The HIMSS14 Health IT Conference was as big as ever with over 38,000 in attendance, 1,200 exhibitors and over 300 educational sessions. While there is always a considerable amount of technology hype at a conference like this, my impression is that we are getting closer to realistic, practical healthcare technology solutions that impact patient care. Interoperability, usability and data/factual based decision-making were major topics at the conference. In reference to this, I would like to focus on some key audiences represented at the conference: the healthcare clinician, the healthcare information technologist and the healthcare administrator.
The physicians and other patient health care providers are the healthcare workers that have direct involvement in patient care. Their work has been impacted, for the most part positively and sometimes negatively, by the move to electronic medical records. As patient care is the primary concern of the clinician, anything that takes away from that focus on the patient will be viewed as detrimental. The clinician user experience is key.
Many feel that the current healthcare information technology does not meet their needs. EMR systems are in the second generation of development, as the first generation in many cases failed the clinician. Along with better integration with other systems on the backend, new EMR systems need to be easy to use, provide the clinician with tools that enable them to be more focused on the patient, and provide them with intelligence that will aid in diagnosis and treatment. User Center Design and holistic evaluation of usability in patient care settings is critical. More broadly, capture vendors need to be aware user needs and the usability of software interfaces. This becomes more critical as the interface is designed for a more casual, occasional user where capture is only part of ones responsibility. While there is a strong call for better usability in healthcare, this need extends into other vertical markets as well.
There were also medical intelligence support systems that could be called into play as a physician / healthcare provider could utilize to support their own medical knowledge base. These support systems will be very helpful in providing the clinician with current and relevant medical information.
The challenge for the healthcare information technologist is different. Their main challenge is the integration of information sources and systems. Information systems are not new in healthcare. From personal experience, clinical laboratory information systems were capable of interfacing directly with clinical instrumentation thirty years ago. The downside was that these laboratory information systems were not integrated into the patient medical record. Paper lab reports were posted to the patient record multiple times a day. In the late 1980’s there were PACS image systems that were capable of image transmission and storage but there were issues with integration of these systems with developing medical record systems. Systems were siloed. In recent years there have been even more complex issues, as there has been the need to integrate departmental and hospital systems across community healthcare information exchange systems.
Today there is a strong need for system interoperability. This is important as capture software vendors move deeper into system applications. Captured content needs to be in a format that is easily transported and understood by other systems. There was much discussion of Vendor Neutral Archives (VNA) at HIMSS14. VNAs are enabled by standards for format and interface. Digital Imaging and Communications in Medicine (DICOM) is the common standard (ISO 12052:2006) for file format definition and network protocols. This standard includes scanning, printing, transmission and storage. Although extremely important in healthcare conceptually one can see the benefits of this Vendor Neutral Archive approach extended to content capture in other vertical markets.
The third major theme at the conference was that of the increasing ability to make healthcare decisions based on data. These data could be evaluated at the disease state/patient population level, the community health level, down to the individual patient treatment level. Former Secretary of State Hillary Clinton as well as high-level government agency representatives spoke of the need for fact based decision-making.
Predictive analytic capabilities have a potential bright and a potential dark side. There were analytic systems demonstrated at the HIMSS performing predictive analytics. These systems could identify which individuals from a patient population would be most likely to require an emergency room visit or hospital stay. Company representatives would say that these predictive intelligence systems could be used to identify and used proactively to design a patient care plan. The intent of this plan to improve outcomes would be to prove the prediction of a hospital admission wrong. On the other hand, these predictive tools could be used by insurers/ payers can be used to identify high-risk populations and potentially limit access to insurance, and or, services. This is an ethical issue that will need to be carefully dealt with as these predictive intelligence tools become more commonplace.
As more healthcare information is integrated and aggregated, healthcare administrators, community advocates and researchers will have better information for decision making. This information could be used for medical research, improve community health, and allocate health related resources.
Technology must serve many masters in healthcare; each with their own needs and thus set of requirements. As for the providers of healthcare information technology it is critical that these individual user requirements are evaluated, incorporated in the design and thoroughly tested. If there is a user interface it is highly important that time and effort is allowed in the schedule for testing and rework as necessary.
With the appropriate design, testing, integration and security there is no question that we will get beyond “technology hype” and truly impact positive patient outcomes.
Mike Spang – VP Research Harvey Spencer Associates, Inc.
About Harvey Spencer Associates:
Since 1989, Harvey Spencer Associates based in New York (US tel: 1+ 631.368.8393) has been specializing in electronic information (image based and electronic transaction) capture technologies. Our services include Market Analysis, Technology Planning Assistance, Product Positioning, Product Management, Client Sponsored Research and Strategic Planning Services. These products include high-speed document scanning hardware, image acquisition software, character recognition software (OCR, ICR), optical mark recognition, barcode recognition and other pattern recognition and classification tools.More at: www.hsassocs.com