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(Focused) Reflections from HIMSS 2018

April 30, 2018

Connected Health Experience – HIMSS

Most folks who attend the annual meeting of the Health Information Management Systems Society (HIMSS) these days will tell you that to make the most of it, you ‘need a strategy’.  On the one hand, just about everyone you would want to meet is there, but with 42000 attendees, you are unlikely just to run into anyone.  Increasingly, people hang out with their own tribe as there are many side meetings. In the last few years, I’m happy to report that all of the areas of health information technology that I am passionate about have become more prominent, so I can pretty much fill my time with connected health events and networking.  This year, I had the extra treat of being asked by my colleagues at the Personal Connected Health Alliance to Emcee their event, The Digital and Personal Connected Health Forum, on March 5th.

The staff of PCHAlliance did a fine job curating this event and all of the talks were excellent.  Herein are a few nuggets that I gained from attending that are still resonating with me weeks later.

David Asch – HIMSS 2018

The day opened with an inspiring keynote from David Asch of Penn Medicine’s Center for Health Care Innovation. David is one of the most prolific thought leaders in the space.  His speech did not disappoint.  My favorite part was when he talked about the need for rapid validation techniques for innovation as opposed to large-scale clinical trials.  The latter have their place but they are time-consuming and expensive.  Asch argues that at the beginning, one needs to employ techniques that allow for iterative development.  He used the analogy of A/B testing, which many of us are familiar with in the world of web design and called out 3 interesting validation techniques. Much more detail is available in his 2015 NEJM piece, but here is the Reader’s Digest version.  The first is called the vapor test.  The idea is to offer something in the open marketplace to see if there is consumer interest.  If a user clicks on the product, an explanation such as ‘this item is out of stock’ is presented.  In reality the manufacturer is simply trying to find out of there is demand.  The second is the ‘fake front end’, which tests out a change in work flow before implementing it.  The third is the ‘fake back end’ where rather than build sophisticated chat bots or other AI systems, you employ actual people when volume is low in order to learn about how the product will be used once it really is automated.

We deal with the challenge of rapid prototyping and clinical research differently (e.g., we employ matched comparison methodologies and the like) so I found David’s talk quite informative. 

The next talk was a tag team, Greg Weidner and Ann Somers-Hogg from Atrium Health.  They talked about a program using automation in service of hypertension control and showed that 80% of those patients could be brought under control without a human interface. They cautioned, however that as we introduce more and more automation into healthcare we need to design programs that feel as human as possible.  This is very consistent with my most recent TEDx Talk.

Rosemary Ventura from New York Presbyterian gave a very practical and interesting talk on n how they consolidated messaging apps on the inpatient service.

Withings products from Nokia Health

Nicolas Schmidt, from Nokia, came up with a new phrase that I really liked – “Grandma Approved”.  His whole presentation was on the journey that he and his colleagues took in designing the original Withings line of products and how they were designed with elegance and simplicity of use in mind.

David Higginson, from Phoenix Children’s spoke about their initiative to put an iPad in every hospital room. The story had multiple layers of insight, including their very patient, family centric approach, to all of the necessary IT integration requirements and the vendors they chose to do these.

Jody Hoffman gave a very detailed policy update, focusing on new reimbursement trends, licensure and interoperability.

Angela Higashi from Kaiser Permanente talked about one of my favorite connected health applications: wound care.  She is wound specialist and told the story of how they used imaging at the point of care to extend her expertise without moving her.  The program continues to expand.

Image courtesy of Qualcomm Life

Jim Mault is an industry veteran and a real pro when it comes to telling his story.  His was the first time I’ve heard about AI in action. So many times, when I talk to clinicians about patient-generated device data, they express worry that they will be asked to review long lists of normal readings. Qualcomm Life is now pioneering a software layer on the inpatient side that takes all of those streams of data and gives the clinician insights rather than just data.  Bravo. Other industries have done this, and we can’t do it fast enough in healthcare.  I can’t wait to see it move into outpatient applications!

Juhan Sonin, from MIT gave us a glimpse into all of the data streams that are being generated that we don’t even think about (mainly data streams from our mobile phones) and how we might use them to improve healthcare.

Josh Neumann, from Salesforce did a really nice job of helping the audience think about healthcare through a customer relationship management lens.

Lee Hartsell, from Duke, talked about crowdsourcing research.  He pointed out that only 10% of users used an app because, in that case, there was nothing compelling for them to promote continued use.  He made a strong case for bringing the community of patients into the design process.

Amy Schwartz from Battelle made an excellent case on why design thinking is critical for any patient-centered initiative.

Vik Bakhru gave us a perspective on the challenges of scaling digital health in the context of social determinants of health. We need to change reimbursement models – move more toward preventative and think about the big picture.  Big art, not big data!

Jill Carroll, from Mt. Sinai gave a thought-provoking commentary on incentives. They are helpful but not a panacea.  He talked about many behavioral economic principles including present bias, the power of habit, cue routine reward and how loss avoidance is more powerful than gains.

A terrific overview.

I left the day feeling educated and stimulated.

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