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Live from HIMSS: A Dickensian Narrative

April 6, 2009
by Mark Hagland
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One felt as though one were reading page 1 of Charles Dickens’ immortal classic A Tale of Two Cities: “It was the best of times, it was the worst of times” What everyone has seemed to agree today is that the healthcare industry faces daunting challenges; yet at the same time, given the federal stimulus and its more than $19 billion to be devoted to healthcare IT investment, there has never been a more exciting (if nerve-wracking) time to be involved in healthcare IT.

George C. Halvorson, chairman and CEO of the Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, put it succinctly to attendees at the morning’s keynote address, when he warned that the current path of healthcare spending and outcomes quality is unsustainable. “Healthcare is consuming $2.5 trillion a year and is on a path to consume 20 percent of GDP,” Halvorson warned. “A number of economists believe that healthcare costs could cripple the economy; so we need to get better on costs and outcomes. One of the great tragedies about consuming $2.5 trillion a year in healthcare is that were doing that while 50 million people remain uninsured” and additional millions remain underinsured, he pointed out. What’s more, something’s amiss in a healthcare system in which 1 percent of the population accounts for 35 percent of the nation’s healthcare costs, and 10 percent of the population accounts for 30 percent of our costs.

The only option, Halvorson emphasized, is to harness the power of information technology to improve care coordination, case management, and care quality.

At the same time, as H. Stephen Lieber, president and CEO of HIMSS, told Healthcare Informatics this afternoon, it is indeed an incredibly exciting time to be in the healthcare IT world, with a gigantic spotlight focused on our industry, and billions in federal stimulus funding set to boost U.S. healthcare IT adoption.

Indeed, Lieber told HCI, the passage of the federal stimulus bill was responsible for a last-minute surge in HIMSS attendee registrations and exhibitor participation. Without the influence of the stimulus, he said, the figure of 25,672 attendees as of Monday morning might have been lower. As it is, he acknowledged that the final attendance figures this year will probably be down 5 to 7 percent from last year’s high-water mark of nearly 30,000 attendees.

Attendees of all stripes certainly had a lot to discuss. Feverish discussion continued today on the seemingly all-absorbing subject of what will constitute “meaningful use” according to the language of the stimulus legislation, as well as speculation as to the disbursement mechanism that ultimately falls into place.

Meanwhile, a clear consensus continues to evolve forward on CIOs’ priorities for IT implementation; certainly that was how it appeared Monday morning at the HIMSS media briefing, where the HIMSS Leadership Survey results were released. Asked their top IT priority for the next two years, fully 51 percent of HIMSS Leadership Survey respondents cited a “focus on clinical systems,” while the next two priorities, “optimizing current systems” and “focus on ambulatory systems,” garnered far fewer votes, at 18 percent and 11 percent, respectively.

Within the clinical IT area, the top focus for CIOs and their organizations now is “ensuring organization has full EMR,” at 31 percent; with “installing CPOE” and 17 percent, and closed loop medication administration at 9 percent.

Still, large barriers to IT implementation remain, some of them possibly recession-related. Asked the most significant barriers to their implementation of IT, survey respondents cited “lack of adequate financial support” (28 percent), “lack of staffing resources” (15 percent), and “vendor inability to deliver product” (10 percent).

Finally, as they discuss and reflect on the issues facing them, those attendees who have felt vexed by the capricious weather at this first-ever Chicago HIMSS (with slushy sleet and snow Sunday night, and high winds today) will be happy to know that the HIMSS Conference will take place in far warmer climes the next two years—in Atlanta in 2010 and in Orlando in 2011. After that, Lieber told HCI, will come either New Orleans or Chicago (again). Those cities are now the main stable of HIMSS sites for the time being, though Lieber also told HCI that San Diego may at some point become a HIMSS city again, if convention center officials expand their facility as they have indicated they may well do.

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