I've spent some time at the front of the classroom, but I've spent much more time in the lab studying…
Jenn’s HIMSS 3/3/16
My last day at HIMSS … how I already miss seeing friendly faces around every corner, the fantastic free food in the press room, readers stopping by the HIStalk booth to tell me why they love (or hate) some of the things we do. I’m already looking forward to Orlando, and can’t say goodbye quickly enough to Pacific Time. But I’m getting ahead of myself.
My last morning got off to a nice start. I found that chivalry is indeed not dead, as several gentleman helped me cart my luggage between the HIMSS shuttle and conference entrance. I wasted no time in grabbing coffee from the press room before meeting with Lauren Douglass, brand manager for Medhost’s YouCareUniverse. She brought me up to speed on several nuggets of news, including the fact that the company’s YourCareEverywhere mobile app has recently been certified for Meaningful Use – the first of its kind to attain certification, to the best of her knowledge. The company, like many others at the conference, is joining the interoperability conversation in a big way via a project with an unnamed EHR vendor.
Encore Health CEO Dana Sellers joined me afterwards to chat about the show. (I love talking with smart folks that have been in the industry as long as she has; it’s a great way to absorb just a tiny bit of their wisdom.) We talked about everything from The 5 Love Languages to value-based care. She pointed out that, while a theme usually emerges by this point in the conference, she just couldn’t put her finger on one this time around. She equated it to post-Y2K, when the industry settled into a six month lull to catch its breath. “We’re in that same lull,” she explained, adding that her customers are taking a step back to recover from Meaningful Use and ICD-10. Sellers predicts that once they’ve taken a breather, providers will move full speed ahead with figuring out how to derive value from their healthcare IT.
Her comments regarding lack of a theme hit a nerve. HIMSS conference news cycles in years past have been driven by industry-wide EHR adoption, then ACOs, then Big Data (as its history of HISsies attests), and I was fully prepared for yet another buzzword to rear its ugly head. While population health management, analytics, cybersecurity, and value-based care have been tossed around, I haven’t gotten a sense that one is more important than the rest to providers walking the exhibit halls. Yes, everyone is talking about interoperability, but as BIDMC CIO John Halamka smartly said in his session with Jonathan Bush, “Interoperability is a bit like porn. I can’t define it, but I know it when I see it.” I haven’t even heard much mention made of precision medicine, aside from HHS reps talking it up in various sessions. Perhaps readers will offer a different perspective.
After coffee talk, I walked just a few yards to the HX360 Pavilion, which turned out to be a really nice, open space for its exhibitors, including Matter and Startup Health. I’m not sure how it compared to pavilions past, but it was nice to enter into an exhibit space not filled to the gills with humanity.
I caught the #HITsm panel featuring illustrious thought leaders like Drex DeFord, a longtime friend of HIStalk and participant in our HIMSS16 CIO luncheon. Host @HealthStandards kept the live and virtual discussion high level by focusing on innovation in HIT. A number of themes emerged, including the consumerization of healthcare and technologies poised to have the biggest impact. My vote goes to any type of tech – high or low – that can alleviate the costs associated with aging in place, long-term care, and palliative care. A big chunk of healthcare dollars goes towards caring for the elderly in these categories, and so it stands to reason that technology that addresses these areas might make some waves (if it’s not already doing so) in terms of cost and outcomes.
Standards were also mentioned, at which point everybody groaned.
I spent the rest of my time walking through the exhibit hall one last time. Traffic was light in some areas and heavy in others, as this picture of HL7 International’s booth can attest. Folks were lined up two to three deep to hear Massachusetts EHealth Collaborative President and CEO Micky Tripathi talk about the Argonaut project.
The #FHIRSelfie photo op just around the corner from where he spoke looked like a lot of fun.
Healthfinch co-founder and CEO Lyle Berkowitz, MD (and associate CMO of Innovation at Northwestern Memorial HealthCare (IL)) was gracious enough to stop and snap a selfie with me, even though I initially mistook him for Cedars-Sinai CIO Darren Dworkin.
My last official “drive by” of the day was to say one final thank you to the Xerox team for the lovely dinner the night before. Chief Innovation Officer of Commercial Healthcare Tamara StClaire and I chatted about the fabulous food and conversation (creamed corn = amazing / value-based care = struggle), and Xerox’s new population health management solution, which I’ll cover in HIStalk Practice’s Population Health Management Weekly Wrap Up on Sunday. I threw her a curveball in asking for her thoughts on HealthSpot’s stealthy departure/implosion. She equated Xerox’s partnership with HealthSpot as a learning lesson – one that has left the company now fully committed to remaining in the telemedicine space with an eye towards offering virtual queuing and payment processing. She wouldn’t name names, but did say that the company is in talks with several telemedicine vendors to prop up their IT infrastructure in the coming months.
I shuffled through tweets as I queued for a taxi to the airport (the line was not that bad), and had to share this one because it is apropos no matter which HIMSS conference.
As is this chart tweeted by @MandiBPro and @drNic1. The expo’s WiFi actually ended up being pretty reliable, which isn’t always the case at HIMSS.
My flight home has thus far been fun. The terminal was filled with familiar faces and longtime friends and I’m about to crack open one of the books I splurged on at the airport bookstore. I’m hoping humor – and healthcare IT – will get me through the long flight. Safe travels everyone!
Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Thanks for that nice summary.
As I wrapped up my week at HIMSS, I was encouraged by what’s out there, but also overwhelmed with some of the major challenges that face our industry. As a healthcare technology executive, I found myself asking these questions:
1) Are we funding the new “wolves of wall street”?
The vendors in this industry are full of “work hard / play hard” types and it really comes out at HIMSS. But it often goes beyond just a fun atmosphere and I find myself asking “am I really so desperate for this service or product that I’m willing to pay to support this?” When a consulting firm president can be in active litigation for putting a sexual innuendo on official company letterhead (among other things), and then the same president can be seen getting extremely drunk and touchy-feely with a co-worker at an official company networking event, I’m dismayed. Dismayed that my colleagues in this industry are really so desperate for help with our overly complex IT systems that we’re willing to pay a cardiologist salary to these firms for a 25 year old implementer. Dismayed that we’re willing to put our values aside to continue to work with firms that are spending our hard-earned healthcare dollars perpetuating a hard-partying frat-boy culture in the industry. (And it’s not just any one firm or person.)
2) Have we lost touch with the mission?
Perhaps the strangest thing I’ve ever seen at a HIMSS event happened during a CHIME presentation on Monday. Responding to a question about hospital margins, Gary Loveman stated that hospitals simply need to convince people that healthcare is valuable so that they will pay more. The strange part was that a room full of CIO’s (presumably thought leaders) applauded this. It was one of the few ovations of the day. That’s correct: in a country where healthcare consumes about 1 out of every 5 dollars in the GDP, a room full of “thought leaders” applauded the idea that we need to charge more. Perhaps this is why we’re ok with funding the “new wolves of wall street”? If we run out of money, we believe there’s plenty more where that came from.
So, all in all, a good HIMSS, but one for reflection.
You should really link to or give credit to XKCD for your standards comic.
http://xkcd.com/927/
http://histalk2.com/2016/03/04/jenns-himss-3316/
@HimssRecapper: To your point of semi-ethical or “boisterous” vendors: What are you doing to support the vendors you think are true partners and in the HIT market for the long term? How are you differentiating the references or mentions you make of each type of vendor? Do you go out of your way to recommend your best vendors even when not asked about their particular product? Maybe said another way, much like the ratio of good/bad restaurant reviews, it seems the “good guys of HIT” are way under-praised and, in reverse, almost taken advantage of by the customers themselves. Maybe the Bad Guys just say “No” or charge so much that you don’t have a choice but to take it or leave it?
Think about it another way: If you have three vendors sharing responsibility for a problem, who gets the call first? Will it be the vendor most likely to be the root case of the issue? Or the one that picks up the phone first with the most useful support person? What if each vendor involved provides a quote to fix the problem and they break down something like this:
1) Bad Guy #1 says $50k and two weeks — you know it will take them 10 hours to fix the problem yet they just don’t want to do so; they have a reputation of overcharging and under delivering; it seems like on every project you get a new guy (who has been with the company a few months)
2) Bad Guy #2 says $20k and six weeks — they say they have go-lives on-going and can’t free anyone up to fix your problem before then; often accurate in pricing and provides questionable solution; rarely on time and always distracted; history shows your team ultimately needs to do extensive QA on any changes
3) Good Guy says $30k and three weeks — you suspect it is an honest quote for reasonable effort on their part to resolve the issue; you’ve worked with the same support person for seven years (turn over is very low) and you trust the implementation engineer as he has done your last four projects and knows your site, your team, and provides quality work.
Which choice do you make? Do you ask the Good Guy to lower his price to match Bad Guy #2? Do you ask the Good Guy to speed up his delivery since Bad Guy #1 can do it in two weeks? Which vendor will likely put qualified people onto the project? Will you work with your accounts payable department to get the project invoice paid in a timely manner? Will you push your clinical team to QA the project on time? Which vendor will earn your endorsement once the challenge is behind you? Will you recommend the vendor with the solution?
Maybe said a third way: You pay your primary EHR vendor more in support ANNUALLY than you have given to virtually any other application vendor EVER. Why is it that the “smaller” vendors are always accommodating the vendor in your organization that is paid the most? What is the comparative value you receive from the vendors based on how much you paid them? When your EHR vendor support person is on the phone with a support person from an ancillary application and they both spend three hours resolving an issue, ask yourself what percentage of the annual support fee you pay was used up by the three hours from each vendor. If we assume the burdened cost of a competent support person is $160/hour, each vendor spent about $500 in hard costs resolving the issue. For the big vendor that might represent 0.0125% of what you paid them. For the small vendor it could be 1% of your annual support fee. How do you think the small vendor feels when it turns out to be the Big Guy’s fault? And further how does the Small Guy feel when he is asked to accommodate / resolve the issue for free?