Monday, March 7, 2011

The Major Themes of HIMSS 2011

I was in Japan during HIMSS this year, but I asked Jeff Blair, an nationally known informatician from the Lovelace Clinic Foundation, to summarize the key themes from the events he attended.   He declared HIMSS 2011 to be the year of the healthcare information exchange with the following points:

*There was a better understanding of the capabilities and limitations of NwHIN Direct and NwHIN Exchange.  In particular, it seemed as if most attendees now look at NwHIN Direct as a near-term solution and at NwHIN Exchange as having the capabilities to address Stage 2 and Stage 3 of meaningful use.

*A lot of progress has been made during 2010 by independent HIE networks and state HIE networks to develop their strategies, plans, and resources.

*The federal government, including ONC and CMS, has really ramped up to move forward with all of the HITECH initiatives and they are pushing forward on all of these initiatives at the same time.

*Many HIE networks are reporting that they have been able to expand connections to health care provider stakeholders in their communities, and that community support for HIE network services has been growing as HIEs can deliver more services.

*The vendors that provide solutions for HIE networks have matured and are able to more clearly articulate the capabilities of their components, as well as the synergies their components have with other HIE components.

*A lot of progress has been made to define the requirements for provider directories.

*The HIMSS exhibit floor was massive and impressive.  There are many new information technologies that have become available and it will be interesting to see how quickly health care can adopt these new technologies (including cloud computing, mobile health, Twitter, etc.) to address health care challenges.

*There is greater awareness that the CDA/CCD is not at the level of plug-and-play compatibility, and that work needs to be done to tighten the constraints to limit optionality to get closer to plug-and-play.

*The resources of HIE networks are now stretched thin trying to participate in all of the ONC initiatives, including conferences, committees, communities of practice, workgroups, etc.

*As ONC and CMS roll out more and more funding opportunities, HIE networks are finding that the resources of their local provider partners are also running thin to participate and/or support these funding opportunities.

*It is now clear that the development of provider directories in each state will be major projects, not just an additional component of HIE networks.

*More specifically, it is now clear that provider directories will involve entity-level provider directories (ELPD) and individual level provider directories (ILPD); that the ELPD and the ILPD will need to interact with each other; that there will be many more users of the provider directory than just HIE networks, which means that there will be several different use cases that will need to be created and addressed; and finally, that existing sources of listings of providers at the national, state, and professional association levels will all be needed to create a complete provider directory to support the meaningful use initiatives for Stage 2 and Stage 3.

*Many state HIE networks have lost their State HIE Coordinators, public health supporters, or Medicaid supporters due to the turnover caused by the state elections in November of 2010.  It may take several more months to re-establish relationships with new state administrators."

Thanks to Jeff for this thoughtful summary!   I'll see you all at HIMSS next year.


David said...

Hi John,
Thanks for this summary. Interesting comment about "CDA/CCD is not at the level of plug-and-play compatibility, and that work needs to be done to tighten the constraints to limit optionality to get closer to plug-and-play." Ironically, the original HITSP C32/C83/C80 was closer to this goal (with a tightly constrained vocabulary for meds, allergies, problems, etc.) whereas MU in attempting to accommodate existing systems, allowed for many variations in the vocabularies. I can understand the reasoning to allow time, e.g., a "glide path" for providers and vendors. But variability in vocabularies is really due to that allowance more than it is attributable to CDA/CCD. The same statement could be applied to CCR or any other content standard where multiple vocabularies were selected by ONC.

George Dealy said...

Another interesting development I encountered at the HIMSS Interoperability Showcase was the popHealth initiative, which is being funded by ONC. popHealth is an open source software package for computing and reporting meaningful use clinical quality measures (see The initial development has been focused on the measures for eligible professionals. Inpatient / eligible hospital measures are TBD, though the package could be extended by any interested party given the open source nature and organization of the project. It seems like this might be a potentially viable solution for hospitals and physician organizations who assemble their quality measures information from multiple sources. Has your team at BIDMC looked at popHealth? Perhaps it is a topic worthy of a future blog post?