Physician Symposium #DrHIT #HIMSS14

The Physician (#DrHIT) Symposium at #HIMSS14
Opening session was eloquently covered by Robert Wah, MD (@RobertWahMD) detailing the spectrum of issues ranging from the new Healthcare System:

The challenge of SGR “fix(es)” and the evolution of the systems we are implementing and the value proposition. As he put it

Quality of care is improved with better information — saving lives and money

But Health Technology is not easy to implement:

Health tech is hard, but harder part is changing #workflow & #workforce. @RobertWahMD#HIMSS14#DrHIT Org alignment: pic.twitter.com/AQsX1a3846

— Wen Dombrowski MD (@HealthcareWen) February 23, 2014

And layered on top is the increasing challenge of securing the data with hackers seeing healthcare data as 15x more valuable than financial hacked data!

MT @CraigJoseph: #DrHIT@RobertWahMD Arms race btwn those trying to protect patient data & those trying to get it. Who'll win? #HIMSS14

— HIMSS (@HIMSS) February 23, 2014

What we need is coordinated care and Dr Wah offered this visual of the way forward

Christine Bechtel focused on the Activate Evidence Based Patient Engagement and as she reported - Patients like doctors who have an EHR

Patients think EHRs help doctors deliver better care

• Timely access to information, sharing info across care team, med history, managing health conditions
• Overall, EHRs were rated between 23%-37% points higher than paper on these elements

Interesting since doctors have been reported as saying they dislike the EHR but patients like seeing their doctors with an EHR

MT @drnic1: 80% patients say online #EHR access improves #health and a reason to stay with a practice. #DrHIT#Himss14#HITworks

— HIMSS (@HIMSS) February 23, 2014

The sad thing was this session was concurrent with @ePatientDave in another room - The Connected Patient: Learning How Patients Can Help in Healthcare only social media united these sessions

@cmaer@ePatientDave Missed opportunity - would be so much better to have those two intersecting rather than in parallel #DrHit#HIMSS14

— Susan Shaw (@drsusanshaw) February 23, 2014

As for Jonathan Teich and his session Improving Outcomes with CDS - he used his personal experience where peer pressure (as he described it 3rd time he was pressured to take on an expert triple diamond ski slope) he finally agreed and ended up in a serious ski accident fracturing multiple vertebrae. Interesting analogy relative to the Clinical Decision Support System and the pressure this applies to clinical practice sometimes inappropriately...
Interesting look at alerts and the potential for providing more than just alerts but actually providing intelligent data that distill down to 10 types of CDS interactions

1. Immediate Alerts: warnings and critiques
2. Event-driven alerts and reminders
3. Order Sets, Care Plans and Protocols
4. Parameter Guidance
5. Smart Documentation Forms Improving Outcomes with Clinical Decision Support: An Implementer’s Guide (HIMSS, Second edition, 2011)
6. Relevant Data Summaries (Single-patient)
7. Multi-patient Monitors and Dashboards
8. Predictive and Retrospective Analytics
9. Filtered Reference Information and Knowledge Resources
10. Expert Workup Advisors

And the important summary slide was the CDS Five Rights (Right information, people, formats, channels and times)

And returned to one of the core opportunities - Patient Engagement with a a session by Henry Feldman, MD FACP: Informatics Enabling Patient Transparency. He asked the same questions as another presenter - how many fo the audience considered themselves a patient (Still only a shabby 80%) and then took this further asking

• You feel that you know exactly what your provider was thinking in making his decisions
• You think the clinical systems helped your provider understand comprehensively everything about you
• You build clinical systems or are a provider
• With the inevitable decline in hands up
• You think your (or anyone else’s) software truly helps the patient or even the provider understand comprehensively or transparently what is going on

Sadly we are not near this and the reality is much further with physicians thinking patients are unsophisticated. Yes at he pointed out the airline industry gets it and even the DMV/MVA gets it offering customer engagement models:
Their experience and stats blow the unfounded resistance out of the water

• Only 2% of patients found notes more confusing than helpful
• Only 2% found the note content offensive
• 92% said they take better care of themselves
• 87% were better prepared for visits

Importantly we need to turn data into information for patients and he cited the Wired example of a Laboratory test (Blood Test Gets a Makeover Steve Leckart) and the makeover for
Basic Labs

Cardiology Result

and the PSA result

I know where I'd like to be receiving my care (and lab results) from! Great finish to the session. So as he summarized where we should be with patient engagement an data

• Open your data to your patients
• Patients understand more than we think
• Teach patients how to use data effectively – This can save you time in the long run
• Put your patients to work on their own health!
• Vendor work on how patients will view big data
• It’s a new drug, research the risks and benefits

Great start to what will be a busy HIMSS