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Key trends show potential benefits for use of IT in healthcare<\/h2>
Editors from Health Data Management spent several days at HIMSS18 in Las Vegas last week. After attending many educational sessions, meetings with vendors and other professional groups, and discussions with dozens of attendees, the following major trends emerged from the industry\u2019s largest show, suggesting that they will impact the use of IT in healthcare. These common themes emerged as important trends at the conference.<\/p>

AI\/machine learning<\/h2>
Artificial intelligence and machine learning were the buzz again, with some providers beginning to demonstrate practical applications for specific uses of technology, particularly in radiology where AI is being in specific use cases, such as identifying cancer in breast tissue. However, most results are early, and the next phase appears to be the ability to deploy solutions so that they\u2019re available at the point of care without creating additional workflow burden on clinicians.<\/p>

APIs<\/h2>
There was more talk about using application programming interfaces to facilitate data exchange. For example, APIs will play a role as the federal government seeks to expand options for data sharing. The Centers for Medicare and Medicaid Services announced a next-generation version of the Blue Button program that enables Medicare beneficiaries to get and share claims data with family and friends and other entities. CMS is working with Human API, a vendor that markets a FHIR-based application that supports secure data sharing.<\/p>

Blockchain<\/h2>
Blockchain continues to move slowly from theoretical discussions to potential use cases in specific applications within healthcare. Industry experts remain optimistic that the distributed ledger technology will make an impact to help health systems manage pharma and medical device supply chains, recruit patients for clinical trials, and improve security and interoperability of IoT and medical devices.<\/p>

The cloud<\/h2>
As providers become more comfortable with the cloud, they\u2019re looking for more ways to move data and computing services off-premises. Doing so enables easier exchange of health information and the ability to make use of services inexpensively and with more reliability. Vendors are beginning to offer more choices for infrastructure, platforms and software as services to providers. Notable exhibitors at HIMSS18 included Amazon Web Services and Google. <\/p>

Cost containment<\/h2>
In an era where healthcare services continue to be cost-prohibitive for many patients, technology is being brought to bear to make care cheaper and billing more understandable. For example, Surescripts has launched a price transparency program\u2014it\u2019s working with EHR vendors, insurers and pharmacy benefit management firms on the project. The company is giving providers data from insurance companies showing patient co-pays and out-of-pocket costs so providers can consider appropriate treatment options that best comply with the patient\u2019s insurance formulary and also talk with patients about alternatives such as generic medications. <\/p>

FHIR<\/h2>
The Fast Healthcare Interoperability Resources specification continued to gain more traction at HIMSS, as more vendors looked to seriously implement it to better exchange health information. HL7, which is leading the charge on developing the FHIR standard, expects to release the fourth version of the standard, which will be the normative version stable enough for widespread industry use, says Chuck Jaffe, MD, HL7\u2019s CEO, and Wayne Kubick, the organization\u2019s chief technology officer.<\/p>

Opioid crisis<\/h2>
Numerous sessions at HIMSS18 discussed how provider organizations were using technology to make inroads against the opioid crisis. For example, prescribing systems now flag those prescriptions and patterns that may lead to addiction. However, the rush to address the problem needs better coordination. Speaking at a press event sponsored by the Electronic Health Records Association, Leigh Burchell of Allscripts noted that each state has a Prescription Drug Monitoring Program in place, with the potential to keep track of patient prescriptions. However, PDMPs use different technologies and struggle to share information with each other\u2014that\u2019s a problem when patients may cross state lines to obtain drugs to which they\u2019re addicted, Burchell suggested.<\/p>

Population health management<\/h2>
The population health management market is growing in importance, as more healthcare organizations take on risk under value-based care programs. Many now see population health as a strategy, not a technology. More healthcare delivery organizations are seeking to manage risk by using technology to achieve population segmentation and risk stratification\u2014the intent is to move to appropriate clinical interventions through patient engagement, all predicated on pop health integration with the EHR. The results can be dramatic\u2014Faron Thompson, chief operating officer for Innovation Care Partners has been able to achieve cost savings each year under the Medicare Shared Savings Program, qualifying for bonus payments as a result, through use of applications from Orion Health.<\/p>

Precision medicine<\/h2>
More healthcare organizations expect to use precision medicine approaches in treating patients in the future, but storing, sharing and acting upon genetic information will be challenging. For example, a recent survey by Oracle noted that 62 percent of respondents say they currently participate in research activities to drive biomarker discovery or translational research, while another 12 percent say they expect to do so in the next 12 to 24 months. There\u2019s increasing promise in the use of precision medicine because the trend is that it\u2019s becoming affordable and actionable, says Rebecca Laborde, principle field scientist for Oracle Health Sciences.<\/p>

Ransomware and security threats<\/h2>
The rise of ransomware will not abate anytime soon because it enables attackers to monetize immediately if healthcare organizations are its victims and feel they have no recourse but to pay the ransom. Or attackers can keep the data and create false insurance claims, or put the data on the Dark Web market to sell, says David Hood, cyber resilience strategist at security firm Mimecast. Attackers, he adds, see no reason to stop until provider defenses get better.<\/p>

Social determinants of health<\/h2>
Providers are paying more attention to social determinants of health, especially as awareness grows that factors such as family support, access to medical care and wholesome food, and availability of transportation impact the health of individuals. Providers are looking to information systems to gather data from information systems that lie outside the \u201cfour walls\u201d of hospitals or group practices. For example, Allscripts has formed a relationship with Lyft, the on-demand ride service, integrating its services into its electronic health record. Paul Black, CEO of Allscripts, says this enables caregivers to help arrange rides for patients who need them, helping them to provide ongoing care while reducing the chances that patients will be no-shows, which could reduce care oversight and revenues.<\/p>

Vendor affiliations and cooperation<\/h2>
Healthcare vendors are increasing partnerships to round out offerings for providers, filling in gaps in capabilities. For example, Epic is teaming with Nuance Communications to create and deliver an array of AI-powered healthcare virtual assistants integrated into Epic\u2019s EHR. In another example, AMRA, the international leader in body composition analysis, and Siemens Healthineers have announced a new agreement that will see AMRA\u2019s cloud-based, body composition analysis integrated into Siemens Healthineers Digital Ecosystem.<\/p>

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Key trends show potential benefits for use of IT in healthcare<\/h2>
Editors from Health Data Management spent several days at HIMSS18 in Las Vegas last week. After attending many educational sessions, meetings with vendors and other professional groups, and discussions with dozens of attendees, the following major trends emerged from the industry\u2019s largest show, suggesting that they will impact the use of IT in healthcare. These common themes emerged as important trends at the conference.<\/p>

AI\/machine learning<\/h2>
Artificial intelligence and machine learning were the buzz again, with some providers beginning to demonstrate practical applications for specific uses of technology, particularly in radiology where AI is being in specific use cases, such as identifying cancer in breast tissue. However, most results are early, and the next phase appears to be the ability to deploy solutions so that they\u2019re available at the point of care without creating additional workflow burden on clinicians.<\/p>

APIs<\/h2>
There was more talk about using application programming interfaces to facilitate data exchange. For example, APIs will play a role as the federal government seeks to expand options for data sharing. The Centers for Medicare and Medicaid Services announced a next-generation version of the Blue Button program that enables Medicare beneficiaries to get and share claims data with family and friends and other entities. CMS is working with Human API, a vendor that markets a FHIR-based application that supports secure data sharing.<\/p>

Blockchain<\/h2>
Blockchain continues to move slowly from theoretical discussions to potential use cases in specific applications within healthcare. Industry experts remain optimistic that the distributed ledger technology will make an impact to help health systems manage pharma and medical device supply chains, recruit patients for clinical trials, and improve security and interoperability of IoT and medical devices.<\/p>

The cloud<\/h2>
As providers become more comfortable with the cloud, they\u2019re looking for more ways to move data and computing services off-premises. Doing so enables easier exchange of health information and the ability to make use of services inexpensively and with more reliability. Vendors are beginning to offer more choices for infrastructure, platforms and software as services to providers. Notable exhibitors at HIMSS18 included Amazon Web Services and Google. <\/p>

Cost containment<\/h2>
In an era where healthcare services continue to be cost-prohibitive for many patients, technology is being brought to bear to make care cheaper and billing more understandable. For example, Surescripts has launched a price transparency program\u2014it\u2019s working with EHR vendors, insurers and pharmacy benefit management firms on the project. The company is giving providers data from insurance companies showing patient co-pays and out-of-pocket costs so providers can consider appropriate treatment options that best comply with the patient\u2019s insurance formulary and also talk with patients about alternatives such as generic medications. <\/p>

FHIR<\/h2>
The Fast Healthcare Interoperability Resources specification continued to gain more traction at HIMSS, as more vendors looked to seriously implement it to better exchange health information. HL7, which is leading the charge on developing the FHIR standard, expects to release the fourth version of the standard, which will be the normative version stable enough for widespread industry use, says Chuck Jaffe, MD, HL7\u2019s CEO, and Wayne Kubick, the organization\u2019s chief technology officer.<\/p>

Opioid crisis<\/h2>
Numerous sessions at HIMSS18 discussed how provider organizations were using technology to make inroads against the opioid crisis. For example, prescribing systems now flag those prescriptions and patterns that may lead to addiction. However, the rush to address the problem needs better coordination. Speaking at a press event sponsored by the Electronic Health Records Association, Leigh Burchell of Allscripts noted that each state has a Prescription Drug Monitoring Program in place, with the potential to keep track of patient prescriptions. However, PDMPs use different technologies and struggle to share information with each other\u2014that\u2019s a problem when patients may cross state lines to obtain drugs to which they\u2019re addicted, Burchell suggested.<\/p>

Population health management<\/h2>
The population health management market is growing in importance, as more healthcare organizations take on risk under value-based care programs. Many now see population health as a strategy, not a technology. More healthcare delivery organizations are seeking to manage risk by using technology to achieve population segmentation and risk stratification\u2014the intent is to move to appropriate clinical interventions through patient engagement, all predicated on pop health integration with the EHR. The results can be dramatic\u2014Faron Thompson, chief operating officer for Innovation Care Partners has been able to achieve cost savings each year under the Medicare Shared Savings Program, qualifying for bonus payments as a result, through use of applications from Orion Health.<\/p>

Precision medicine<\/h2>
More healthcare organizations expect to use precision medicine approaches in treating patients in the future, but storing, sharing and acting upon genetic information will be challenging. For example, a recent survey by Oracle noted that 62 percent of respondents say they currently participate in research activities to drive biomarker discovery or translational research, while another 12 percent say they expect to do so in the next 12 to 24 months. There\u2019s increasing promise in the use of precision medicine because the trend is that it\u2019s becoming affordable and actionable, says Rebecca Laborde, principle field scientist for Oracle Health Sciences.<\/p>

Ransomware and security threats<\/h2>
The rise of ransomware will not abate anytime soon because it enables attackers to monetize immediately if healthcare organizations are its victims and feel they have no recourse but to pay the ransom. Or attackers can keep the data and create false insurance claims, or put the data on the Dark Web market to sell, says David Hood, cyber resilience strategist at security firm Mimecast. Attackers, he adds, see no reason to stop until provider defenses get better.<\/p>

Social determinants of health<\/h2>
Providers are paying more attention to social determinants of health, especially as awareness grows that factors such as family support, access to medical care and wholesome food, and availability of transportation impact the health of individuals. Providers are looking to information systems to gather data from information systems that lie outside the \u201cfour walls\u201d of hospitals or group practices. For example, Allscripts has formed a relationship with Lyft, the on-demand ride service, integrating its services into its electronic health record. Paul Black, CEO of Allscripts, says this enables caregivers to help arrange rides for patients who need them, helping them to provide ongoing care while reducing the chances that patients will be no-shows, which could reduce care oversight and revenues.<\/p>

Vendor affiliations and cooperation<\/h2>
Healthcare vendors are increasing partnerships to round out offerings for providers, filling in gaps in capabilities. For example, Epic is teaming with Nuance Communications to create and deliver an array of AI-powered healthcare virtual assistants integrated into Epic\u2019s EHR. In another example, AMRA, the international leader in body composition analysis, and Siemens Healthineers have announced a new agreement that will see AMRA\u2019s cloud-based, body composition analysis integrated into Siemens Healthineers Digital Ecosystem.<\/p>

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12 top HIT trends from HIMSS18

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