The Moment for Transformational Change is Now
HIMSS President & CEO, Hal Wolf, takes time to reflect on 24 months of healthcare IT and its positive contribution to better, more equitable healthcare
Healthcare professionals across all disciplines struggle with the inherent dichotomy that exists in our industry and community: Medicine requires excellence and specialization, so you may well have the top doctors, top nurses and top hospitals, but if you’re only serving the top-end of the population, then do we have the best healthcare?
This conflict is not lost on Hal Wolf. In fact, the conflict fuels HIMSS’s mission: Reform the global health ecosystem through the power of information and technology. Wolf believes that the solution to improved, more equitable healthcare lies at the nexus of technology, medicine and compassion.
“Healthcare is anomaly-based. Medical professionals are continually seeking to identify anomalies from the norm that characterize a condition. Preventative healthcare is when we’re looking for the anomaly before it even occurs,” Wolf explains. “Healthcare information systems allow us to set the norm so we can more easily spot the anomaly occurring with individual patients, but also occurring with populations. We absolutely need the expert medical professionals and the compassionate caregivers, but if we can be more efficient and effective with professionals and more compassionate with our broader population then we can apply information technology better and more broadly.”
Wolf’s perspective is informed by 18 years in healthcare information systems, 4 of which he has helmed the HIMSS organization but he says the past two years of pandemic and lockdown have been even more instructive and inspirational of his career.
“The pandemic prompted an extraordinarily heroic effort in every single facet of the healthcare ecosystem, whether you’re on the frontline, whether you’re in IT, whether you’re a front desk receptionist, it has been a massive challenge met by a gigantic effort on the part of our community. We have learned much and applied insights and learnings that will yield continual improvements at in-patient and population health and system efficiency and reach for years to come.” Wolf says referring to technology realms such as telehealth and digital health where progress had been made prior to March 2020 but that experienced considerable acceleration in the months since.
“Telehealth, traditionally, is a face-to-face encounter, which takes place a bit like a traditional consultation where doctor and patient can see one another and have an exchange. Telehealth in that more restrictive definition is fundamentally a video replacement of the encounter and it serves a tremendous purpose over the pandemic in keeping patients, providers and the population at large safe by having patients not come to hospitals and clinics. Now that a telehealth infrastructure is in place and patients are more comfortable with the service, we will see broader acceptance and use. This acceptance advances health and equity because now issues like childcare, transportation and other limiters are largely — but not entirely — eliminated,” Wolf explains.
“Digital health can build on this momentum and take our community and population to the next level with the use of machine learning, predictive modelling, Artificial Intelligence (AI), wearable devices, monitors on phones, and motion detectors and sensors in the home. Digital health with this technology provides patients, medical professionals and caregivers with actionable information for better healthcare. That information could be as urgent as an elderly patient falling in their home or as slow to develop as rising blood pressure in a younger person over time. In both cases, digital health is facilitating better comfort and quality of life but also better optimization of precious resources we call clinics and hospitals.”
Wolf believes that the combined impact of these diverse technologies coming under the auspice of healthcare information systems which had previously been under different groups — sensors under building, facilities or operations; devices under practitioners — is facilitating a positive move outside the hospital.
“I spoke with a CFO not long ago about a hospital he had just built and he characterized it as having just spent $1.2 billion building a massive facility that acts as a health factory from six in the morning to six at night, but from six at night to six the next morning it’s a really bad motel. He recognized that shifting care out of facilities into the home would optimize use of capital, address growing demands and advance patient comfort and care, and he knew that getting there required the embrace and strategic deployment of healthcare IT technologies — including those not yet commercialized.”
The healthcare CFO will no doubt have to address privacy and security issues and the perception of privacy and security issues with cloud infrastructures before realizing his vision, and Wolf shares the CFO’s concern on both issues.
“The big challenges in front of us are to maintain security, maintain privacy, maintain the need for individuals to know that their information is theirs and that it’s secure,” Wolf says. “At the same time we do need to de-identify and depersonalize and improve population health backends so that we can look at it on an aggregated basis in order to do better predictive modeling. Nothing is more personal than our own health and nothing is more precious than our own data, but we also have to contribute to a society and to the world as a whole. We’re making great headway along those lines.”
“Security and confidence in the security of the healthcare IT infrastructure is what will facilitate broader use, and this is where the innovation really starts to shine,” Wolf says. “For example, a nursing station with an LG monitor looking at a presentation layer with basic data of an individual such as their history or their genomic data, or just their ID. Meanwhile, back-end systems can do the computations and make predictive modellings about what is next for the patient in a simplistic component of clinical decision support or more complex diagnoses that help us know what this anomaly could mean and what response needs to occur. That’s where the equity starts to come in because it’s scalable. And scale is simply not possible without security.”
Switching gears from the application of healthcare IT technology in clinical care and population health to the deployment of healthcare IT technology for education and training — especially when it comes to healthcare IT — Wolf believes there is considerable untapped potential for improvement, operational efficiency and equity.
“We see fundamental IT infrastructure education — professional development, training, best practices on a worldwide scale — beginning to transform. The use of digital technology has multiple layers including the location of technicians, their grasp of infrastructures and of data architectures, and how to take full advantage of technologies like the cloud. A recent HIMSS survey on readiness of digital health capabilities measured hospitals and systems found that 20% were ready and about 80% were not. A comprehensive educational process is clearly required to take full advantage of existing and emerging healthcare IT technologies and ideas,” Wolf explains. “Then also ask, how do physicians, nurse practitioners and hospital administrators need to consider technologies, infrastructures and budgets differently than previously? We built the HIMSS Accelerate platform, which applies Healthcare IT for online education, training and credentialing, for exactly this reason. It aggregates, presents and certifies programs from diverse bodies around the world in a single, easy-to-access, easy-to-navigate platform backed by HIMSS. As one example, there are 123 nursing associations producing excellent products and services on the platform. It would be tremendously confusing and difficult to publish or access this quality of content and credentialling were it not for Accelerate.”
Wolf and his team know first-hand how much has been achieved and yet how much untapped potential still exists. This August, they held the 2021 HIMSS Global Health Conference in Las Vegas where they met with members, ran educational sessions and held an exhibition.
“We got to meet people for the first time in a long while and get first-hand accounts of how they coped with all of the challenges of 2020 and 2021,” Wolf says. “Members appreciated the intimacy of the show and being able to spend quality time with peers exploring ideas and technologies, sharing war stories and finding opportunities to collaborate. It was a very memorable event and, I think, it became an inflection point for many attendees as they felt better supported and energized than when they arrived on day one of the conference. For those who could not attend, we doubled down on Accelerate and featured a virtual conference that global visitors could easily access, and that drew considerable attendances during and after the conference.”
That galvanizing moment from HIMSS clearly had its impact on Wolf himself. When we spoke with him for this interview he had finally taken some vacation since the pandemic and excused himself from his family to take our call. Hearing his stories and insights and feeling his commitment and optimism for equitable, advanced healthcare through the power of healthcare IT has a visceral, humanizing effect on an industry sometimes mis-characterized by ones and zeros.
“I think this tech transformation is going to take a cultural change,” he says. “The exchange of data information in the speed with which we do it is going to lend itself to back-end capabilities around the cloud and other computational forefronts that will help drive care innovation and therefore improve equity as well. Equity is almost impossible to ever fully achieve because there are always going to be disparities. Our responsibility is to champion that fight and to go after it with everything we have!”
We think he will do exactly that.
