Monday, January 30, 2017

HIMSS17 Preview: Same Thing, Different Year or a Whole New World?

Each year at the HIMSS Conference and Expo, there are hundreds of educational sessions, which are grouped into categories. Last year I attempted to analyze trends based on which categories gained or lost prominence compared to the previous year. Unfortunately, the categories themselves changed significantly from 2015 to 2016, making a direct comparison difficult. However, there’s good news for 2017; the categories have not been shuffled around to the same extent as last year, meaning that a change in popularity for a category truly represents a trend.

click to embiggen

Privacy and Security

This year the top category is Privacy, Security and Cybersecurity. This is up from the number 3 position last year, compared with number 6 in 2015. It’s clearly trending upward for good reason. The number of cybersecurity incidents is growing every year.

It’s a topic that needs a lot of attention and requires immediate action.

Care Coordination, Culture of Care and Population Health 

This category was tied for first place last year, and even though the number of sessions in this category is up from 29 to 32, it places second this year. As EHR implementation projects wind down and new programs like MIPS and MACRA ramp up, the sustained focus on population health makes perfect sense.   

Health Information Exchange, Interoperability and Data Access

This topic jumps four spots to number 3 this year, demonstrating the importance of establishing interoperability as well as deriving value from interoperable systems. Interoperability is a perennial hottopic because even though industry is starting to get a handle on the problem, there are always new systems and data sources to integrate with the existing information ecosystem. As long as the industry continues to innovate new systems and use cases, HIMSS attendees will demand educational sessions about interoperability.

Quality and Patient Safety Outcomes

Quality outcomes climbed from number 10 to number 6 this year, but it’s surprising that it didn’t advance even more. With MIPS and MACRA coming in the near future, it would seem like a category that deserves a lot of attention.  

Process Improvement, Workflow and Change Management 

This category was tied for first place last year, but plummeted to number 10 in 2017. This is perhaps due to the fact that most hospitals have completed their ICD 10 and EHR projects, so there are fewer processes and workflow changes pressuring IT departments.

EHRs 

In a related vein, the topic of EHRs is now last on the list, again reflecting the fact that EHRs are now widely implemented.

An Industry in Transition

Whenever the goal is to improve processes through data analysis, the first step is always to capture the foundational transactions electronically, then implement systems to analyze the transactional data and determine where and what to improve.

In healthcare, the core transactions are patient encounters, which are captured in an EHR. Analysis and quality measurement happen in population health systems, and process improvements follow from there. Based on the fact that demand for educational sessions about EHRs has waned and population health is on the rise, we can conclude that the first phase is complete and, as an industry, we are moving into the second phase. We’re climbing the value ladder from simply capturing transactions electronically in EHRs to analyzing them and making improvements based on the analysis. As the value of our electronic data assets increases, so does the need to ensure their interoperability and security.

In my opinion, the breakdown and trends of the HIMSS17 educational sessions accurately reflects what is happening in healthcare IT right now.

Monday, January 23, 2017

2017 Healthcare IT Trends and Predictions

Unlike last year’s list of predictions, I’m  only focusing on a few broad trends for 2017.

Legislative and Regulatory Uncertainty

A new administration in Washington brings a whole new set of appointees to lead the various departments of the executive branch. Organizations like CMS, FDA, ONC and many others will experience changes in leadership and budget that will impact healthcare reform.

The biggest changes will come from repealing and replacing the Affordable Care Act. Right now the magnitude of the impact is unclear because exactly how to replace ACA is still in flux. The ACA affects nearly every aspect of healthcare, increasing the potential for disruption; however, it seems likely that many of the current elements of the ACA will stay in place with moderate updates. Healthcare information technology may see less upheaval than other parts of the healthcare system.

Another legislative change comes from the 21stCentury Cures Act, a $4.8 billion package of healthcare spending laws that was passed by the outgoing Congress and President. As part of the act, President Obama’s Precision Medicine Initiative and Vice President Biden’s Cancer Moonshot will receive further funding. There are also provisions related to telehealth, opioid abuse prevention and mental health.

Perhaps the biggest regulatory change included in Cures relates to the FDA. There are several provisions related to how the FDA regulates clinical trials with an eye toward speeding up approvals. Real world evidence will be permissible in place of a full clinical trial for new indications of already-approved therapies. Many types of healthcare-related software will be exempt from FDA regulation.

Cybersecurity

Security is always a top concern in healthcare IT, but the problem got worse – not better – in 2016. The risks associated with cybersecurity are now receiving board-level attention at many organizations, and improving best practices will be a primary focus in 2017. 

Cloud-based technologies could stand to benefit from increased attention to cybersecurity. Using the cloud means ceding at least some control over security to the cloud provider. As a result, IT leaders have been historically wary of cloud deployments. 2017 may mark a tipping point. Cloud providers are increasingly focused on high standards of security, and the benefits of cloud-grade security practices now outweighs the advantages of keeping control. 

Many companies are expecting blockchain to gain momentum in 2017 as the industry looks for breakthrough technologies to combat cyber threats. 

Population Health and Precision Medicine

Quality measurement programs and value-based reimbursement are long-term trends that began several years ago and will continue to rise in 2017. Population health management initiatives require software and processes, and adoption has not kept pace with business needs. This is partly because organizations have focused on EHR optimization, Meaningful Use requirements and other projects. In 2017, population health will start to get the attention it needs.

With population health taking center stage, precision medicine will continue to wait in the wings. Precision medicine is seeing some uptake in oncology and a few other specialties, but broader adoption is unlikely in 2017. The trend for 2017 will be to investigate, but not widely deploy, precision medicine technologies. The five-year trend may be that population health and precision medicine work hand in hand to radically transform healthcare as we know it. 

What Does This Mean for You?

With an uncertain regulatory and legislative environment, healthcare IT budgets in 2017 may be primarily focused on concrete, low-risk projects. Cybersecurity and population health management are two areas where investment is overdue, so they are most likely to rise to prominence. When the industry catches up in these areas and the regulatory environment becomes more certain, attention will turn in the coming years toward other initiatives.