Of course there were the themes of HIEs and ACOs, but they were also major talking points at last year’s HIMSS conference. Below are five new themes that I observed in sessions at HIMSS 2012.
“Data-driven healthcare” was a repeated phrase in several presentations throughout the conference. In the education session “Care Coordination in Practice,” Dr. Bob Dolin stated that more than 60% of clinical data is not contained in coded lists. Without coded lists, clinical decision software cannot be utilized to its fullest extent for more efficient and better quality healthcare.
Currently, much of the data is present in free text and scanned documents. According to Dr. Dolin, advances in natural language processing (NLP) can be harnessed to help encode more medical data in a machine-usable format. Coding more medical information will lead the industry towards “data-driven healthcare,” where clinical decision software can assist in patient care.
Multiple Levels of HIEs Necessary
Gaurov Dayal, MD, senior vice president and chief medical officer at Adventist HealthCare, compared statewide HIEs to a bus, “The bus gets you where you want to go, but it can be slow and stodgy.” Adventist launched the ACES (Ambulatory Care EHR Support) program that is aimed to support affiliated physician practices to adopt EHRs and also provide an infrastructure with an HIE.
Dr. Dayal believes that, for a successful coordinated care model, data flow must be efficient and tracked from hospital to physician and vice versa. Having a local, hospital-led HIE is key to establishing trust, efficiency, and timely sharing of data. State-level and national HIEs are required for cross community sharing, but it is the local HIE that will be responsible for fostering patient-focused care coordination.
Privacy and Security is Top-of-Mind
Of all the sessions I attended, those related to privacy and security had the most attendees, and they came armed with questions. Topics ranged from protecting data at rest and in transit, to user access and tracking, to all the related standards in support of these issues.
For those that stuck around HIMSS12 until Friday, Eric Heflin, CTO at Texas Health Services Authority, provided an excellent summary of how privacy protections can be enforced across regional, state, and federal HIEs. Heflin walked through a plethora of standards including those within the NwHIN criteria such as SAML (Security Assertion Markup Language) for Healthcare and XACML (Extended Access Control Mark-up Language), and specifically BPPC (Basic Patient Privacy Consents) which he is promoting for patient consent.
Heflin wins my award for best technical content of any education session.
Devices Becoming More Integrated
More time seemed to be devoted to medical device integration this year. There was a Knowledge Center on the trade show floor dedicated specifically to Medical Device Integration, as well as several education sessions addressing this topic.
Devices are getting smarter with more robust communications to transfer data in and out. IHE profiles in the PCD (Patient Care Device) domain are beginning to be accepted and adopted, leading to better interoperability and more timely patient data available through a common health system interface. And, more coded data available in the patient’s record leads to better quality patient care through “data-driven healthcare.”
Efficient Coordination of Care – It is possible
By far the most inspirational part of my HIMSS week was an “education” session by Dr. James Holly. Dr. Holly received a resounding applause at the end of his presentation, which included numerous patient success stories based on utilization of electronic care transitions.
Dr. Holly is CEO of Southeast Texas Medical Associate (SETMA), where they began implementing electronic health records in 1998. SETMA has been leveraging electronic health records ever since with statistical analysis for population management in 2000, quality metrics in 2003, and the maintaining of access to medical records during Hurricane Rita in 2006. SETMA is dedicated to patient-centered medical home, care coordination, and transitions of care to decrease preventable admissions.
Amazing stories were shared of not charging copays, paying for medication, and providing major services free-of-charge through the SETMA foundation, while following through with the patient to get them back on their feet. Respect and human dignity is a theme with Dr. Holly, who is not only very inspirational, but SETMA, now structured as a patient-centered medical home, is an example of care coordination done right.