We all understand how the rigors and strains of everyday work can, over time, dull the energy, excitement and passion we once felt for our health care industry, company and professional track. For me, the best prescription to defeat the waves of complacency, cynicism and apathy is to surround myself with health care colleagues, peers and professional-turned-personal friends – all for whom I hold the utmost respect. These people challenge, question and encourage me, and are always eager to allow the dreamer in me to take time to articulate a new vision and then add to it in a collaborative “mind blend” experience. When this happens, we always learn something. Again, HIMSS’ final day-and-a-half didn’t let me down.
The result? This year’s HIMSS theme is top-of-mind for me and so many of my colleagues: ONWARD! … Innovation, Impact and Outcomes.
The passion for personal health IT at HIMSS
Within the first 10 minutes of Wednesday morning’s “Health IT-It’s Personal” session, I knew the difficult commute was worth it as I was energized for the day with the powerful quote from Leonard Kish: “Patient engagement is the blockbuster drug of the century!” Jane Sarasohn-Kahn, Dr. Daniel Sands and Dr. Peter Hudson (co-founder of the blockbuster personal app iTriage) took off down the runway in a fast-paced discussion of the criticality and successes of personal health IT, tempered with various points-of-view that confront personal health devices and approaches.
As providers and payers have recognized the importance to better engage their patients as consumers, personal health IT is fast-focused on capturing all the data points of consumer interaction to best understand – through advanced analytics – the wants and needs of the patient (both clinically and in market demands). Various personal health devices now fill market categories for monitoring activities like weight tracking, sleep, food, hearing, stress and mood, medications and connectivity with home and car! Still, personal health IT is still emerging. So it’s not a surprise that the topic presents different points of view – such as:
- This is awesome stuff! Guiding patients and caregivers to be actively involved in their health and experiences is a purpose of the Society of Participatory Medicine, and these tools for monitoring will generate more data (always good) so that one can practically be their own doctor.
- It’s a big market but will personal health IT/devices deliver the financial payoff it seems it should? Too many of us remember the disease management market that struggled to quantify returns. Who pays for it? Perhaps more important is the challenge of how to cross the chasm from early adoption to mainstream demand. About three-fourths of that session’s attendees were presently wearing some form of fitness/activity monitoring device, yet the majority were also already physically fit. So the question begs itself … how many will find these devices desirable in an attempt to get fit? More on this in my closing remarks…
- Not so fast my friend! The academics are still challenging the assumption that personal devices improve outcomes or lower health care costs as the data is still anecdotal and the market too young. Of significant concern over the next several years will be how best to share FitBit data, for example, with doctors in a summarized, useful way?
- How can this help me deliver care? The physician community is still exploring how to merge personal health devices into their care service. Who do I prescribe these for and who pays for them? Is this really going to help my most challenged patients? Who is going to review all this data (more data isn’t always a good thing)?
The conclusion of the group? Huge potential but more work is needed to define value and sustainability. But – now is the time to aggressively use analytics to study, evaluate and predict. The iTriage example fortifies the general “soft” consensus that personal health IT’s time has arrived as the 4 ½ star rated app has responded to the public’s growing demand for more information to make better decisions. Furthermore, returns indicate that patients are 19 times more likely to select an in-network care provider and 40 percent less likely to select an acute-care provider when a non-acute condition exists through the insight empowered by iTriage. It is all about empowerment, leading to behavioral changes, leading to better outcomes!
The passion of Hillary
Will she run? Wednesday’s keynote address by former Secretary of State Hillary Clinton sure sounded like a campaign speech to the packed main hall. Secretary Clinton gave a full hour of prepared comments and Q&A covering her involvement in health care program development and reform, as well as anecdotal observations regarding Vladimir Putin and Russia, the successful elimination of Osama bin Laden, and her various experiences in and with the White House as First Lady, US Senator and US Secretary of State.
Despite orders to the contrary, cameras were snapping and tweets flying out the door as soon as she walked out on stage. But she good-naturedly remarked “I see you all out there tweeting and taking pictures …make sure you get my good side!”
Her compassion and caring for our nation’s health care system and our citizens came through loud and clear as she repeatedly referenced the importance of this national debate. I particularly appreciated her emphasis on the need for cooler heads prevailing if we want to build upon health care’s reform to make sure that what works remains – but we fix and improve that which isn’t effective. The passion of views on health care is important, but that passion must be funneled into constructive discussion – not the destructive purposeful spread of unfounded fear, uncertainty and doubt.
No more kicking the can down the road
While the passion of the final day’s activity pushed the limits of stamina, the resolve to stay-the-course was laid out:
- Continue with development of new analytic viewpoints to impact outcomes, readmissions, quality and efficiency.
- Elevate the conversation: The role of health IT is to make health care more effective!
- Health informatics sits at the crossroads between health care science and computer science. It will only be successful if both disciplines perform better with insight from health informatics units.
- E.H.R. adoption rates and meaningful-use certifications will change the game.
And… providers, payers and claims’ clearinghouses can look for NO RELIEF from the looming October 1, 2014 compliance deadline for the nationwide conversion to the IDC-10 family of diagnostic and procedural codes. However, some case-by-case exemptions will be made for providers having a tough time meeting their Stage 2 meaningful-use targets. “There are no more delays and the system will go live on Oct. 1,” Marilyn Tavenner, CMS Administrator, said during her keynote address Thursday. “Let's face it guys, we've delayed this several times and it's time to move on.” Health care data analytics can now play in a larger, more robust data capture as the intersections within the data fields of ICD-10, compared to ICD-9, will “explode” in volume and opportunities for new insight.
This is “just” personal
So HIMSS14 is over and we look forward to Chicago HIMSS15. It’s been an interesting week of revelations for me. My career has taken me from government public and personal health regulatory positions, to publicly-traded provider and payer positions, to the past 16 years in analytic software work laser-focused on aligning health care issues and challenges with analytic solutions. I’ve never once considered myself to be anything but working in the health care industry. Yet I don’t think I’ve paid enough attention to health success stories, because as the years progressed, I very easily fell into the American mainstream: a frequent weekend warrior, one who has eaten the wrong foods in the wrong portions, had a drink or two too often and never looked in the mirror as critically as I looked at others. All the ingredients for a disaster.
It seems like there are three tiers of people: the first or younger tier where health means looking attractive to others (all the wrong reasons!) and at the other end, the third or older tier when health is a scary reality that better be addressed before one misses out on seeing their grandchildren grow and thrive. The middle tier is a period of time that only ends when health begins to take a turn of concern – a time of denial.
Thanks to my wife, my daughters and my friends, maybe I’m shifting from the middle to the third tier without a catastrophic health occurrence. At least that’s my objective and I’m monitoring my progress with gadgets and apps. And now, 14 pounds lighter than last Christmas, I know this geek likes the gadgets and apps because I feel more in control of my personal health. And the goals I’ve set for the rest of the year don’t seem as daunting.
In the HIMSS opening keynote, Mark Bertolini, Aetna CEO, said the last of three objectives that he thinks are required to remake the US health care system is to embark on a 20-30 year journey in investing in personal wellness programs and devices. A wellness system that can “sit in the palm of your hand” making it simple, relevant for a young person to adopt for all the right reasons, and to empower. I couldn’t agree more.
Yes, I think the personal health device market is a great thing! Yes, I believe that data and analytics will give greater insight for providers and payers into better engaging patients. Yes, I know that analytics are and will continue helping the health care industry improve care, satisfaction, outcomes and costs … but you might say this is all just a “personal opinion”. You bet it is!