Originally published in April 2018
It’s been two weeks since attending the 2018 HIMSS Conference in Las Vegas, and I am finally able to digest the experience and share a few impressions.
First of all, HIMSS feels like the Coachella of healthcare IT — overwhelming, with 40,000 attendees and 1,300 vendors competing for your attention with vividly designed booths, “unique” schwag, free coffee, and bold promises writ large like “Big Data = Better Patient Care” and “Complete Solution For Modern Healthcare.” Combine this sensory overload with the Great American Neural Flood known as Vegas — an entire metropolis devoted to grabbing your primate attention and draining your wallet — and it was hard to stay grounded and remember why I was there.
I came to the desert to learn, to connect, and to listen. I did enjoy many of the educational sessions — most led by folks at the top of their game who are actively working on solving problems (some with inspirational success). And it was great to connect with clients, friends, partners and colleagues over meals and events. Most notably I was able to wrangle a group on an “Escape HIMSS” 3-hour hike at Red Rock Canyon, which was a stunningly beautiful and welcome antidote to the madness.
Here are my top 3 takeaways as I listened to the buzz and took it all in.
1. Cloud is a go!
At HIMSS 2017 last year in Orlando the question that seemed to be swimming around for providers was, “Should we go to the Cloud?” This year, that shifted from if to how and when. This was a core message of Google’s Eric Schmidt’s keynote address on Monday and was reflected in conversations I had and my own observations.
Clearly a large part of any provider’s digital infrastructure will remain on premises, but by migrating to secure cloud environments, providers can create opportunities to innovate, to connect with other systems, and to safely unlock massive value in EHR data. CSOs and CIOs seem to have reached a comfort level with Cloud as a concept, driven probably in part by the realization that these systems are often more secure than on-premises systems, and the majority of reported breaches in 2017 were on-premises and not Cloud-based system.
The good news is that the space is maturing and there are a number of companies who have been focused on purpose-built, highly secure (HIPAA-, HITRUST- and SOC 2- compliant) health clouds including big vendors like IBM and Google, as well as specialized companies like CloudMine — and as a result cloud deployments in healthcare are getting much easier.
2. AI begins its residency.
The last few years in healthcare IT have been marked by a lot of hype and debate around artificial intelligence and associated practices. It is a hard thing to even define, but it was clear at HIMSS that machine learning and automated chat systems have started to go mainstream.
Whether assisting radiologists in flagging items in images for further review, or crunching population health data to identify high risk individuals or moments, the powerful self-improving pattern recognition skills that machine learning brings are starting to make a positive impact in the field. It is also now quite common to see sophisticated automated interaction with patients through text, chat, or IVR for medication reminders, handling inquiries, and administering care plans.
There remains a great deal of smoke and mirrors — and jargonitis — in the field. I was speaking with one vendor at HIMSS and cheekily asked about his “deep artificial machine big data neural cloud bot” and he responded in earnest with an excited pitch for whatever panacea he was peddling. That description sounded clear to him.
3. The disruption is here and it’s starting to hurt.
In addition to the thousands of startups upending care models, in the last year, two big news items (should) have scared traditional providers: the CVS/Aetna merger and the Amazon/Berkshire Hathaway/JPMorgan Chase joint venture.
The first represents further leveraging the footprint of retail pharmacies, which are already conveniently located for consumers. CVS, Walgreens, and others are swiftly becoming healthcare providers whose point of care becomes much more compelling being able to pick up drugs or other therapeutics on the spot and have a built-in insurance plan.
The second represents the awakening of American employers to their power and their interest in driving change in healthcare and the wellness of their employees. They are going to demand more for less, and if the traditional providers won’t meet that they will find it elsewhere.
The providers are feeling it. One CIO at a large provider in a roundtable discussion I participated in lamented that occupancy across his inpatient facilities was down 10% year over year. There is an existential realization that innovation and diversification needs to happen — and that the methods used date to stem the tide through consolidation and cost-cutting are reaching the end of their effectiveness.
With the exception of acute care, the differentiator will be the experience — as it has been in other industries that have been disrupted in the last 10 years. Providers have not focused on this in the way that an Amazon, Netflix or an Uber has, and they need to learn how and shift from pathology-centric, reimbursement-centric, clinician-centric and operations-centric views toward patients-centric, focusing on the end-to-end experience. Convenience, control, simplicity, and delight will reign.
The traditional providers are starting to turn the ship by degrees. Almost all providers have a telemedicine program in some phase of maturity or exploration. In my work as patient advocate and digital innovator on the board of NODE Health, the most common problem statement for innovators seems to be lowering 30-day and 90-day readmission rates (driven by incentive changes for Medicaid and Medicare as part of MACRA).
This means they are looking beyond their four walls in a serious way and starting to adopt technology to extend engagement into more parts of the care continuum — which is good not just for patients and the system as a whole but for defense against disruption.
This trip was the first time I had been to Sin City and didn’t place a single bet — maybe because I’m older, or maybe because I was too overwhelmed and exhausted from HIMSS. I would, despite the hype and complexities, bet big on technology truly transforming healthcare — and that shift happening faster than you think.