HIT Think

How HIMSS19 shows that effective IT must focus on patients

People as individuals and human beings are regaining an appropriate central focus in healthcare. The shift in thinking of putting relationships front and center was especially evident during the annual mass gathering of the healthcare information technology sector at the HIMSS Annual Conference.

Without a so-called blockbuster announcement, this arguably most important element of healthcare was able to permeate all levels of discussion.

The focus on individuals was evident in a variety of venues—from the government dropping a long-anticipated regulation just as HIMSS19 started, to the way in which companies framed their offerings, to the gathering of different communities. Being able to consider how best to enhance the relationship between clinicians, patients and other stakeholders was a refreshing change from chasing the latest shiny object, which was often the feeling in the past.

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Certified nurse practitioner conducts a check-up on a patient at a Community Clinic Inc. health center in Takoma Park, Maryland, U.S. Photographer: Andrew Harrer/Bloomberg

Big news for this year’s event was the release of a proposed rule to implement numerous portions of the 21st Century Cures Act, including the use of application program interfaces, stopping information blocking and other means of encouraging or promoting access to data by individuals. Various officials of the Centers for Medicare and Medicaid Services and the Department of Health and Human Services, the point is that patients are entitled to their data, and arguments over ownership should not get in the way of that access.

Staking out a position of demanding free access and flow of patient data is arguably a substantial shift by the government. While long-existing laws and regulations (mostly HIPAA) have stood for the ability of individuals to access and use their data as each individual sees fit, the government has not done much to focus on such access rights or to discourage organizations from erecting barriers or hurdles to access.

The old laissez-faire approach is quickly disappearing, though how long the government remains dedicated to this approach will be worth watching. The suggestion by HIPAA enforcers that an action is coming centered around an access issue is noteworthy. If such an action is really announced, it could be one of, if not the first settlement around a patient’s right of access or really any privacy right.

The information blocking component is a major issue for access. The proposed rule includes potential penalties and public shaming of entities that hinder or prevent access to data. While the final means of implementation remains to be seen, the fact that the concepts are included in the proposed rule suggests that the government will take some form of punitive action to free the data.

Given the breadth of the rule, it was no surprise to hear it as one of the most frequent topics of discussion at HIMSS.

In a change from promoting tools and software products as the end solution, conversations with vendors focused more on how the tools can enhance the role of clinicians and allow direct connections to be re-established. One of the most powerful statements made to me was one company suggesting that it did not want to work with clinicians or healthcare organizations that would not fully utilize a solution, which is intended to foster and grow connections between clinicians and patients.

The sentiment of that vendor was no longer unusual. Instead, many vendors talked about the ways in which their tools would fit into the background of healthcare operations. Instead of putting the technology at the forefront, it would enable the clinician to more effectively interact with a patient, whether in person or, increasingly more likely, in between visits and as a means of reducing needed utilization of services.

Other solutions were targeted to patients themselves to ensure understanding of communications from clinicians or to help patients promote their perspective. Thinking of the discharge and planning process, patients can often be overwhelmed with information, which can easily undermine health post discharge. If that information can instead be effectively communicated to the patient or set up so it can be re-accessed later in time, then outcomes could improve.

Conversations with representatives from two different healthcare organizations also revealed how people are becoming the primary consideration again.

One conversation delved into the gradual development of value-based care models in an organization. Instead of jumping right into the deep end and risking the alienation of the clinicians, the organization gradually ramped up its participation. The slow and steady progress helped create an environment where success would be more likely and also permitted broader relationships with ancillary providers. Creating a deliberate and thoughtful framework was seen as a means of strengthening bonds even outside the organization.

The second conversation went to how change and new ideas can be communicated. When messages were sent from the top leadership, emails would not be opened, and practices remained static. To gain the relatively small success of high email open rates, the sender eventually went down a number of levels until it came from someone who each of the disparate offices may actually know. The end result seems obvious. If a recipient actually knows the person sending a message, then engagement and response will be higher.

Healthcare will not survive without ensuring that people remain the full focus. Healthcare is ultimately about what happens to individuals and not an industry. That message can become muddled or lost, which means it should be repeated often.

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