In the midst of the crazed swirl of the annual HIMSS Conference, it can be challenging for any attendee to keep everything in perspective at any particular moment, with events and information rushing at one at warp speed. And this year’s conference, held March 3-7 at the Ernest N. Morial Convention Center in New Orleans, was no exception, with frenetic activity on all levels and across so many dimensions.
But with a week-and-a-half’s distance from the frenetic activity of the conference, it’s possible to look back at HIMSS13 and see things in a broader context. And a number of themes emerge, all of them, in my view, falling under the broad heading of clarity. Let’s look at the varieties of clarity one by one.
Policy clarity at the forefront
Indeed, the policy clarity coming out of the conference, based on very clear signals sent to the industry by federal healthcare officials, more or less put everything else into clarity by extension. When a joint announcement coming out of the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (HITECH) was published on the morning of Wednesday, March 6, just before the speech given by CMS acting administrator Marilyn Tavenner, R.N., and then a press conference by Farzad Mostashari, M.D., national coordinator for health IT, everything fell into place on the policy front.
Federal health officials themselves described the 2013 goals of the Department of Health and Human Services (HHS), the umbrella federal healthcare agency, as “aggressive,” among them pushing for the goal of 50 percent of physician offices using EHRs and 80 percent of eligible hospitals receiving meaningful use payments, by the end of 2013; increasing the emphasis on interoperability; enhancing the effectiveness of EHRs through programs like Blue Button; and “underscor[ing] program integrity,” including through audits of EHR-driven coding on the part of providers.
Ms. Tavenner and Dr. Mostashari confirmed their agenda in their remarks to the public and the press that morning. As Tavenner put it in her speech immediately after the release of the HHS healthcare IT agenda on Wednesday morning, “What I can say is that I am truly committed to health IT as a platform and a strategy for the work ahead of us at CMS. We have made so many strides, and the progress is truly amazing.” She underscored her commitment to thoughtful but firm progress forward by announcing that no Stage 3 preliminary rule for meaningful use would be released before the end of calendar year 2013, a signal that HHS/CMS/ONC were going to, as she put it, “take time to digest” input and feedback from the field about Stage 2 of meaningful use before pushing on to Stage 3.
And then Dr. Mostashari further reinforced the message when he said at his press conference held immediately after the Tavenner public presentation, “The administration is absolutely committed to health information technology as a platform for payment and delivery reforms, and that we can really cannot succeed in shifting payment and delivery models from volume to value without having information technology as a platform and as a strategy.” He then went on to discuss the ways in which the level of computing capability available to providers successfully moving through MU Stage 2 was already robust enough to support key federal healthcare reform initiatives, including avoidable readmissions reduction and state-level payment and care delivery innovations.
As I noted in a blog on March 7, the logic of that policy agenda is fairly unassailable, and really, what the HHS announcement called an “aggressive” agenda seems imminently reasonable, given the context in which it was made: a healthcare system about to go over a demographically induced cost cliff, attached to a policy and political system reeling from a series of federal budget showdowns, given fundamental differences in perspective between the two major political parties in this country. In short, we need the increased effectiveness in healthcare delivery coming from automation more desperately and urgently than ever. Could anyone really argue with that core assertion?
Industry and technology clarity next?
The “talk” of this year’s HIMSS was undoubtedly the announcement of the creation of the CommonWell Health Alliance on the part of six of the biggest EHR and clinical IT vendors in the industry (Cerner, McKesson, Allscripts, athenahealth, Greenway, and RelayHealth). What made that announcement so dramatic was the revelation that behemoth Epic had not been invited to participate, which raised the specter of internecine warfare, rather than interoperability, as a potential result of the move. Perhaps because of the uproar (though, honestly, who knows?), CommonWell leaders did make a move to reach out to Epic, as Epic president Carl Dvorak told HCI exclusively last week. It’s hard to say what ultimately will come out of the CommonWell announcement—whether that alliance will be a force for good, or even a force at all. But what is absolutely clear is that, faced with looming deadlines to make meaningful use happen and happen very quickly, hospitals and medical groups are having to decide with great urgency how to fulfill the requirements of meaningful use, and the best-known, and arguably most reliable, vendors are continuing to benefit from the rush. Countless conversations have been swirling around the “Epic issue” in recent months, and it’s impossible to deny the potential policy concerns around the consolidation of the EHR vendor industry down to a small number of mega-vendors. But what is unavoidably clear is the fast track that the entire industry, both on the vendor and provider side, has been put on now; there’s simply no going back, and, if the feds have their way, no slowing down, on progress towards universal automation in healthcare.
Clarity in what matters most
Finally, for this editor, what was supremely clear coming out of HIMSS13 is how all roads—policy, industry, technology—right now are leading to the same place, and that is towards clinical transformation and the transformation of healthcare delivery and payment. That theme was made beautifully clear to me personally on Monday evening, March 4, when Dr. Mostashari came to the Healthcare Informatics Innovator Awards reception, held at the Palace Café. Dr. Mostashari spoke passionately about the progress being made nationwide by pioneering patient care organizations whose leaders are leveraging healthcare IT to do what’s most important—improve care quality, not only for individual patients, but for entire communities, through population health, accountable care, and other strategies.
And he was drawn to our reception because of our editorial team’s recognizing teams from Illinois, Louisiana, Colorado, and Texas whose leaders are finding truly ingenious ways to improve the healthcare and the health of their communities through IT-facilitated strategies. Of course, we were very much honored to have Dr. Mostashari attend our event and speak to our reception’s attendees; but even more than that, what stood out for me about that evening was the mutual recognition of where healthcare needs to go. Federal health officials see it, pioneering provider and payer leaders see it, and we at Healthcare Informatics see it. So while it’s easy to get distracted at moments amid the hyper-activity and the hype of HIMSS13, at a short remove of time and distance, what was clear before this year’s HIMSS Conference is absolutely clear now—we are reaching an inflection point of policy, purpose, and pioneering activity in healthcare and healthcare IT, and anyone paying attention can move ahead knowing which way the
industry is going overall, as we leap forward into the future.