#HIMSS14: The patient has no clothes


Someday, the opening speaker at the Health Information Management Systems Society (HIMSS) annual meeting will not say that this is the best year ever for health information technology.  But not this year.


“What a fabulous time it is to be working in health IT,” said Scott MacLean, chairman of the board for HIMSS exclaimed as he opened the world’s largest annual meeting on health IT – with an estimated 37,000 delegates and 1200 vendors in attendance.

MacLean is speaking to the converted, and the boosterism rampant at the meeting makes it difficult not to turn a jaundiced, journalistic eye to the proceedings. This meeting is filled to the rafters (or, in the case of the kilometre-long Orange County Convention Center – skylights) with either those who truly believe health IT is going to transform the health care system or those who want to sell something to the former.

Too few speakers echo American Medical Association president-elect Dr. Robert Wah who spoke to a physician symposium yesterday and stressed that health IT is just a tool and a means to an end.

Electronic health records, mobile health tracking devices, patient portals and the like have been transformed into a pantheon of icons that will benignly change the wasteful and expensive U.S. health care system into vision of efficiency and positive health outcomes.  And the latest addition to the pantheon is patient engagement through digital means.

Few would deny that patient engagement is a good thing especially since it no longer means just ensuring that patients do what doctors tell them to do. But stating that patients will be intimately involved in decisions about their own care, will have access all of their own medical records, and will even be involved in developing health care systems is one thing. Operationalizing this is quite another.

Dave deBronkart (aka e-PatientDave) told an audience yesterday that while the majority of patients will discover errors in their own records when the evaluate them, there are few mechanisms or resources in place for doctors’ offices to correct those records.

And deBronkart’s physician Dr. Daniel Sands, who has been integral in nourishing the engaged patient movement, noted at the same seminar that many physicians are unprepared for the impact truly engaged patients will have on their workflow.

While patient engagement may truly lead to more efficiencies by saving some steps in the patient visit, it is not means certain such engagement is going to lower system costs.

To quote another of yesterday’s speakers Christine Bechtel, quoting Leondard Kish, patient engagement may well be “the blockbuster drug of the century.” But surely as with too many other blockbuster drugs in recent years, it is being put into widespread use with insufficient randomized controlled trials and little monitoring of adverse events.



HIMSS of praise and frustration (#HIMSS14)


It’s the most Tweeted health care conference in the world.

As such, the Health Information Management System Society annual meeting held in Orlando starting Feb. 23 represents the best and worst of Twitter use in support of health care conferences.

An estimated 37,000 people and 1200 vendors will attend #HIMSS14 to discuss the latest developments in e-health and the use of health information technology (HIT) to support the U.S. health care system. The conference is relatively short on current HIT research but a font of best practices, pilot projects, opinions, commentaries and prognostications .

This is a conference that puts capital letters on concepts such as Meaningful Use (as in, requirements that physicians and hospitals must meet to cash in on government incentives to promote the implementation of electronic medical records) and, more recently Patient Engagement (but to be clear, this is a conference about engaging patients and not for engaged patients ).

At HIMSS everybody wants to talk to everybody else and many want to try and sell you the latest in security/privacy/patient portal/EHR software or hardware.  Those in attendance are leaders in the use of communications technology in health care and eager to share their messages and thoughts.

As a result it is no surprise that the #HIMSS hashtag is ground zero for all of this.

According to HIMSS officials, the number of tweets associated with the meeting hashtag has grown from almost 16,000 in 2011 to almost 39,000 in 2013 and tweets are already trending 90% higher than last year when 7,000 people contributed comments. Others have predicted that when retweets are included the number of tweets associated with this year’s meeting could top 70,000 after hitting 60,000 last year.

While this makes the meeting hashtag a comprehensive way of following what is going on at the meeting minute-by-minute it has also demonstrated why a meeting hashtag can be a frustrating tool and even counterproductive, for the following reasons:

  • With hundreds of people live tweeting and serving as “transcribers” for what is being said at the main speeches, be prepared for dozens of repetitive tweets about exactly what Hillary Clinton and others are saying.
  • Spammers love this meeting and several times during the event the channel becomes unusable with some tools because of the number of scantily-clad women avatars posting spam
  • Those with something to sell well understand Twitter and repeatedly post advertisements for their product/booth on the meeting hashtag.

So, if you are attending the meeting and trying to follow what is going on at the sessions you can’t attend, #HIMSS14 is a feasible but often frustrating option. The numerous expert bloggers who curate information and provide their take on the meeting may well be a better bet.

A number of sub-meeting hashtags also come into play at HIMSS but these are often inconsistently used.

So, if you want #HIMSS14 to be your showcase to the latest e-health developments in the U.S., you have been warned.

Of course, Twitter is just one of the social media tools being used at HIMSS and those will be discussed in another blog post. And, as I too will be joining that army of live twitter transcriptionists in Orlando be prepared for my own outpouring of #HIMSS14 related-tweets.