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Healthcare Informatics’ HIMSS17 Survival Guide

February 8, 2017
by Heather Landi, Rajiv Leventhal and Mark Hagland
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How is the vendor market shifting to the changes we will be seeing in health IT policy, and how much conversation will there be around these topics?

We, the editors of Healthcare Informatics, will be joining, very shortly, an anticipated 40,000 people at the Orange County Convention Center in Orlando, Florida for the HIMSS17 Conference and Exhibition, sponsored by the Chicago-based Healthcare Information and Management Systems Society. The sheer size of the HIMSS Conference has grown steadily in the past two decades, as the 1993 event, held in San Diego, drew 4,000 attendees, according to a review of HIMSS history. Last year’s HIMSS conference drew a total of close to 41,000 attendees. Going into HIMSS17 in Orlando, we are anticipating it will be bigger than ever, and as frenetic with activity as ever. As veteran conference attendees well know, once the conference begins, it becomes a sprint to pack as much networking and education into five days as possible all the while trying to navigate between point A and point B through crowded hallways. Over five days, HIMSS17 will feature 300 educational sessions and 1,200 exhibitors, and, keep in mind, last year’s exhibit space occupied over 1.3 million square feet of space. Additionally, HIMSS is projecting an attendance of 45,000.

While the volume and sheer size of the HIMSS Conference have steadily grown, more importantly, in the last two decades, healthcare IT issues have become central issues for U.S. healthcare. The healthcare industry is already tipping into transformational change—change that is already occurring at many patient care organizations, with the shift to alternative payment models (APMs) and delivery system reform. And, it has become clear to many healthcare leaders that health IT will be absolutely essential to any shift away from volume to value. Additionally, with a new Administration in the White House, it seems almost certain that more changes are to come with regard to federal healthcare policy. As in year’s past, this year’s HIMSS conference promises to provide fascinating insights and perspectives and ongoing innovations that are helping to shape this industry at this crucial inflection point in healthcare. And, there are sure to be some surprises at HIMSS, as well. With this in mind, we interviewed healthcare IT leaders to gain their insights into what to expect at HIMSS17, to provide you, our readers, with a HIMSS Survival Guide that can serve as a forecast for this year’s conference.

What will be the biggest buzzwords and “buzz concepts” this year?

Charles E. “Chuck” Christian, vice president, technology and engagement, Indiana Health Information Exchange, Indianapolis, IN:

Other than FHIR [Fast Healthcare Interoperability Resources], I think you’ll see several iterations around “blockchain.” I’d had more than one conversation with several folks on the topic. It’s more about what we can do with the technology, can it apply to healthcare and how might it apply. I’m unsure if there is really a revenue model for it yet, but one can never tell.

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Joseph Scopelliti, IT director, data management, Geisinger Health System, Danville, PA:

I’ve got to believe that security’s going to be very big this year, and everybody’s concerned about breaches. And of course, analytics is going to be huge, too. And also, with the change of administration in Washington, that’s going to be big.

Vince Vickers, KPMG’s healthcare technology leader:

I believe there have been the same topics for the last two years and I think we’re going to see a shift this year. We’ll see more interest in machine learning, and I think that’s going to be a hot topic. I think we’re going to see more discussion around efficiency from an operational standpoint around software bots and process automation. There’s a number of startups that I see are going to be there around data and ownership of that data, and patient access to their data using new technologies like blockchain. Looking through the exhibitors, I believe there’s like nine or 10 blockchain-related vendors that are going to be at HIMSS, so that’s going to be an interesting topic. Additionally, we saw a significant number of high profile breaches from a cybersecurity perspective in 2016 and that is not going away. As that’s becoming a bigger challenge, I suspect cybersecurity is going to be a big topic as well. I think we’re going to see and hear a lot about patient access and patient experience. Regardless of what happens with the Affordable Care Act (ACA), I think the consumerization of healthcare is going to continue to be a hot topic, and that includes mobile technologies and anything around the patient experience.

Gregg Mohrmann, partner, The Chartis Group:

Where we kind of see things going is IT elevating itself to the enterprise strategy level, and really tying the IT strategies to the business strategy. Ten key topics, in no particular order: electronic health record (EHR) value realization; business informatics, paired with finance and administrative systems; innovation and digital health; continuing to align IT and its value to the enterprise strategy; precision medicine and genomics; convergence of performance improvement and analytics to drive value; the new administration and implications; integrated care management—population health on steroids; what I would call one-stop-shop access centers, not just call centers—for patients and consumers; and clinically integrated networks, which ties to interoperability and common EHRs. Those are the top ten trends we see.

Gregg Mohrmann

As far as what the vendors will pitch, there’s going to be a lot of analytics of all forms. How do analytics platforms do more for you in terms of driving data along with different EHRs? The other piece of that is integrated care coordination, extended outside the hospital walls, to social work, SNIFs, etc., using apps to drive actions and activities of all of those working outside the hospital walls. The third thing will be telehealth and digital health, and tying those into the systems, and new ways of getting to your consumers, anything from even teleconsults, how you tie in the home, the workplace, etc., from a technology perspective. I think there’s going to be a bit on precision medicine and genomics. Now, I think the spin on that will be on how traditional vendors deal with it in terms of the storage (tons of data) and the analytics; and also, how traditional vendors will incorporate precision medicine not only into the analytics, but also the workflow. And the whole clinical trials management piece, we see a lot of that coming in. If you could target people from a precision medicine perspective, into clinical trials and into the post-acute care setting. And the big 50 healthcare institutions are doing precision medicine. So how that all ties together, so having that functionality across those.

Will we see a significant promotion by clinical IT vendors of FHIR-enabled/FHIR-supported apps on the exhibit floor?

Charles E. “Chuck” Christian, vice president, technology and engagement, Indiana Health Information Exchange, Indianapolis, IN:

I’m thinking that the majority of the EHR vendors’ booths will be on FHIR (pun intended). It is all the buzz and there appears to be a solid push from the ONC [the Office of the National Coordinator for Health Information Technology] and others in D.C. to provide a level of access to the data for the patients. However, there are those that are concerned about the legal ramifications, which may or may not be well founded; we need lots of attorney discussion on this one.

Charles E. "Chuck" Christian

Joseph Scopelliti, IT director, data management, Geisinger Health System, Danville, PA:

As far as FHIR-based apps—I’ve got to believe that there will be more of that.

How is the vendor market shifting to the changes we will be seeing in health IT policy, and how much conversation will there be around these topics at HIMSS?

Leslie Kriegstein, vice president of congressional affairs, the College of Healthcare Information Management Executives (CHIME):

Even with the change in administration, we can very much anticipate that the shift to alternative payment models (APMs) and delivery system reform—ushered in by IT systems—is here to stay. I would expect that the conversation around the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and around APMs to continue to rise in prominence. Looking at our membership, the traditional hospital/doctor boundary is blurry, and so many of our CIOs are concerned about MACRA and ACI [Advancing Care Information, a new performance category under MIPS] as well as the traditional Meaningful Use, so those conversations are here to stay, will expand and definitely not shrink. Given the fact that MACRA was such a bipartisan proposal when it came to Congress, I would anticipate that of all the reform programs, that program will stick around and be of interest to policy makers. I think this is definitely the long-term policy planning that our members and vendors are planning for. Understanding providers’ technology needs going forward is at the top of vendors’ lists.

For 21st Century Cures, there is still very much that is up in the air, because the new federal advisory committee hasn’t been formed yet, and we don’t know who the head of ONC will be. Although there were some details in the statute regarding the functionalities about what vendors will be reporting on, a lot of that will still have to be flushed out when the leadership is identified. It’s definitely on vendors’ radars, and will increasingly be on providers’ radars. I do think that the fact that the information blocking components go into effect very quickly will be on the top of the priority list. Some of the other components, though—the usability, interoperability, security reporting, and the new EHR reporting program that Cures creates—is less of an immediate priority due to the uncertainty around it right now.

Regarding policy developments at HIMSS this year, there are a few things that are still hanging in the balance, and I know the current administration is trying to “clear the decks,” but there is nothing that is at the top of the list that we’re expecting. With this transition, with so many folks being in interim positions, and the civil service versus political appointees still being identified, and the fact that nothing is pending like the Stage 3 final rule, and still being a few months away from any kind of next iteration of rulemaking on the MACRA front, it will be quieter than in years past. Local HIMSS folks are not expecting the new HHS Secretary or CMS Administrator to be there this year. So I don’t expect [policy] to be as prevalent as in years past.

Bradley Howard, M.D., executive medical director, consulting at The Advisory Board Company:

That’s a difficult question, to be honest. From scanning the HIMSS agenda, there are many sessions around moving from volume to value, including a keynote address around risk sharing. Also, cybersecurity is much more emphasized than before. I think the vendor floor will be crowded with booths focused on risk capture, and the big EHR vendors have been talking about their capabilities in this space. This aligns with MACRA very well in my opinion. Keep in mind, the HIMSS request for presentations went out during the early summer and that is driving the agenda, which was finalized prior to the presidential elections. So I suspect the hottest topic of conversation will be what happens to Obamacare, the Trump administration, and how will Medicaid and Medicare be affected. I suspect more than half of speakers will mention the uncertainty that remains.

Bradley Howard, M.D.

As a consultant/provider, what might particularly draw you to a vendor’s booth at HIMSS?

Leslie Kriegstein, vice president of congressional affairs, CHIME:

For the most part, our members go in with a clear expectation if they are looking for a product. So they do less general wandering and more of finding what they’re looking for.

Kevin Coloton, executive vice president, consulting, The Advisory Board Company:

At HIMSS, vendors that offer tactical activities and defined outcomes are going to be the ones that are most attractive to attendees. Consultants and providers who can demonstrate tactical activities and have defined outcomes for those investments are going to be the ones who are most interesting to talk to. We’ve seen that in our work, so clearly defined ROI solutions is the name of the game in 2017.

People are interested in how [others] solve the problem. So it’s not just about the final statistics/numbers, [but they] would love to know the equation. There is so much noise and marketing hype; everyone does HER optimization, but no one defines what they think it is. We do great outcomes—here’s the input we do to get them.

Kevin Coloton

All of the changes in policy are getting more oriented to results, and collaboration between various parties. That’s why there’s momentum around data interoperability and vendor platforms to have better information sharing—collaborating with other vendors that will impact care.

What are you hoping to see or learn at HIMSS this year?

Vince Vickers

Vince Vickers, KPMG’s healthcare technology leader:

Coming off the election, and with the discussions about repeal and replace of the ACA and variations of what could come out of that, it will be interesting to spend some time with people and understand how that impacts their coming year relative to their spending in the IT space, whether they are going to slow down a little bit or if they are going to speed up. I suspect that the sustained, fundamental priorities and interests that CIOs have will likely not change, but I’ll be interested to see if the market starts to freeze a little bit. Hopefully that’s not the case, and people keep moving forward. I don’t suspect trends in priorities will have changed and I’m hopeful that people are not slowing down their efforts, simply because the underlying issues that healthcare is faced with, regardless of what happens with ACA, are the same. Healthcare organizations need to be become efficient and find ways to take out cost. With HIMSS being four weeks after the inauguration, I just wonder, at that point, would that have created more certainty, or more uncertainty?

What will the ongoing consolidation of the vendor space, especially of the clinical IT vendor space, look like, on the exhibit floor, this year?

Vince Vickers, KPMG’s healthcare technology leader:

The exhibit floor, in general, is becoming an interesting animal. Each of the last few years, there’s been one of those big vendors who hasn’t even shown up on the exhibit floor. They have said, effectively, that is not the best return on my investment, we are known in the marketplace and HIMSS has become a large event where the decision-makers are not on the floor. And so, why put hundreds of thousands of dollars into that space. That doesn’t mean that those big vendors don’t have some type of presence there, but not necessarily on the vendor floor. So it’ll be interesting to see if that trend has changed one way or the other. In terms of vendor consolidation, I think we’ll see what we’ve seen in the last few years. As companies acquire smaller organizations, they have brand presence so you use HIMSS as your coming-out party. Here’s who we acquired and you put both logos and both brands out there and use this as an opportunity to tell attendees about why 1 + 1 = 3. That’s what I’ve seen traditionally at HIMSS and I expect we’ll see something similar this year. Overall, I don’t think that consolidation, in total, reduces the number of vendors showing and I don’t think that reduces the number of people attending, as I think the market is continuing to grow, but some of the signage and names may change a little bit.

Should we anticipate any surprises at HIMSS this year?

Gregg Mohrmann, partner, The Chartis Group:

I think we’re going to start seeing some vendors announcing some unique partnerships, because a lot of these things that come together result in combinations that provide better solutions. And I don’t know if we’re going to see any of those partnerships or not, but if you want to continue to evolve in the market, which all the vendors do, I think you’ll see some unique ventures and partnerships. And going along with that, we may see some non-traditional players come into the market, like some of the pharmaceutical manufacturers and some of the medical device companies. It will be interesting— those are some of the things I’ll be looking for. To summarize, and per the 10 topics I mentioned, I think that IT executives really need to strengthen their knowledge of these topics and then educate their fellow C-suite executives. And you’ll need new roles in your IT department, as with precision medicine, for example; and it changes the way you do things; and third, I don’t think you can build an IT plan without pursuing an integrated approach around these individual items.


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The Modern Healthcare CIO, CMO, and CTO

December 10, 2018
by Lori Williams, Industry Voice, vice president of fulfillment, Gigster
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Disruption in the healthcare space comes primarily from the expansion of data’s role in the industry, and the healthcare C-suite’s familiarity with that expansion will help drive company and industry success

For the healthcare C-suite executive, the industry has never been more complex—nor has it ever contained so much potential. Emerging technologies mixed with political uncertainty has created an environment where incredible amounts of healthcare data are revolutionizing how patient care is handled, but patients remain uncertain about the future of their own health. With better data and the means to draw insights from it, healthcare CIOs, CMOs and CTOs are in a position to help address patients’ uncertainties and make hospitals and clinics more accessible and effective than ever before.

Here’s a look at how the role of the modern healthcare CIO, CMO and CTO is changing:

The Modern Healthcare CIO
The modern healthcare CIO’s role has evolved to become more innovative. No longer a title reserved strictly for engineers and IT professionals, today’s healthcare CIOs are focused on information science instead of simply setting up network infrastructure or providing back-end support. The trend towards a more data-centric role began as hospitals rolled out electronic health records, equipping individuals with better access to healthcare provider data. Through enterprise data warehousing, CIOs are becoming masters of data management, governance and predictive analytics, and passing along the many benefits of those knowledge bases to patients.

The Modern Healthcare CMO
The confusing healthcare landscape makes the role of a healthcare CMO more necessary than ever before. Thanks to ongoing regulatory changes, uncertainty surrounding the Affordable Care Act, and shifting consumer expectations for on-demand services, healthcare CMOs are responsible for helping patients navigate their way through a complex and opaque industry. As patients continue to assume the role of consumers, carrying out comparison shopping as they would for any other industry, CMOs must be adept in crafting a healthcare provider’s brand and messaging.

At the same time, CMOs must also ensure that healthcare providers offer a modern online experience, ensuring websites are mobile-optimized and social media accounts are generating engagement. This also means CMOs need to help move marketing efforts into the 21st century, transitioning away from direct mail or billboards towards digital marketing and CRM tools. Because if they don’t, there are plenty of med tech startups that will promptly eat into their market share.

The Modern Healthcare CTO
Unlike healthcare CTOs of the past who remained siloed off from the rest of the organization, today’s modern healthcare CTO is fully engaged with healthcare providers and their technology stacks, utilizing new software and hardware to improve daily workflows. The CTO is enabling the transition to patient-oriented self-service operations, enabling patients to carry out administrative tasks like scheduling appointments or refilling prescriptions over the internet. Because medical data is often stored in a variety of different sources, it’s critical for the CTO to be able to keep these systems interoperable with one another. For hospitals riddled with legacy software, CTOs should expect to continue employing middleware solutions to bridge the gap between old and new.

Members of the healthcare industry C-suite have the power to transform lives, and the CIO, CMO and CTO have roles that directly affect a provider’s ability to carry out positive change. With better data from the CTO’s tech stack, the CIO can use better analytics to help providers determine the best solutions for their patients, marketed to consumers by the CMO through modern platforms in clear, easy-to-understand language.

Lori Williams currently serves as Gigster’s vice president of fulfillment. Prior to joining Gigster, Lori was the general manager for Appririo.


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What Does Your Magnum Opus Look Like? A Few Operatic Thoughts

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I was given the privilege and pleasure recently of presenting, for the second year in a row, a lecture on Richard Wagner’s “Ring” cycle, as the leading opera company in my city, a world-class opera house, has been putting on, in yearly succession, the four operas of the “Ring of the Nibelung” cycle by German composer Richard Wagner (1813-1883). Last year, the second opera in the tetratology, “Die Walküre,” was performed; this year, the third opera, “Siegfried.” After the concluding opera, “Götterdämmerung,” is performed, the entire cycle will be presented in festival format, always a major cultural event. I spoke on “Siegfried.”

I’ve been fortunate to have seen six complete “Ring” cycles in live opera houses in different cities, and I can tell you, it’s a life-changing experience, as this four-opera work (16 hours of music altogether), sits at the absolute summit of western art. Richard Wagner was a hideous human being himself, but spent numerous years working on something that changed the course of classical music and redefined opera.

What’s more, from the summer of 1848, when Wagner wrote a first sketch of the libretti, or texts, of the operas, until their true compositional completion in 1871, more than 23 years were to pass; and it would be another five years before the tetralogy was fully presented, in a purpose-built new opera house in the Bavarian town of Bayreuth. It was a herculean feat to create the entire text of these four long operas, and compose 16 hours of music that would completely redefine the concept of opera. Indeed, when the crowned heads of Europe, the great living composers, and the 19th-century European intelligentsia and glitterati, gathered at the new Festspielhaus in Bayreuth in 1876, many were so overwhelmed by what they saw and heard, that they were rendered speechless. Even now, 142 years later, first time Ring-goers are overwhelmed by the breadth and sweep, the musical and dramatic audacity, and uniqueness of the “Ring” operas, with their story of gods, giants, dwarves, flying Valkyries, Rhinemaidens, one huge dragon, humans, gold mined from a river, magic swords and spears, and of course, a gold ring whose possessor can control the world and its fate.

Even just looking at the third opera, “Siegfried,” Wagner struggled mightily. For one thing, being essentially a grifter and a cad, Wagner borrowed/took money from everyone who would lend/give it, and often had affairs with the wives of the patrons bankrolling his compositional work, leaving his life in constant chaos, as he fled from one city to the next. One such wife, Mathilde Wesendonck, inspired the opera “Tristan und Isolde,” groundbreaking operas that Wagner wrote during a 12-year hiatus in his composition of “Siegfried.” And “Tristan” itself changed the entirety of classical music, its tonality-challenging chromaticism.

Well, no one is expecting anyone to match the unique creativity of Wagner’s “Ring” cycle. But the leaders of U.S. patient care organizations are doing a lot of important things these days, including using formal continuous improvement methodologies to rework core patient care delivery processes in order to transition into value-based healthcare. What’s more, as our Special Report on Leadership outlines, the entire role of the CIO is being rethought now, as the demands for leadership and strategic capabilities are catapulting that role forward; and patient care organizations are beginning to make real headway in advancing equality for women and people of color among the ranks of healthcare IT leaders and managers.

So while no one is expecting anyone to create an operatic tetralogy that will change the face of music, there are plenty of heroic endeavors open to anyone willing to envision the healthcare system of the future. The opportunities are as limitless as the imagination.

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Using Performance Management to Scale

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Performance management is so much more than just a year-end performance review
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Performance management and goal setting have always been part of my DNA. It’s like a compass that tells us we are steering the ship in the right direction or gives us a chance to course correct if we wander off track. It’s hard for any organization to determine how they are doing unless there are clear measurable objectives. CIOs and their leaders need monthly, quarterly and annual goals to measure how you and your team are doing against the plan. I also firmly believe they should be S.M.A.R.T. goals: Specific, Measurable, Achievable, Relevant and Time-based.

Once the goals have been established, you need a written plan. I like three-year rolling plans so you can look into the future and describe your vision of what your organization will look like 36 months out. Then you can work back to the second year, and eventually the first year, to give you the framework for what you need to accomplish in the next 12 months. I suggest you do it with your managers. It makes them accountable to the organization since they are involved in the formation of the plan.

Your plan must be a living document to be used frequently during team meetings throughout the year to see how you are performing as a team and individually. This is not a process you invest in to review at year-end to see how you performed. By then it’s too late. It must be reviewed on a consistent basis to make sure everyone is on track. Performance management is so much more than just a year-end performance review. If there are individuals who are not performing against the plan, you can use the plan as a tool to performance manage them to re-engage as an important member of the team. 

I just returned from the Scale-up Conference in Denver and learned so much about taking goal setting and performance management to a whole new level by adopting the "Rockefeller Habits," as written by Verne Harnish. After reading the book, everything changed for me in the way we will be doing our planning, goal setting and performance management forever. It’s so brilliant and easy to understand. Here they are:

Rockefeller Habit #1: The executive team is healthy and aligned

Rockefeller Habit #2: Everyone is aligned with the #1 thing that needs to be accomplished this quarter to move the organization forward

Rockefeller Habit #3: Communication rhythm is established and information moves through the organization accurately and quickly

Rockefeller Habit #4: Every facet of the organization has a person assigned with accountability for ensuring goals are met

Rockefeller Habit #5: Ongoing employee input is collected to identify obstacles and opportunities

Rockefeller Habit #6: Reporting and analysis of customer feedback data is as frequent and accurate as financial data

Rockefeller Habit #7: Core values and purpose are “alive” in the organization

Rockefeller Habit #8: Employees can articulate the key components of the company’s strategy accurately

Rockefeller Habit #9: All employees can answer quantitatively whether they had a good day or week

Rockefeller Habit #10: The company’s plans and performance are visible to everyone

Accountability is no longer hard to measure since the entire plan is visible to everyone throughout the organization. Each part of your team should have key people accountable for every functional part of your organization. No more guessing is required. I’ve read countless books about leadership, performance management and goal setting, as I’ve been an avid student on the subject for decades.

These ten habits, once adopted and measured regularly, can change any organization that wants to grow and scale, and keep everyone accountable along the way.

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