Skip to content Skip to navigation

Reflections in a Golden Incentive: HIMSS10

Printer-friendly version

HIMSS10 is over. The blogs have been written, the pundits have spoken, but at the end, my original observation prevails: People are working.

I talked to a lot of attendees on the floor, in sessions and waiting in line for anything. And while, yes, overwhelmingly, their first sentences were often about meaningful use, if you took the moment to pause and get past those few sentences with them (I did) there is something else going on entirely. It’s called “business as usual.” It’s the same reason clinicians, administrators, legislators, and everyone else in the healthcare space come to HIMSS every year — to see what’s new, look for IT tools that can help them with planned projects, and most of all to be educated by their peers. If HITECH and ARRA weren’t happening, there would still be a HIMSS. Vendors would still be selling, and education sessions would still be happening. You wouldn’t know that to listen to the vendors out there, and I know I am not alone in feeling that the hysteria around MU was overkill at the conference. As I tweeted at one point, “If I hear ‘GOOD TIMES!’ once more from a vendor I’m not responsible for my actions.”

Please, let’s not forget one important fact about meaningful use: not everybody is SUPPOSED to get it. Folks, your government is counting on you to screw up. If you look at the Federal ARRA budget carefully, the government is paying $35 million in incentives, but has written in $18 billion in provider penalties to help fund it. So either you’re going to collect the incentive or fund the dollars to pay your competitor. Your country is counting on you!
 
Bottom line, the people that are working on this for the right reasons like safe, accessible care, and above all the patient (something I heard very little about at HIMSS10) are probably OK. The others? Well, there’s no way that buying a lot of product is going to get them where they need to go. That's what most of the CIOs I talked to said — and even the vendors told me the same thing (off the record, of course.) Care providers chasing the dollars will be probably be the ones coughing up part of that $18 billion. And the hospitals continuing to do the right thing because it’s the right thing to do, and not because of MU will be fine. Natural evolutionary process? (My only MU tip, and I heard from many—get a dedicated project manager for MU)

That said, it’s clear that hospitals are soon going to be swimming in data. They can think about using it to satisfy MU requirements, or they can begin to start using it to stop operating in the dark: data mining will be critical to future financial success. The same goes for streamlining and automating processes and workflows for everything from clinical decision support to claims. Not taking care of the bottom line means you are not going to have the resources to provide better care, and a lot of people were already working on projects right in that vein. In addition, anyone who is working the whole continuum of care from physician office to long term care is on the right track, too. It will all be part of the ARRA package, but cradle to grave and loyalty like that at Kaiser is done for the right reasons. Connectivity challenges, not to mention payment confusion and security and regulatory issues are a hurdle for many, yes, but there were many IT solutions at HIMSS10 that could fill in the gaps. Being patient-centric first may turn out to be the great differentiator between who makes it and who doesn’t. And those are the kinds of projects that so many I talked to at HIMSS10 were already working on.

The whole health care debate in this country underlined another issue at HIMSS too — how provincial we are. Other countries in the world have a wealth of global HIT experience out there, yet we hear very little about that at HIMSS. Heck, we’re still crying about how we are going to move to ICD-10 (delay the deadline again) while the rest of the world moves on to 11! Sure our payer model is somewhat unique, but there are still solutions that translate. Should we pay a little more attention to HIT solutions that weren’t born in the USA? HIMSS10 made me think so.

Finally, a big cheer of support to all the less than 100-bed hospitals out there. They chug along in our heartland, providing necessary care to their communities, very often unseen and unheard in this great debate. Most of them are working with impossibly small budgets and they are going to have to meet the same requirements as the big systems. The good news is that many of them are Stage 4 or higher—for the right reasons.

HIMSS10 is over. The blogs have been written, the pundits have spoken, but at the end, my original observation prevails: People are working. I

Comments

Daphne, I love how you cut right through the muck. This is the most honest (and accurate) take I've read so far about HIMSS. And I'd like to see more focus on the smaller hospitals as well. Half of all hospitals in the U.S. are under 100 beds, and I think it's time we paid more attention to how they are implementing IT with fewer resources. Well done!

Daphne,
That was a great blog post. You captured the essence of the major themes at HIMSS in an actionable way. Those people who dismiss all bloggers as daily diarrhea (yes, I heard that from an otherwise prominent thinker) simply don't understand learning in the era of Internet.

For example, you shared the critical insights:

"get a dedicated project manager for MU"

"you're going to collect the incentive or fund the dollars to pay your competitor."

"there's no way that buying a lot of product is going to get them where they need to go"

"hospitals are soon going to be swimming in data."

"Being patient-centric first may turn out to be the great differentiators between who makes it and who doesn't."

"we're still crying about how we are going to move to ICD-10"


"a big cheer of support to all the less than 100-bed hospitals out there. They chug along in our heartland, providing necessary care to their communities, very often unseen and unheard in this great debate"

Daphne, again, I think you nailed the issues, and nailed them succinctly. Boy, can you write well !

To paraphrase your advice: Focus on three things - achieve MU, the 5010, and ICD-10. Everything else needs to be deliberately deferred. They're defocusing, waste valuable time, and end-up transferring your assets to your competitors (as you elegantly pointed out.)