Editor’s Notebook: Empowering Data

I spent the weeks leading up to this year’s HIMSS conference working with “e-Patient” Dave deBronkart on our cover story, “Beyond Empowerment: Patients, Paradigms, and Social Movements.” I was still thinking about empowerment as I traveled to Las Vegas in late February to join more than 41,000 people at HIMSS, by far the largest annual health IT conference. In recent years, coming off the euphoria of federally funded incentive payments for electronic health records (EHR), the mood at HIMSS has been subdued by meaningful use requirements and economic challenges. But even though I was admittedly still under Dave’s uplifting influence, I sensed a much more positive, proactive, and—yes—empowered energy at HIMSS16.

Interoperability is a perennial HIMSS topic. Although much work remains to achieve true interoperability, the industry is more optimistic, with a heightened sense of imminent improvement compared to years past. These new opportunities and attitudes are the result of a number of forces and events, including an agreement announced at HIMSS by Sylvia Burwell, secretary of the U.S. Department of Health and Human Services. Vendors representing 90% of the U.S. EHR market will join health systems, professional organizations, and other stakeholders in improving the flow of health information through sharing data with each other and consumers while improving security and privacy.

We’ve finally entered what many at HIMSS referred to as the post-EHR era, which will focus on using the data collected to actually improve health and healthcare. That’s been the goal all along, but it has often been lost amid the competition and angst of EHRs. Fast Health Interoperable Resources (FHIR)—an open-standards framework based on HL7 and designed to promote data sharing, application development, interoperability, and communication in ways that are easy to implement—is an important driver of the new attitude. HIMSS was full of announcements, challenges, and discussion of apps that will enable everyone, from health systems to individual clinicians and patients, to get their hands on useful data. Referring to competitive challenges her agency has issued for developers, National Coordinator for Health IT Karen deSalvo, MD, said, “It’s time for us to see some digital dividends, to really make that data sing.”

The HL7 Argonaut Project is an initiative designed to hasten interoperability through industry (vendor and provider) leadership and the development and testing of FHIR-based applications. At HIMSS, Argonaut Project Manager Micki Tripathi described both the promise of FHIR and the technical challenges inherent in delivering truly useful data in ways that support rather than disrupt clinical workflows. Tripathi thinks it is time for the federal government to be less involved in HIT, allowing the pendulum to swing back toward private enterprise. He observed that the industry has reached a level of maturity that should allow innovation and improvement to evolve: “Things accelerate when we have more people working on problems. Open innovations, technologists jumping in and trying things, that’s what makes things get better.”

John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston and an important national HIT policymaker, also felt the optimism at HIMSS. On his blog, Halamka reported, “It’s time to replace compliance (fear of failure/sanction) with determination (joy of success) to make healthcare better. Although some of the innovations sound like they could increase risk (cloud/mobile/apps), in fact they are likely to reduce risk by leveraging the experience of a larger number of people outside any given institution. I left HIMSS this year with great optimism. Vendors, technologies, and incentives are aligned for positive change. 2016 will be a great year.”

SUSAN CARR

Editor, scarr@blr.com