Healthcare Information and Management Systems Society (HIMSS) kicked-off its annual global conference this week in Orlando, Florida, addressing leading topics in healthcare information technology. Over 45,000 healthcare and information technology professionals and 1,300+ vendors are expected to attend the week-long event.  

Rise of the Machines — It was standing-room only at the “Machine Learning and AI for Healthcare” pre-conference program on Monday.  Health systems, technology companies, and clinicians pulled back the curtain on their efforts to utilize AI technologies to improve healthcare operations and health outcomes. Several themes emerged:

• AI is in its infancy, but growing up quickly. Many presenters noted that we are in the early stages of the application of AI to improving patient care and healthcare operational efficiency (though perhaps at the top of the current hype cycle for AI technologies generally). As AI applications become more available and affordable, the expected return on investment with incentivize a broad array of healthcare industry participants to utilize it as an analytic engine. Optum included survey results that healthcare systems plan to spend on average $34.2 million dollars over the next 5 years on AI.

• Local data drives results. For AI applications to produce accurate outputs, they must be trained on quality input data. Many commentators noted the importance of high quality, labeled datasets from local populations in training AI algorithms. Better data over bigger data was the refrain of the day from many presenters.

• The Human/Machine Dyad. Presenters noted that AI is best understood as “augmented intelligence” in which machine learning serves as an ever evolving tool to the healthcare professional. Greatest success was noted when clinicians and data scientists collaborate closely so that clinicians trust the technology and it fits within their existing workflows.

The Value of Blockchain — Not to be outdone by their colleagues interested in AI, HIMSS conference on “How Blockchain Technology Brings Value to Healthcare” was packed. The morning presentations included an overview of blockchain and distributed ledger technology, including the strengths and limitations of this emerging technology as applied to healthcare.

• David Houlding, Principal Healthcare Lead for Microsoft Corporation started the day by sorting through the reality and the hype. He highlighted blockchain’s strengths as to data integrity, transparency, decentralization, resilience, and anti-fraud. He noted that applications where blockchain can reduce costs (e.g., provider directories, provider credentialing, and drug supply chains) will be first adopted, followed by the more complex applications that improve patient outcomes, engage patients and enhance their experiences, and finally those that enhance healthcare professional experiences.

•  Heather Flannery, Global Lead Consensys Health; Brian Behlendorf Executive Director, Hyperledger; and Kevin Clauson, Associate Professor, Pharmacy Practice, Lipscomb University College of Pharmacy provided an interesting panel discussion on considerations beyond the technology,  what has worked in current blockchain projects in healthcare, where blockchain is today and what is realistic in the near future. They stressed that it is critical to review and evaluate your use case and assess whether you really need a blockchain solution.

• Steve Posnack, Executive Director, ONC Office of Technology, outlined the work of HHS with blockchain technologies. He discussed how last year HHS launched Accelerate, which uses distributed ledger technology, machine learning and artificial intelligence to deliver real-time information on pricing and terms and conditions from across HHS. Identity management (identity, authentication, authorization,) and credential verification; access control and consent; auditing, and new and improved workflows were noted as key potential applications in healthcare.

• The afternoon sessions focused on practical applications and companies leveraging blockchain, including, among others:

  • ARxChange and its integrated suite of patient financial care and revenue optimization applications

  • BitMED and its focus on incentivized healthcare on the blockchain.

  • Honeycomb Health and its blockchain-based platform for health information for patients suffering from rare diseases.

  • Embleema and its distributed ledgers for allowing healthcare data to be managed securely.

• For further information on blockchain and healthcare, please see our paper How Blockchain Can Impact Healthcare

Focus on Interoperability — The need for private companies and government to work together to achieve interoperability in healthcare technology had bipartisan support during Tuesday’s panel discussion on interoperability. Moderator Hal Wolf (President and CEO, HIMSS), started the discussion by alluding to the proposed rules issued by the Department of Health and Human Services on February 11, 2019. Seema Varma (Administrator, Centers for Medicare and Medicaid Services), explained the goal of the proposed rules, which is to support the seamless and secure access, exchange, and use of electronic health information by consumers, increasing patient choice, control, and driving competition.

Kathleen Salvo (former National Coordinator for Health IT and Consumer-Directed Exchange Advocate during the Obama administration) emphasized the importance of the government providing guidance in achieving interoperability. Former Governor Michael Leavitt (and former HHS Secretary) and Aneesh Chopra (former U.S. Chief Technology Officer) agreed with their fellow panelists that the government was building on the work of past administrations, essentially carrying forward the important baton of interoperability.

The panelists also shared a vision of interoperability that includes placing actionable patient health information into consumers’ hands by building into each EHR system a portal for a consumer-facing application. Through such an application, a consumer would be able to pull out from their medical record the medical data needed to make reasoned healthcare decisions and to hold providers accountable. For this to work, EHR vendors will need to agree on uniform standards for interfacing with and retrieving information from any EHR.