Editor's Corner

So, HIMSS is already beginning to slow down, even though the show doesn't officially end until tomorrow. (It could be that people are exhausted after walking the exhibit hall floor--we're talking a brightly colored, flashing, extremely loud hall stretching several city blocks in length from one end to the other. Vendor overload!) All in all, HIMSS has had a landmark year, attracting a record 20,000 plus attendees and several hundred exhibitors.

Despite the overwhelming scale of the show, one theme still stood out for me. I believe this year may have been a turning point for consumer-facing applications. While the majority of companies attending have been pitching standard categories of business solutions, a number were showing off technologies that touch the consumer at key points on the care process, too.

Relay Health, for example, demoed its "e-visit" technology, a Web-based question-and-answer form which allows consumers to communicate with doctors through a Web form. What makes their approach neat is that Relay Health has convinced some health plans (CIGNA, for example) to pay doctors for analyzing and responding to these e-visit questionnaires.

Other vendors, including Relay Health parent company McKesson, were showing off applications which will allow consumers to register for ambulatory or ED visits at a kiosk. McKesson's demo also included a credit card/debit card option, allowing the consumer to pay their visit co-pay up front. Makes a lot of sense, as consumer-driven healthcare comes roaring down on the industry--collecting payments up front may cut the number of unpaid bills. (And some observers are predicting that there will be a problem there, as some consumers will face a high deductible but have little money in their HSA.)

There was one surprise, however: While I was expecting to see a bunch of competing PHR solutions, there weren't many in evidence at this year's show. Most of the consumer-oriented applications I saw were designed to solve process problems in moving patients through the system, rather than encourage patients to maintain med lists, allergy lists or any of the other standard catalogs of personal information the industry has been abuzz over the past few months. In short, despite some well-publicized posturing on the PHR issue by insurers and employers, it seems the vendor community hasn't caught up yet.

Still, I'm very confident we'll begin to see new PHR applications roll out over the next several months. And we're not talking about static PHR records, but smarter, more-integrated PHRs which use consumer-driven information to directly affect physician's decision-making picture. (ActiveHealth Management's CareEngine technology is one model for this.) In the mean time, clinical managers and health IT execs will want to research and develop their own ideas as to how they can make use of patient-reported health records. When the blizzard of consumer apps hit at HIMSS '08, you'll be glad you did. - Anne

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