A dispatch from HIMSS

"Interoperability is big at HIMSS in 2015."
By John Halamka
08:50 AM
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Unfortunately, I was unable to attend HIMSS this year because a special request from Andy Grove, the former CEO of Intel. He asked me to serve with Roni Zeiger (Smart Patients, Google Health) and John Mattison (CMIO of Kaiser) as co-presenters for the first annual Marc Shuman Anti-Medical School Lecture in San Francisco, sponsored by the Grove Foundation. When Andy calls, you listen.

My second-in-command at BIDMC, Manu Tandon, attended HIMSS on my behalf and sent the following analysis of the key themes he experienced.

"Interoperability is big at HIMSS in 2015. The challenge of patient identification and finding the location of patient records are important informatics problems to solve.

I spoke to Surescripts and the CommonWell Health Alliance. Surescripts is piloting with 3 vendors and CommonWell is embraced by many vendors. The participating EHR system can send  a patient match request and if matched ask for list of documents available and then send a request to get documents (CCD, lab reports etc). I asked about consent – they don’t plan on storing that at the HIE level and depend on the requesting systems. I asked Surescripts about a charge model. They are developing it.  It may be transaction based for each document received. Their current data set for 230 million patients is prescription oriented. They would like to collect Admit/Discharge/Transfer (ADT) transactions and documents to enhance their model. They will also support the direct protocol transport functionality to send/receive ADTs.

I spoke to Epic’s Judy Faulkner about this. She seemed supportive of the idea of a record locator service. She said they have been working on this for a year. Her view was that Surescripts has the most covered lives at the moment. When I asked about charges she said that Epic will pass on Surescripts fees to the providers. Epic is also still working on the consent issues.

Also, Epic is focusing on patient management solutions. They have a patient facing mobile based app for appointment scheduling, video visits, personal health device data integration and paying bills via credit cards. They also have upgraded the patient facing portal and have a bedside solution for patients to see their upcoming procedures and to communicate with their care team.

Meanwhile, over at the CommonWell booth, there was a promising demo using the CommonWell broker (Relay Health) to route FHIR transactions among three CommonWell member vendors in a pilot project that demonstrated the power of using FHIR to move discrete data instead of CCDAs. These vendors (Cerner, McKesson, and AthenaHealth) showed near-real-time propagation of medication records and problem lists in the FHIR demo.

I can’t tell you how many vendors have the story line 'just give us your claims and financials data and we have the prettiest dashboards to show back to you'.  Several established vendors offer an Extract/Transform/Load/data model tool to collect data from administrative, financial and clinical systems to create a warehouse. Price point is $3-4 M to implement. Some smaller companies are offering services that sit on the wire and track HL7 transactions to build analytics in real time. Many are focusing on Population health. Some have shiny dashboards. Some can pull data from devices  (scales, glucometers, BP monitor) and feed analytics engines.

They is a entire area devoted to interoperability demonstrations. There are many use cases of data transfer based on point to point exchange. Will be interesting to study that from a scalability perspective.

I found a vendor that offers 'Enterprise Output Management'  managing printers (who can use color, follow me printing, if one goes down, divert jobs to another etc).

One vendor would like every patient and doctor to wear a tag so they can show who is where at any time. The network team will love all that traffic.

HIMSS tracks who is in the midst of replacing their major clinical systems etc. about 170 projects going on in New England according to them.

A very busy time for CIOs."