HIMSS Preview: Big Show; Big Ideas—Big News?

They call New Orleans the Big Easy, and next week's Healthcare Information and Management Systems Society conference, March 3-7 at the Ernest N. Morial Convention Center, will be a chance to enjoy that unique city's style and grace.

But while some will hear a funeral dirge for the way healthcare used to be, others will detect the romping, stomping, second-line beat of technology-fueled change.

It will be big: Former President Bill Clinton will be a keynote speaker, as will political heavyweights Karl Rove and James Carville. As of this writing, I've already been contacted by 152 technology vendors and service providers asking to meet with me at the show.

But it won't be easy: I will be lucky enough to have time to meet with only few of them, though none is a former occupant of the White House.

Nevertheless, I'm excited about the lineup. More than ever, the HIMSS conference will be showcasing healthcare that fits in your pocket or tucks neatly onto your tablet. One workshop, led by Copper Mobile CEO Arvind Sarin, provides a direct hands-on experience of what it's like to develop a mobile app.

Also for the first time, there will be a special portion of the show floor dedicated to Meaningful Use demos and presentations. Off the floor, the patient engagement requirement of Meaningful Use Stage 2 will be the focus of a Patient Experience through HIT Forum.

Some of the most interesting ideas promise to come from the strong lineup of breakout sessions:

• Edward Martinez, Senior VP and CIO
  Miami Children's Hospital
  Implementing Patient Engagement and Care Coordination Technologies for Improved Outcomes
• Darren Dworkin, VP of Enterprise Information Systems and CIO
  Cedars-Sinai Health System
  Leveraging Smartphones to Simplify Communication Across Multiple Systems
• Ferdinand Velasco, MD, VP and CMIO, Texas Health Resources
  Luis Saldana, MD, Texas Health Associate CMIO
  Innovative Approaches to Physician Engagement and Team Collaboration
• Indranil Ganguly, VP and CIO
  CentraState Healthcare System
  Actionable Analytics for Value-Based Purchasing, Readmissions and Business Intelligence
• Phyllis Teater, CIO
  Ohio State University Wexner Medical Center
  Lessons Learned from Expanding the Boundaries of the EMR

Other breakout sessions are equally deserving of your time. Try to arrive by Saturday if you can, to catch some of the pre-conference sessions on Sunday.

Big News or Big Snooze?
As for breaking news, the big buzz is all about a possible interoperability announcement to be made by EHR system competitors Cerner and McKesson. They'll be holding a joint press conference at HIMSS, so we'll have to wait and see. 

After last year's HIMSS—where I struggled to find acknowledgement at any major EHR vendor's booth that other EHRs existed—this could either be the start of something big, or it could be little more than a  marketing ploy.

Who Supports Direct Project?
I doubt such developments will cause any provider to switch from one EHR to another. I will spend far more time at HIMSS asking IT vendors and service providers about their specific support for the Direct Project, which "specifies a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet."

I get mixed signals from the industry. Are they supporting Direct, or not? And how and when will patients be able to access data via Direct? I hear they must have a special email address and must go through patient Web portals as they do now. What patients want to hear is that they can also use popular email programs such as Gmail or Outlook to get at their Direct-authenticated messages. I will look around HIMSS and report back on what I find.

Half the fun of HIMSS is asking the tough questions of vendors and providers alike. For instance, a big wrinkle in the transition to EHRs is that patients' psychiatric histories are now being incorporated into EHRs that all care providers in a system can access.

This makes sense from the system's point of view, but runs counter to what many psychiatrists have been telling their patients for many years: that their notes are not shared with other providers in the same system or other systems such as health information exchanges.

An audio from the 2012 Health Privacy Summit, features some disturbing experiences by patients who felt their trust was violated by this larger sharing of their psychiatric histories. Some are even reluctant to share information with their physicians due to this sharing.

At a time when the industry is struggling to accommodate HIPAA and deal with a variety of privacy breaches, it must also deal with the unexpected ways digital information flows within its own systems.

As I said, the show will be BIG—the conference brochure (PDF) alone is 51 pages—and I can't get to every session I'd like to attend, but I've selected a few specialized topics I will be delving into at HIMSS.

• Did you know that FICO, the credit score people, now markets a Medication Adherence Score with data purchased from large pharmacies? How will this data affect the cost and availability of care, and what issues does it raise, such as poor patients having to choose between paying for medicines and paying for food?
• In many states, patients can “self-refer” and order their own lab tests. How will this play out under accountable care organization models?
• Is ERP technology a blessing or a curse for providers? Or is it a bit of both?

For the answers to these and other questions, follow me to HIMSS next week. Don't be surprised if I've heard from upwards of 300 vendors by then... and maybe some Washington big shots.