While there were over 38,000 attendees at HIMSS14, and there were some 95,000 tweets, so I was able to see a lot of what stood out from my armchair by some very diligent tweeting, which appears to be growing exponentially around Health IT.
Among several themes, the now usual suspects stood out: patient engagement, meaningful use, mHealth and interoperability. These are all very important, but what I noticed emerging was how each of these fit into a much bigger picture of decision-making driven by context and more transparent data.
Doug Fridsma, Chief Science Officer at the ONC, says, as Farzad Mostashari said in the past, the stages of meaningful use are intended to act as a vehicle to accomplish healthcare’s Triple Aim. Health IT is really moving toward accountable, value-based care, which ultimately has its success rooted in better decisions by patients, physicians and caregivers. The interoperability must ultimately lead to delivering more transparent cost and quality data in context.
To make effective decisions, and to effectively engage, we must understand all the factors influencing a person at a given time, we must understand contexts, and get key information placed into that context. That’s how we can put mHealth, interoperability and patient engagement into a framework that drives patient engagement.
It’s the decision-making context that drives the decisions, and senior leaders seem drove that point home. Last year after HIMSS13 I wrote about the Rise of Contextual Medicine, and so I was excited to hear the new National Coordinator for Health IT, Karen DeSalvo, mention the importance of context in health care in her first remarks at HIMSS as ONC chair:
I was nearly clapping on my HIMSS armchair. Transparency also stood out as a key theme. Transparency was mentioned by Mark Bertolini, chairman and CEO of Aetna, Hillary Clinton, and several times by DeSalvo and CMS Administrator Marilyn Tavenner. Maybe this needed attention can be attributed to Steven Brill’s now-famous 2013 TIME article Bitter Pill: Why Medical Bills Are Killing Us, that highlighted just how dimly lit most health care pricing is, and how that lack of transparency is killing us.
Maybe it’s because meaningful use has created so much data that can now be used if it’s made liquid and available. Or, maybe an understanding is evolving around the triple aim of “improving the experience of care, improving the health of populations, and reducing per capita costs of health care,” including the fact that we can’t actually improve these things without more, accurate data.
If not for the #HIMSS14 hashtag, I might have thought this was the “data liberation” crowd talking. Certainly for Washington, but also for payers, it was apparent that data liberation is not just a neat slogan, but a broad recognition that we need more, better and accessible data to improve the healthcare system and drive it from volume to value. Access to accurate data should be foundational in health IT for the future.
We can’t influence the most basic healthcare decisions, nor can we have true engagement, without more transparent costs, quality and information. Otherwise, what is the basis of engagement and decision-making? How can we measure progress toward the triple aim? A marketplace, by definition, cannot exist without cost and quality information. A functioning economy in healthcare (that won’t take up 20% of GDP) requires free flow of information.
Let’s look at some of the choice tweets on transparency quotes from some of the big keynotes:
I’m excited to be working with several companies here in Colorado and beyond that are working toward the triple aim, engaging patients, driving transparency, making health data accessible, and making communication better throughout the system. As Hillary Clinton said, “data drives decisions.” Let’s continue to open it, put it in context, and drive better health decisions.