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Impressions From HIMSS19

The Healthcare Information and Management Systems Society (HIMSS) conference was a huge event that took place in the Orange County Convention Center in Orlando, Florida, with 44,000 participants staying across 90 hotels, visiting 1,200 exhibitors. As a first-timer, I took the seasoned participants’ suggestions for comfortable footwear and laced up my sneakers to traverse the expanse of hallways, exhibit halls, and meeting rooms, inhaling all I could. The tagline for the year was “Champions of Health Unite.”

The headline theme for this year was interoperability. Centers for Medicare and Medicaid Services administrator Seema Verma, one of the keynote speakers, underscored commitment to interoperability, driving home the message that this was going to happen one way or another. Given the long road that interoperability has already been on—with tepid progress—these announcements are part of the long road ahead reaching for that goal.

Five key themes generously featured were revenue cycle management (RCM), artificial intelligence (AI), value-based care (VBC), blockchain, and patient experience. While RCM and patient experience have made headway, AI remains in the early phase of adoption, and blockchain is more concept than norm today. VBC sounds like a good idea to me, but I fear it is hard to align patient outcomes with low costs. While each offers a worthwhile value proposition, there is an unspoken, perhaps even subconscious, resistance to change due to inertia, a confusion amidst the dozens of technology partners offering variations of an already nebulous theme, compounded by a don’t-fix-what-isn’t-broken mentality, and a lack of clarity and talent to figure out how to get there from here.

I was surprised to find the extent of coursework offered as part of the conference. There were well over 100 continuing education sessions to help participants earn professional credits. A career fair was set up, as part of the conference continued the theme of searching for and recruiting talent into the industry. Both activities underscored the pressing need for professional education in health information, health IT, and technology to boost the next-generation talent pipeline. The shortfall around talent is one that is not likely to go away soon. I wouldn’t be surprised if the HIMSS20 headliner was talent-development-related.

What I didn’t see, and really would have liked to see, was information on how all the savings promised across exhibitors and speakers trickled down to the individuals that ultimately own or use a health insurance policy and visit a health specialist—in other words, to all of us, not as health industry professionals but as individuals who consume health services, as users of health insurance products and as patients who routinely receive baffling medical bills and encounter the joy of figuring out how to pay for them. A handful of exhibitors and speakers covered patient finance and patient payments, but I wonder if they were heard loud and clear. That, I guess, is another story for another set of champions.

Another topic I found lacking was the role that health benefit accounts play in the broader context of growing out-of-pocket healthcare expenses, and how they can help alleviate the cost burden of healthcare on employers and employees. After all, it is the employees—or patients—who directly or indirectly provide the revenue for health plans in the form of premiums and give viability to many technology partners there. Without thinking about the financial weight of health on a patient, the whole patient engagement theme remains disappointingly incomplete.

This tells me that health benefit account providers and HSA providers are not top-of-mind for healthcare providers and healthcare payers. This is concerning since the share of out-of-pocket payments across all health expenditures makes up US$370 billion, about 10% of all health expenditures, and given the rise in out-of-pocket payments and uncompensated care, it can make or break a hospital’s often fragile operating margins.

As a first-timer, I noted how Epic, Cerner, Meditech, and Allscripts were the 600-pound gorillas sitting in the center of healthcare, with many exhibitors eager to showcase their point solutions and how compatible they were with these electronic medical records and electronic health records systems. The goal for many technology vendors was expanding their clinical reach and relevance; providing a more comprehensive, 360-degree view of the customer; and promoting decision-making tools using robust data sets, whether sourced internally or externally.

Much to the chagrin of my colleague who accompanied me, I had to skip the blues concert, as I had already walked what felt like 26.2 miles during this memorable event. After all, champions of health need their sleep.