Next week, I will be joining an anticipated 46,000 people at the Sands Convention Center in Las Vegas, as I fly to Nevada for the HIMSS Conference, sponsored by the Chicago-based Healthcare Information & Management Systems Society. And it feels authentically like an inflection point in U.S. healthcare and healthcare information technology.
To begin with, I should context this by referencing that this will be my 25th HIMSS. That’s right—I’ve participated in a quarter century of HIMSS Conferences, beginning in 1991, and missing only one year (1996). It’s been astonishing to see the changes in the conference itself. Purely on a statistical level, it’s fascinating to look back at the history of HIMSS and the HIMSS Conference, and to see that the 1991 HIMSS Conference attracted 1,800 attendees to the Moscone Convention Center in San Francisco. As I reported last year, the official total attendance figure for HIMSS15 was 43,043—an astonishing increase in attendance—with possibly a few more thousand people joining the throng this year.
And of course, the number of educational sessions, networking opportunities, exhibitors—the volume of everything—has grown dramatically. But far more importantly, healthcare IT issues have become central issues for U.S. healthcare—and indeed, for global healthcare.
What is fascinating to me now is this: a confluence of factors has put healthcare IT at the center of overall healthcare considerations. How so? First, U.S. healthcare is about to go over a cost cliff. As the Medicare program’s actuaries reported last autumn—as reported in an October 2014 Health Affairs article—total healthcare spending is expected to go from 17.2 percent of the U.S. gross domestic product in 2012 to 19.3 percent in 2023, with potentially disastrous results. As the actuaries noted, “Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013-23,” the authors write, “the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023,” with total expenditures going from $2.894.7 trillion in 2013 to $3.056.6 trillion in 2023.
Those staggering statistics represent the stark reality facing the purchasers and payers of healthcare—federal, state, and corporate. And the cost cliff that U.S. society is going over is inevitably pushing a profound policy and payment shift towards value-based care, accountable care, and population health, and away from the existing high-cost, volume-based fee-for-service U.S. healthcare system.
And what has become more and more clear by the day is that healthcare IT will be absolutely essential to any shift away from volume to value, on so many levels. IT for analytics, to assess what is going on; IT for clinical decision support, to help physicians and other clinicians at the point of care and diagnosis; IT for continuous clinical performance improvement; IT for health information exchange; IT for revenue cycle management; IT for health information exchange; IT for community health improvement; IT for true patient and consumer engagement.
And all of this is directly relevant to the annual HIMSS Conference. I remember back in 1991 and 1992, walking the exhibit floor, and being offered very nebulous, awkward pitches about closed-system IT solutions that promised they could do everything, while giving one a very unfocused feel about what they could actually deliver. But times have changed. With such a clear policy and payment landscape—and federal healthcare officials making it clearer by the day what they want and expect the U.S. healthcare system to do—there has never been a clearer strategic or operational landscape for healthcare and healthcare IT leaders.
My own perspective is that the past three or four years have been quite different qualitatively from previous years at the HIMSS Conference, in that regard. With the landscape becoming more and more clarified in the wake of federal healthcare reform, the meaningful use program, and other federal healthcare initiatives, things have become highly clarified for the healthcare industry, and specifically, for healthcare IT leaders. Thus, the clarity of the landscape overall has helped to focus everyone at the HIMSS Conference in recent years—providers, payers, vendors, everyone.
That has led to what I would call a “concretization” of vendor self-presentation on the exhibit floor at HIMSS. Particularly in the past three or four years, HIMSS attendees know what they’re looking for, and looking at. They’re coming onto the exhibit floor to compare solutions around data analytics, population health, care management, clinical decision support, health data exchange, imaging informatics, revenue cycle management, and a number of other very clear, often targeted, use cases. So the vague, generalized pitches of 20 years ago simply won’t cut it any longer.
The same attitude seems to prevail even around educational sessions, where attendees are increasingly focused, and knowledgeable, and coming into sessions with well-developed thoughts around specific areas of inquiry. That, of course, puts pressure on presenters, who need to be more than just one step ahead of the attendees with whom they are sharing their knowledge and wisdom.