#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.



7 thoughts on “#HIMSS14: The patient has no clothes

  1. Absolutely spot-on, Pat (as one would say to another whose views mirror one’s own!)

    I had a similar niggling reaction while attending Stanford University’s 2012 Medicine X conference on an ePatient Scholarship. The Quantified-Self tech hypemeisters of Silicon Valley who joined us there were positively giddy throughout the proceedings. More here: http://myheartsisters.org/2012/10/10/no-smartphone/

    So glad you mentioned Dr. Danny Sands, a very common-sensical sort who tweeted this challenge to the high-fiving hypemeisters from yet another conference, Health 2.0:

    “Why so many services and apps for the 1%? The users of so many of these products are not the same as real patients I care for.”

    I’ve already asked Dave directly about his “stats” in his medical chart error story, wondering if the real story in his anecdote might actually be that over 3/4 of those surveyed had not bothered to even look at their own records. THAT’S the “stat” he could be focused on in future talks, and the one that the boosters who believe tech alone will somehow change the reality of human nature should be considering.

  2. Hi, Pat – I’m sorry we didn’t connect while you were there!

    Your thoughts are exactly why for more than a year I’ve been saying “Let’s get to work, huh?” Usually a speech audience needs the basics – why patient engagement is real and useful – but off the podium the work is starting to get our hands dirty and see what makes a difference. They’re two different parts of the evangelist work.

    A big step in that work happened late Monday. I posted yesterday that I finally got the okay to announce my first real live, genuine C.E. course – Patient Engagement in Health IT, through the University of Minnesota School of Nursing.

    And as for the “blockbuster drug of the century” meme – it’s premature to say anything, but I have some new ideas in development to blow that to smithereens. I don’t fault the intention of my friends and colleagues who say it, but I’m too much of an engineer to hear something like that without wanting to take it apart and see if it has any actual gears that move anything. More to come on that this year, I hope.

  3. Pingback: Patient Engagement: A defining moment | Colleen Young

  4. Hi Pat, Dave and all others.. Great observations. Indeed large volumes of interests..
    Interests in both meanings of curiosity and of weight (in the sense of self-interest) are high in this case. After a history of telling patients what to do (see for instance http://sco.lt/7DGqp7 ), it will be no wonder that we really do want change to happen, but that is tricky. As Pat suggests: let’s do some research and in any case let’s write evaluations of any trial or pilot we undertake. It will not be easy surely.
    That’s why I was thinking in building efforts to cooperation among protagonists. I gave a description of it here: http://bit.ly/1icTOvZ . I’m curious of what you think of it. By the way co-creation and co-creation of experience is an excellent method to process coordination in this. 😉

    • Hi Rob! I don’t have space to give your whole (good-looking) essay the attention it deserves tonight but I’ll give a first impression from skimming:

      I certainly HOPE 2014 will be a year of integration. Time. Will. Tell.

      It’s been so bleeding obvious for years (to patient voices) how severe the consequences have been of our lack of integration. My big (very big) question is which of today’s hospital managers have what it will take to do *any* of these methods. I know some who have already been doing it for years, without waiting for the sticks and carrots of our changing environment.

      • Thanks Dave,
        Would be nice to have constructive discussion how we could motivate and facilitate both care professionals, institutions and the industry to move quicker ..;-)
        I know that you are quite busy with the very same.
        Maybe we could dedicate a special conference/seminar to that.;-)
        Thx and all best

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