Last Friday I had the pleasure and privilege of attending the annual HIMSS Nursing Informatics conference, this year held in Kenosha, Wisconsin. The event was well attended in spite of the lousy weather bringing clinicians, clinical informaticians and a few vendors together to listen to topics of interest. One of the best aspects of these conferences is the absence of the vendor element. There were only two sponsors and sales pitches were kept to a minimum.
This was my second consecutive year for attending this conference and I was joined by our client executive covering Wisconsin hospitals, Keith Kohls. Last year was a significant eye opener in seeing the passion for clinical IT in this group and in getting a feel for how underserved they felt by the vendor community. The passion was no less this year; however I didn’t get the same sense of discontent as I did last year. Perhaps the change in atmosphere was due to the topics and speakers, or maybe the new emphasis on clinical workflow, meaningful use, and the promise of billions of stimulus dollars flowing into providers to support the use of computerized systems has affected their attitudes in a positive way.
There was an all-star lineup of presenters, each with at least 2 cans of alphabet soup behind their names that included:
- Dr Connie White Delaney, PhD, RN, FAAN, FACMI, Professor & Dean, School of Nursing, University of Minnesota
- Dr Ida M. Androwich, PhD, RN-BC, FAAN, Professor and Director of Health Systems Management & PICES, Niehoff School of Nursing, Loyola University, Chicago
- Dr Dennis Weaver, MD, MBA, President & CEO, Eastpoint Health, LLC, Co-Chair, Board of Directors, PlugIn!
- Kay Jansen, MSN, PMHCNS-BC, Clinical Assistant Professor, University of Wisconsin-Milwaukee, College of Nursing and Terminology Manager, ICNP, ICN
- Julie Glen, MBA, RN, Director, Medical Information Systems, Loyola University Medical Center
- Dr Margaret Ross Kraft, PhD, RN, Assistant Professor, Niehoff School of Nursing, Loyola University Chicago
- Dr Sue Huerta, PhD, RN, Associate Vice President, Patient Safety and Clinical Effectiveness, Rush University Medical Center, Chicago
- Melissa Barthold, MSN, RN-BC, CPHIMS, FHIMSS, Corporate Manager, Nursing Informatics, Baptist Health, South Florida
- Dr Karen Carroll, PhD, RN-C, NEA-BC, Nursing Informatics, Childrens Memorial Hospital, Chicago, Il
Of course, a huge spotlight was on the ARRA funding with discussions of the current status, timeline, and implications to clinicians – particularly nurses. From these presentations I drew the following conclusions:
- –Meaningful use is still the central issue being discussed and the push is to relate it to clinical outcomes
- –There is a meaningful use timeline for recommended objectives for the years 2011 through 2015 that begins with delivering lab results and ends with medical device integration
- –Data and systems interoperability and exchange will be a core requirement for any of these objectives to be reached
- –More definition needs to be given to provider and consumer incentives and penalties to use the systems and technology at hand, specifically CPOE, E-prescribing, data exchanges, and PHRs
- –More incentives and penalties need to be established to ensure the creation of actionable standards for data and information exchange
- –Nurses and clinical informaticians will play a vital role in the definition of standards for exchange and use, education and implementation of clinical systems, and reporting
- –The balancing act between data exchange, privacy and security will require an increasing amount of effort on the part of providers (and their IT groups) to maintain
- –Personal Health Records (PHRs) are going to be required, but the current offerings fall very short of being usable in practice
- –Clinicians (and their IT groups) continue to need help in transforming data into actionable information
- Much more money and people will be required to achieve the outlined reform objectives
Dr. Delaney did a fantastic job summarizing the HIT policy committees efforts and recommendations. If you ever have a chance to hear her discuss this I highly recommend it. Dr. Androwich was terrific in picking up the thread that Delaney passed to her with a discussion of current hot IT topics in healthcare, in particular PHRs, data exchanges and the potential of social networking in healthcare (a.k.a. consumerism). While I can’t re-publish the entire content of the presentations, I’ll share her list of hot topics:
- –Personal health records/Consumer involvement
- –NHIN and RHIOs
- –E-Prescribing
- –Privacy and confidentiality
- –Quality and safety
- –Reimbursements (“Never Events”)
- –Certifications and meaningful use
- –Federal involvement – ONCHIT
- –Internet
- –Terminology
Dr. Dennis Weaver delivered a compelling presentation on the efforts of a startup venture named PlugIn for Healthcare (.org). It’s a non-profit organization geared to drive a change in the behavior of patients, clinicians and payors to create real reform. It was sometimes difficult to understand where Dr Weaver’s how efforts were or weren’t related to PlugIn but the long and short of his presentation was this
- –the current healthcare delivery system is broken (I could and may drone on about this at some point in another blog post)
- –exchange of healthcare information should be and needs to be easier and more ubiquitous
- –healthcare repositories could be big, ie. diabetes and immunizations
- –the practice of healthcare needs to shift from a physician oriented model to a team model (a good message to deliver to a group of nurses)
- –a PHR data exchange mechanism needs to be developed for all to use – current models are too limited and not usable in practice
It was a day well spent learning about the issues on the minds of some of our customers. I wish I were able to pick the collective brains of the group that attended the conference as I know I would not only be more enlightened, but would be better positioned to find and deliver solutions that help them solve the challenges they face. It was encouraging to hear through conversation that one of the major issues they hope to solve is workstation and application login time as that is something we know how to do with our Thin Identity solution. I was not surprised to hear too that optimizing workflow was also at the top of their priorities.
After reflecting on the day I believe that fundamentally the money trail needs to be better aligned with the goals of the care givers; otherwise the lofty objectives of healthcare reform will be rendered inert. Having worked in and around healthcare IT since 1988 I’ve seen a lot of well intended ideas get mired in the muck because the financial incentives did not support the exchange of data or improvement of certain clinical or administrative processes. It’s yet to be seen if ARRA’s healthcare reform will provide this motivation, but I’m encouraged by what was presented Friday.
Dave Durbin
VP Business Development
