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This Is Not 1991

February 3, 2014
by Mark Hagland
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As I and the rest of the Healthcare Informatics editorial team prepare to fly down to Orlando for HIMSS14, the annual conference of the Healthcare Information and Management Systems Society, my mind has been darting back naturally to past HIMSS Conferences, and all that has happened in healthcare and healthcare IT over the years.

Indeed, this is my twenty-third HIMSS Conference; I’ve attended the HIMSS Conference every year beginning in 1991, with the exception of one year in which it wasn’t possible for me to attend. That’s a lot of walks across the exhibit floor!

More importantly, when I look back on how much everything has changed in 22 years, I am struck by a number of fundamental changes in the landscape since then—beyond the fact that back in 1991, the HIMSS Conference enjoyed the participation of 1,800 people, whereas last year in 2013, over 37,000 attended.

Most fundamentally, the entire landscape of healthcare, encompassing the policy landscape, the business/operational landscape, and the technology landscape, has changed dramatically. In the policy sphere, the core cost/quality/efficiency issues that were already strongly emerging in 1991 finally led to comprehensive federal healthcare reform in 2010. And with the Affordable Care Act came a slew of “internal” healthcare reform mandates, including avoidable readmissions reduction, value-based purchasing, and healthcare-acquired conditions reduction, along with optional programs, including the multiple accountable care organization and bundled payment programs. At a very basic level, the demands on the part of the purchasers and payers of healthcare for fundamental change is now being manifested in U.S. healthcare; and no wonder, given that our healthcare system is now consuming nearly one-fifth of our nation’s gross domestic product, even as it struggles to demonstrate transparency and accountability.

On the business/operational side of the industry, things have fundamentally shifted as well. The managed care “revolution” of the 1990s, while broadly derided because of its numerous failures, did set into place some of the mechanisms of what would become post-ACA healthcare operations. But some areas were lacking in alignment back then, especially with regard to hospital-physician relationships and finances; and in addition, some technologies were missing in the 1990s that were essential to the more transparent and accountable, higher-quality, and more efficient system now emerging.

Of course, that leads to a discussion of technology. So much has happened with regard to IT in the past 22 years that it would be impossible to briefly summarize all the tech advances since 1991. What is worth saying here is that the most important emerging initiatives in healthcare right now, including population health management, management of the transitions of care, big data and analytics, and certainly genomic-informed medicine, simply could not have been technically possible back then, but clearly are now.

Given all this, it is not surprising that the atmosphere of recent HIMSS Conferences has been one of increasing clarity. And it will be fascinating later this month to see what HIMSS14 is like, with so much activity now swirling through U.S. healthcare.

Within that context, it is always our privilege and pleasure as the editors of Healthcare Informatics to present to you, our readers, the stories of the winning teams in the Healthcare Informatics Innovator Awards program. Please read our profiles of the four winning teams, as well as summaries of the accomplishments of nine semi-finalist teams. What the leaders in these organizations are doing is literally creating a conceptual path to the future of healthcare. Want to know what the new healthcare looks like? It looks like the Innovator teams’ innovations. Happy reading!

First Place Winner: Catholic Medical Partners

Co-Second Place Winner: Maimonides Medical Center

Co-Second Place Winner: North Memorial HealthCare

Third Place Winner: Vanderbilt University Medical Center

Innovator Semifinalists: Let a Thousand Flowers Bloom



Mark Hagland