I think at this point, that I can honestly claim the mantle of “grizzled veteran,” when it comes to the history of my participation in HIMSS Conferences. This will be my 27th Annual HIMSS Conference—yes, really! I’ve participated every year beginning in 1991, with the exception of 1996. And yes, that’s a whole lotta HIMSS Conferences. But the point is not me, but how much the conference has changed over the years.
And I do remember the 1991 HIMSS Conference, though, looking back now, it feels like it was another world. Back then—yes, before everyone had smartphones!—if one couldn’t connect with individuals at exhibit booths in the exhibit hall, one ended up leaving little scraps of paper with notes on them, and hoping that one could reconnect with people later on (hint: one often could not). And, rechecking my facts, via a history of HIMSS and the HIMSS Conference available on the HIMSS website, I see that 1,800 people participated in HIMSS91, and 164 vendors exhibited that year. Wow. Last year in 2017, as of Monday morning, February 20, HIMSS17 saw 40,453 attendees, virtually the same number as HIMSS16 on that conference’s opening day—40,510 attendees. In other words, 22 times the number of attendees as 26 years earlier.
Meanwhile, apart from the numbers and scale, the differences between HIMSS91 and HIMSS17 were vast. Back in 1991, EHR vendors boasted with pride about building deeply closed systems—yes, really! And there was a tremendous amount of so-called “vaporware” on the exhibit floor—meaning, you could see nice demos in vendor booths, but often, if you pressed the salespeople in those booths, they would admit that what was being demo-ed was not quite yet available… but would be, soon.
Most importantly, back then, there was a lack of overall policy directionality in U.S. healthcare, and that was reflected in the somewhat “miscellaneous” feel of many of the offerings on the exhibit floor—as well as among some of the educational sessions back then. U.S. healthcare was slouching forward, but without a unifying impetus. Well, 27 years later all that has changed dramatically. And, fundamentally, the issue of cost is pushing everything. Faced with a double tsunami in the aging of the U.S. population and an accelerating explosion of chronic disease among Americans of all ages, the purchasers and payers of U.S. healthcare are in full revolt now against what they see as an overly costly, inadequately responsive and transparent, healthcare provider sector. And they’re moving mountains.
Indeed, the leaders of patient care organizations across the country have been accelerating their participation in new value-based care delivery and payment arrangements, whether that means participation in ACOs (accountable care organizations), both federal and private-sector, or in bundled-payment contracts, or in increasingly risk-bearing contracting. And they’re finding themselves plunged into increasing complexity on all levels, as they attempt to leverage data and IT to facilitate all this important work and change.
Not surprisingly, the HIMSS Conferences—both on the educational side and on the vendor-exhibitor side—have been reflecting all those changes in recent years, with vendors increasingly shifting their focus towards facilitating the new healthcare. The past three or four years in particular have seen a dramatic acceleration in emphases on the vendor side, reflected in an exhibit hall that last year looked dramatically different from how it had ten years previously—and certainly 26 years previously.
Whereas in the early 1990s, walking the exhibit floor, one would have seen a kind of miscellaneous smorgasbord of vendor offerings, very strong themes have characterized the messaging coming out of the vendors participating in the annual HIMSS Conference. From accountable care to population health to interoperability, the themes of the past few years have increasingly reflected very broad consensus around what is important, and what needs to be focused on, in terms of healthcare IT.
And honestly, things have become so much more pragmatic over the years, both in terms of the areas of focus that vendors have merchandised on the HIMSS exhibit floor, and also in terms of the quality of their merchandising. It’s become increasingly vital for vendors to demonstrate that whatever solutions they’re offering will actually help providers to move the needle forward along important dimensions, in terms of improving the clinical outcomes, patient and community satisfaction, and cost and operational outcomes of their care delivery; literally now, no one has the time to waste on anything that won’t help patient care leaders to shift their organizations from volume to value and play a part in creating the new healthcare.
All of this is so very, very different from what things were like 27 years ago when I attended my first annual HIMSS Conference (and I have colleagues who have attended more annual HIMSS Conferences than I have, and who most certainly could provide an even broader historical perspective on all of this)—and that is all good.