HIMSS 2016 and the state of Interoperability

Another enormous HIMSS event came and went. To those that frequent these trade shows, there's always a challenge to cover the floor because of size. This year we walked our miles with the Apple Health App capturing our steps. Reviewing my phone now, I posted nearly 15,000 steps a day at the event. Yay for me! Now what do I do with this information? Therein lies the underlying reality of Healthcare in 2016. I wonder if this same question has been asked for many years except now there's just more data available. In a small way there is a good analogy here.. I saw this same thing at HIMSS16. There is an inevitable chasm our healthcare economy sees between new data and what we should do with it. But, I digress...this post isn't about this new data, instead...it's about how it has value and who will care about this new information in the future so I can help others care for me. Enter in one of the buzziest words of the past few years and the loudest buzz of this year 'Interoperability.' Interoperability has been around for years. So, what happened this year that is different than the past years? Is heightened volume this year a barometer of sorts for the industry truly thinking innovation-like across systems? I think the answer to these questions is 'yes,' but requires some tangible, realistic truths about the momentum before we get excited. So, here's some metadata.

  1. The Office of National Coordination (ONC) announced a plan to accelerate the FHIR standards by way of engaging the private sector in a contest of sorts. Details here.
  2. There was a 'industry-wide interoperability' pledge. Not just any loosey-goosey commitment, but a statement that became a chorus around stated direction for interoperability 'standards.' Could it be?
  3. The Sequoia Project, Carequality, IHE, FHIR continue to provide hope that standards around interoperability's technical challenges are moving forward.

On these three topics, some added insight...

Karen DeSalvo's session on Tuesday, March 1, was a leading indicator that the ONC and the harmonizing effort around the ONC Interoperability Roadmap released last year is proving to be a common theme for the interoperability movement. At a high level, the vision of the Roadmap is a future state that empowers the consumer by putting the patient as the essential target metric to determine what interoperability success will be. The players to meet this consumer-centered future are going to need encouragement politically, financially and ethically. Without these external forces, the industry will continue to languish because of these Triple-Aim purpose or raison d'etre. Notwithstanding, applause should be given to the ONC for providing a means for moving forward. In and of itself, this has not happened with broad adoption across the players within the Healthcare industry. Well done, Ms. DeSalvo.

Another development that was announced at the beginning of the conference by Sylvia Burwell, Secretary of Health and Human Services, was the 'pledge' by the private sector to provide broad adoption of Interoperability across systems. The big three EMR systems that were referenced during her Keynote opening remarks were Cerner, Epic and Meditech, with other leading vendors that have recently followed for the pledge. I couldn't recall where there existed an almost counter-intuitive theme that corralled proprietary vendors to commit to a cooperative effort in how to share data before. Could this be a turning point in the healthcare industry? I was part of the standards movement in the 90s for the retail industry supporting cross-platform standards. I recall the same issue existed then between proprietary POS platforms. Back in the day, IBM, NCR and others eventually joined hands to have backoffice systems talk to each other. Voila, this became the birth of computer-managed inventory and massive foundational improvements in the Supply Chain for retail. There is a natural and inevitable transition happening with EMR application vendors as well. So, everyone...let's define the rules to play nice together. Wait...let's start by making a pledge to define the rules to play nice together. Check that one off the list. Let's see where this goes.

While at the show, my preference is to work the dark alleys or slow-moving corners of the event. Who's in the first row and hardest to get to? Where's the back of the show? That's where I go. So, what did I find this year? Save for the HL7 booth, which was centrally located at the show, the other 'standards' bodies were on the fringe or in hidden poorly lit corridors. I suspect this is due partly because they don't have the gazillions of dollars that other large brands have to market their wares. Instead, they are the collaborative nice people hoping that their ideas are heard and agreed to by those heavy hitters in the main thoroughfares of the show floor. I wonder...who is more interested in a community agreement about how to share information? The big dogs, or the crafty smaller groups. I would submit, the clever, quiet ones who have the smaller lecture settings but pack in the brightest minds to overcome policy, workflow and technology challenges. I witnessed an interoperability prototype conducted at the Sequoia Project booth. The demonstration was a live health data sharing exercise using carequality members. Systems touched included eClinicalWorks, Epic, NextGen and Surescripts. Essentially. the demo collected pertinent information from each of these systems in real-time; or as best a closed-loop demo can illustrate. The fact that each of these system connections was moving data, enriching payloads and collaborating with credentialed and secure connectivity was the value of the demo. Were there oohs and ahhs in the audience? No, not really...but for those contributing minds, there were smirks of achievement that gave all of us another glimmer of hope that solutions are on their way.

There was certainly more at the show than I was able to cover. But, for me, I've learned that its best to unleash the bloodhound in each of us to track down our passions. Mine is trying to glue ugly systems together. Why? As a human race, we can't advance without talking to each other clearly and timely. So, until next year, HIMSS...thanks for keeping the 'interoperability' theme front and center in this industry.