HIMSS conference abounds in 'can-do' optimism


Enthusiasm went viral this year at the annual conference of the Healthcare Information and Management Systems Society (HIMSS). About 37,000 people attended the conference--up from 31,500 last year--and their mood was upbeat in the educational sessions and on the exhibit floor.

One reason for the buoyant atmosphere was new evidence that the federal government's incentive program for the meaningful use of electronic health records is working. The U.S. Department of Health & Human services announced it has distributed more than $3.1 billion in incentives and that hospital use of EHRs has doubled in the past two years, and it seems entirely possible that the Office of the National Coordinator for Health IT will meet its goal of getting 100,000 providers to attest to Meaningful Use by the end of 2012.

Also, new technology continues to amaze. Mobile health apps are proliferating to take advantage of ubiquitous smartphones; workable native EHRs for iPads may be just around the corner; and some EHR vendors at HIMSS were demonstrating the use of natural language processing to improve the usability of their products.

ONC's announcement of its proposals for Meaningful Use Stage 2--which seemed to be the impossible dream a couple of years ago--did not cause consternation at HIMSS. Indeed, to judge by the applause at some Meaningful Use sessions, some of the proposals are quite popular. For example, attendees liked the idea that specialists would no longer have to use EHRs that include features not relevant to their practices. The conference-goers also applauded the Centers for Medicare & Medicaid Services' decision to let physician groups submit data on behalf of their members and to allow eligible professionals to do quality reporting just once for multiple incentive programs.

The critical role of health IT in health reform did not go unnoticed at HIMSS. During a press conference following his keynote speech, Farzad Mostashari, national coordinator of health IT, said that Meaningful Use would provide a firm foundation for providers to participate in accountable care organizations and meet the challenges of payment reforms. "Medicare kind of unplugged a dam, and there's a huge proliferation of initiatives," he said. "That's good, because it finally creates a business case for the coordination of care."

Coordination also depends on the interoperability of HIT systems, and much more needs to be done in that area, Mostashari noted. But Meaningful Use Stage 2 includes many elements that will encourage health information exchange. Most important, the proposal requires providers to trade data across organizational boundaries with other providers that use disparate EHRs. That--in tandem with the Stage 2 public health reporting requirements--will help create a business case for community health information exchanges.

Additionally, EHR vendors will be required to imbed standard vocabularies such as Systematized Nomenclature of Medicine (SNOMED), Logical Observation Identifiers Names and Codes (LOINC), and RxNORM. Although that doesn't mean that interfaces will no longer be needed, it is a significant step toward the real interoperability of systems.

The national transition to adoption and meaningful use of health IT has built a lot of momentum. If the private and public sectors continue to work together as well as they have up to now, health IT will make a major contribution to the transformation of U.S. healthcare. - Ken

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