within health information technology, and managing the country’s growth in overall care expenditures will require providers to expend more efforts taking care of underserved populations.
Vendors in the population heath arena have massive amounts of data that many providers aren’t taking advantage of. New forms of HIT look to provide the granular detail that’s crucial for providers that need to manage individual cases, which often depend on social determinants of care.
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The push for interoperability has reached a new level of urgency, with the 21st Century Cures Act passed by Congress and signed into law by President Obama. At HIMSS17, Acting National Coordinator Jon White, MD, said that ONC is making the law’s implementation a top priority, while he dismissed the idea that the agency has been slowed because the new Trump administration has yet to appoint a new National Coordinator.
Among other provisions, the Cures Act codifies new authority for ONC to address interoperability through additional conditions of certification for health IT developers.
Whereas the Fast Healthcare Interoperability Resources (FHIR) standard was a buzzword at last year’s HIMSS conference, there was more discussion and demonstrations of how HL7’s information exchange initiative is being used in real-world settings at HIMSS17. FHIR continues to progress toward its third iteration as a draft for trial use, but it’s being used now, as vendors are building APIs to use it in a variety of settings.
The SMART Health IT Project has developed an updated version of its app gallery, enabling those looking for apps based on the Fast Healthcare Interoperability Resources standard to have an easier time looking and comparing. The Computational Health Informatics Program at Boston Children’s Hospital unveiled the refreshed gallery as a beta release at HIMSS17.
The Internet of Things
The use of the Internet of Things is growing within healthcare, raising potential benefits as well as possible risks. Educational sessions offered new ways that providers were using the IoT to improve care, especially in using IoT devices in tandem with artificial intelligence to improve care.
That is reducing Code Blues at Hamilton Health Sciences, based in Hamilton, Ontario, which is using technology from Toronto-based ThoughtWire to reduce emergency calls on a year-over-year basis. Other vendors were exhibiting new technology approaches or new devices that are more impervious to hacking, considered a weakness for some devices.
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Uses for application programming interfaces (APIs) were highly touted by providers and vendors alike during HIMSS17. For example, APIs from revenue cycle vendor Recondo Technology enable certain processes to integrate data directly into hospital information systems with providers never having to leave their workflow. Early vendor adopters include MedeAnalytics and HealthPay.
Improving charge capture
Accountable care approaches may eventually obviate the need for charge capture, because reimbursement will be based on a per capita basis and heavily influenced by quality of care. Until then, charge capture will still be important for providers. For example, running daily analytics over encounter data can help the revenue cycle team identify orthopedists’ adherence to capturing charges based on the types of devices they commonly use.