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AMA Hopes To Drive Healthcare AI

Posted on July 6, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Last month, the AMA adopted a new policy setting standards for its approach to the use of AI. Now, the question is how much leverage it will actually have on the use in the practice of medicine.

In its policy statement, the trade group said it would work to set standards on how AI can improve patient outcomes and physicians’ professional satisfaction. It also hopes to see that physicians get a say-so in the development, design, validation implementation of healthcare AI tools.

More specifically, the AMA said it would promote the development of well-designed, clinically-validated standards for healthcare AI, including that they:

  • Are designed and evaluated using best-practices user-centered design
  • Address bias and avoid introducing or exacerbating healthcare disparities when testing or deploying new AI tools
  • Safeguard patients’ and other individuals’ privacy and preserve security and integrity of personal information

That being said, I find myself wondering whether the AMA will have the chance to play a significant role in the evolution of AI tools. It certainly has a fair amount of competition.

It’s certainly worth noting that the organization is knee-deep in the development of digital health solutions. Its ventures include the MATTER incubator, which brings physicians and entrepreneurs together to solve healthcare problems; biotech incubator Sling Health, which is run by medical students; Health2047, which brings helps healthcare organizations and entrepreneurs work together and Xcertia, an AMA-backed non-profit which has developed a mobile health app framework.

On the other hand, the group certainly has a lot of competition for doctors’ attention. Over the last year or two, the use of AI in healthcare has gone from a nifty idea to a practical one, and many health systems are deploying platforms that integrate AI features. These platforms include tools helping doctors collaborate with care teams, avoid errors and identify oncoming crises within the patient population.

If you’re wondering why I’m bringing all this up, here’s why. Ordinarily, I wouldn’t bother to discuss an AMA policy statement — some of them are less interesting than watching grass grow — but in this case, it’s worth thinking about for a bit.

When you look at the big picture, it matters who drive the train when it comes to healthcare AI. If physicians take the lead, as the AMA would obviously prefer, we may be able to avoid the deployment of user-hostile platforms like many of the first-generation EHRs.

If hospitals end up dictating how physicians use AI technology, it might mean that we see another round of kludgy interfaces, lousy decision-support options and time-consuming documentation extras which will give physicians an unwanted feeling of deja-vu. Not to mention doctors who refuse to use it and try to upend efforts to use AI in healthcare.

Of course, some hospitals will have learned from their mistakes, but I’m guessing that many may not, and things could go downhill from there. Regardless, let’s hope that AI tools don’t become the next albatross hung around doctors’ necks.

This Futurist Says AI Will Never Replace Physicians

Posted on June 6, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Most of us would agree that AI technology has amazing — almost frightening — potential to change the healthcare world. The thing is, no one is exactly sure what form those changes will take, and some fear that AI technologies will make their work obsolete. Doctors, in particular, worry that AI will undercut their decision-making process or even take their jobs.

Their fears are not entirely misplaced. Vendors in the healthcare AI world insist that their products are intended solely to support care, but of course, they need to say that. It’s not surprising that doctors fret as AI software starts to diagnose conditions, triage patients and perform radiology readings.

But according to medical futurist Bertalan Mesko, MD, Ph.D., physicians have nothing to worry about. “AI will transform the meaning of what it means to be a doctor; some tasks will disappear while others will be added to the work routine,” Mesko writes. “However, there will never be a situation where the embodiment of automation, either a robot or an algorithm, will take the place of a doctor.”

In the article, Mesko lists five reasons why he takes this position:

  1. Empathy is irreplaceable: “Even if the array of technologies will offer brilliant solutions, it would be difficult for them to mimic empathy,” he argues. “… We will need doctors holding our hands while telling us about life-changing diagnoses, their guide to therapy and their overall support.”
  2. Physicians think creatively: “Although data, measurements and quantitative analytics are a crucial part of a doctor’s work…setting up a diagnosis and treating a patient is not a linear process. It requires creativity and problem-solving skills that algorithms and robots will ever have,” he says.
  3. Digital technologies are just tools: “It’s only doctors together with their patients who can choose [treatments], and only physicians can evaluate whether the smart algorithm came up with potentially useful suggestions,” Mesko writes.
  4. AI can’t do everything: “There are responsibilities and duties which technologies cannot perform,” he argues. “… There will always be tasks where humans will be faster, more reliable — or cheaper than technology.”
  5. AI tech isn’t competing with humans: “Technology will help bring medical professionals towards a more efficient, less error-prone and more seamless healthcare,” he says. “… The physician will have more time for the patient, the doctor can enjoy his work in healthcare will move into an overall positive direction.”

I don’t have much to add to his analysis. I largely agree with what he has to say.

I do think he may be wrong about the world needing physicians to make all diagnoses – after all, a sophisticated AI tool could access millions of data points in making patient care recommendations. However, I don’t think the need for human contact will ever go away.

Recording Doctor-Patient Visits Shows Great Potential

Posted on June 1, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Doctors, do you know how you would feel if a patient recorded their visit with you? Would you choose to record them if you could? You may soon find out.

A new story appearing in STAT suggests that both patients and physicians are increasingly recording visits, with some doctors sharing the audio recording and encouraging patients to check it out at home.

The idea behind this practice is to help patients recall their physician’s instructions and adhere to treatment plans. According to one source, patients forget between 40% to 80% of physician instructions immediately after leaving the doctor’s office. Sharing such recordings could increase patient recall substantially.

What’s more, STAT notes, emerging AI technologies are pushing this trend further. Using speech recognition and machine learning tools, physicians can automatically transcribe recordings, then upload the transcription to their EMR.

Then, health IT professionals can analyze the texts using natural language processing to gain more knowledge about specific diseases. Such analytics are likely to be even more helpful than processes focused on physician notes, as voice recordings offer more nuance and context.

The growth of such recordings is being driven not only by patients and their doctors, but also by researchers interested in how to best leverage the content found in these recordings.

For example, a professor at Dartmouth is leading a project focused on creating an artificial intelligence-enabled system allowing for routine audio recording of conversations between doctors and patients. Paul Barr is a researcher and professor at the Dartmouth Institute for Health Policy and Clinical Practice.

The project, known as ORALS (Open Recording Automated Logging System), will develop and test an interoperable system to support routine recording of patient medical visits. The fundamental assumption behind this effort is that recording such content on smart phones is inappropriate, as if the patient loses their phone, their private healthcare information could be exposed.

To avoid this potential privacy breach, researchers are storing voice information on a secure central server allowing both patients and caregivers to control the information. The ORALS software offers both a recording and playback application designed for recording patient-physician visits.

Using the system, patients record visits on their phone, have them uploaded to a secure server and after that, have the recordings automatically removed from the phone. In addition, ORALS also offers a web application allowing patients to view, annotate and organize their recordings.

As I see it, this is a natural outgrowth of the trailblazing Open Notes project, which was perhaps the first organization encouraging doctors to share patient information. What makes this different is that we now have the technology to make better use of what we learn. I think this is exciting.

Competition Heating Up For AI-Based Disease Management Players

Posted on May 21, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Working in collaboration with a company offering personal electrocardiograms to consumers, researchers with the Mayo Clinic have developed a technology that detects a dangerous heart arrhythmia. In so doing, the two are joining the race to improve disease management using AI technology, a contest which should pay the winner off handsomely.

At the recent Heart Rhythm Scientific Sessions conference, Mayo and vendor AliveCor shared research showing that by augmenting AI with deep neural networks, they can successfully identify patients with congenital Long QT Syndrome even if their ECG is normal. The results were accomplished by applying AI from lead one of a 12-lead ECG.

While Mayo needs no introduction, AliveCor might. While it started out selling a heart rhythm product available to consumers, AliveCor describes itself as an AI company. Its products include KardiaMobile and KardiaBand, which are designed to detect atrial fibrillation and normal sinus rhythms on the spot.

In their statement, the partners noted that as many as 50% of patients with genetically-confirmed LQTS have a normal QT interval on standard ECG. It’s important to recognize underlying LQTS, as such patients are at increased risk of arrhythmias and sudden cardiac death. They also note that that the inherited form affects 160,000 people in the US and causes 3,000 to 4,000 sudden deaths in children and young adults every year. So obviously, if this technology works as promised, it could be a big deal.

Aside from its medical value, what’s interesting about this announcement is that Mayo and AliveCor’s efforts seem to be part of a growing trend. For example, the FDA recently approved a product known as IDx-DR, the first AI technology capable of independently detecting diabetic retinopathy. The software can make basic recommendations without any physician involvement, which sounds pretty neat.

Before approving the software, the FDA reviewed data from parent company IDx, which performed a clinical study of 900 patients with diabetes across 10 primary care sites. The software accurately identified the presence of diabetic retinopathy 87.4% of the time and correctly identified those without the disease 89.5% of the time. I imagine an experienced ophthalmologist could beat that performance, but even virtuosos can’t get much higher than 90%.

And I shouldn’t forget the 1,000-ton presence of Google, which according to analyst firm CBInsights is making big bets that the future of healthcare will be structured data and AI. Among other things, Google is focusing on disease detection, including projects targeting diabetes, Parkinson’s disease and heart disease, among other conditions. (The research firm notes that Google has actually started a limited commercial rollout of its diabetes management program.)

I don’t know about you, but I find this stuff fascinating. Still, the AI future is still fuzzy. Clearly, it may do some great things for healthcare, but even Google is still the experimental stage. Don’t worry, though. If you’re following AI developments in healthcare you’ll have something new to read every day.

AI Software Detects Diabetic Retinopathy Without Physician Involvement

Posted on April 27, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The FDA has approved parent company IDx to market IDx-DR, the first AI technology which can independently detect diabetic retinopathy. The software can make basic recommendations without any physician involvement.

Before approving the software, the FDA reviewed data from a clinical study of 900 patients with diabetes across 10 primary care sites. IDx-DR accurately identified the presence of diabetic retinopathy 87.4% of the time and accurately identified those without the disease 89.5% of the time. In other words, it’s not perfect but it’s clearly pretty close.

To use IDx-DR, providers upload digital images of a diabetic patient’s eyes taken with a retinal camera to the IDx cloud server. Once the image reaches the server, IDx-DR uses an AI algorithm to analyze the images, then tells the user whether the user has anything more than mild retinopathy.

If it finds significant retinopathy, the software suggests referring the patient to an eye care specialist for an in-depth diagnostic visit. On the other hand, if the software doesn’t detect retinopathy, it recommends a standard rescreen in 12 months.

Apparently, this is the first time the FDA has allowed a company to sell a device which screens and diagnoses patients without involving a specialist. We can expect further AI approvals by the FDA in the future, according to Commissioner Scott Gottlieb, MD. “Artificial Intelligence and Machine Learning hold enormous promise for the future of medicine,” Gottlieb tweeted. “The FDA is taking steps to promote innovation and support the use of artificial intelligence-based medical devices.”

The question this announcement must raise in the minds of some readers is “How far will this go?” Both for personal and clinical reasons, doctors are likely to worry about this sort of development. After all, putting aside any impact it may have on their career, they may be concerned that patient will get short-changed.

They probably don’t need to worry, though. According to an article in the MIT Technology Review, a recent research project done by Google Cloud suggests that AI won’t be replacing doctors anytime soon.

Jia Li, who leads research and development at Google Cloud, told a conference audience that while applying AI to radiology imaging might be a useful tool, it can automate only a small part of radiologists’ work. All it will be able to do is help doctors make better judgments and make the process more efficient, Li told conference attendees.

In other words, it seems likely that for the foreseeable future, tools like IDx-DR and its cousins will help doctors automate tasks they didn’t want to do anyway. With any luck, using them will both save time and improve diagnoses. Not at all scary, right?

AI Tool Helps Physician Group Manage Prescription Refills

Posted on April 25, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Most of the time, when we hear about AI projects people are talking about massive efforts spanning millions of records and many thousands of patients. A recent blog item, however, suggests that AI can be used to improve comparatively modest problems faced by physician groups as well.

The case profiled in the blog involves Western Massachusetts-based Valley Medical Group, which is using machine learning to manage medication refills. The group, which includes 115 providers across four centers, implemented a product known as Charlie, a cloud-based tool made by Healthfinch 18 months ago. (I should note, at this point, that the blog maintained is by athenaHealth, which probably has a partnership with Healthfinch. Moving on…)

Charlie is a cloud-based tool which automates the process of prescription refills by integrating with EHRs. Charlie processes refill requests much like a physician or pharmacist would, but more quickly and probably more thoroughly as well.

According to the blog item, Charlie pulls in refill requests from the practice’s EHR then adds relevant patient data to the requests. After doing so, Charlie then runs the requests through an evidence-based rules engine to detect whether the request is in protocol or out of protocol. It also detects duplicates. errors and other problems. Charlie can also absorb specific protocols which let it know what to look for in each refill request it processes.

After 18 months, Valley’s refill process is far more efficient. Of the 10,000 refill requests that Valley gets every month, 60% are handled by a clerical person and don’t involve a clinician. In addition, clerical staff workloads have been cut in half, according to the practice’s manager of healthcare informatics.

Another benefit Valley saw from rolling out Charlie with that they found out which certain problems lay. For example, practice leaders found out that 20% of monthly refill requests were duplicate requests. Prior to implementing the new tool, practice staff spent a lot of time investigating the requests or worse, filling them by accident.

This type of technology will probably do a lot for medium-sized to larger practices, but smaller ones probably can’t afford to invest in this kind of technology. I have no idea what Healthfinch charges for Charlie, but I doubt it’s cheap, and I’m guessing its competitors are charging a bundle for this stuff as well. What’s more, as I saw at #HIMSS18, vendors are still struggling to define the right AI posture and product roadmap, so even if you have a lot of cash buying AI is still a somewhat risky play.

Still, if you’re part of a small practice that’s rethinking its IT strategy, it’s good to know that technologies like Charlie exist. I have little doubt that over time — perhaps fairly soon — vendors will begin offering AI tools that your practice can afford. In the meantime, it wouldn’t hurt to identify processes which seem to be wasting a lot of time or failing to get good results. That way, when an affordable tool comes along to help you’ll be ready to go.

Patient Demand For Digital Health Tools May Exceed Providers’ Ability To Deliver

Posted on March 15, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

It’s taken a long time, but it looks like consumers are getting serious about using digital tools to improve their health. According to a new survey by Accenture, in some cases consumers are actually more interested in using such tools than their providers are, researchers found.

Patients are taking advantage of a wide range of digital health options, including mobile tech (46%), accessing electronic health records (38%), social media (35%), wearable technology (33%), smart scales (27%), remote consultations (16%) and remote monitoring (14%). All of these numbers are up from 2017, notably mobile and access to electronic health records, use of which grew 10% and 9% respectively.

The survey also notes that the number of consumers receiving virtual healthcare services has increased since last year, from 21% in 2017 to 25% this year. Seventy-four percent of those accessing virtual care were satisfied with the encounter. Meanwhile, about three-quarters of consumers said they would use virtual care for after-hours appointments, and about two-thirds would choose this option for follow-up appointments after seeing a doctor in person.

Key takeaways for clinicians, meanwhile, include that while patients agree that in-person visits provide quality care, engage patients in their health care decisions and diagnose problems faster, virtual visits offer some significant advantages too. Virtual care benefits they identified include reducing medical costs to patients, accommodating patient schedules and providing timely care, respondents said.

Clinicians should also note that AI-based virtual doctors may someday become the competition. When asked whether they would use an AI virtual doctor provided by their provider, some were doubtful, with 29% saying they prefer visiting the doctor, 26% that they didn’t understand enough about how AI works, and 23% that they did not want to share their data.

However, 47% said they would choose a virtual doctor because it would be available whenever they needed it. Also, 36% said they’d use a virtual doctor because it would save time by avoiding a trip to the doctor, and 24% said they’d like to access a virtual doctor because the AI would have access to large amounts of relevant information.

Right now, it’s far more likely that hospitals will have the capacity to deliver such services, which may demand a higher level of IT expertise and staff time that many medical practices have available. Nonetheless, it seems likely that at some point, medical practices will need to offer more digital services if they want to remain competitive.

Meet the #HIMSS18 Press – A Wrapup Discussion of the Conference

Posted on March 13, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week most in the healthcare IT community are recovering from the massive healthcare IT conference we know as HIMSS. The conference brings together a wide variety of people from the healthcare IT community and everyone is guaranteed to miss something that they’d find interesting and valuable. With that in mind, we’re hosting this week’s #HITsm chat to talk about what we saw and heard at #HIMSS18. Be sure to join us and share your insights and perspectives since we all no doubt had unique experiences.

As I’d done once previously, on the last day of HIMSS I hopped on video with my friend and colleague, Neil Versel who now writes at Genome Web, to talk about what we saw at HIMSS 2018. While I’m attending my 9th HIMSS, this was Neil’s 17th. So, we have some experience and perspective to offer having attended HIMSS for a combined 26 years. Enjoy our wrap up discussion on the final day of HIMSS:

What was your experience at HIMSS18? If you didn’t attend, what would you have liked to see? Did you follow along on Twitter? What do you think of the trending topics we discussed. How will they impact your business? Let us know in the comments.

#HIMSS18 Exhibitors Shift Away from Glitz & Glamour in Vegas

Posted on March 9, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

The crucible that is the #HIMSS18 exhibit hall is over. 1300+ vendors have taken down their booths and rushed off to catch flights home. In the quiet aftermath of the vendor exodus, I had the chance to reflect on the overall themes of this year’s exhibits.

AI was everywhere and nowhere

Going into #HIMSS18 I fully expected that artificial intelligence would be a dominant theme. It was…and then some. AI was splashed across banners and monitors as far as the eye could see. Michael Rothman PhD, Co-founder and Chief Science Officer at Pera Health summed it up best: “Artificial Intelligence was liberally sprinkled across the #HIMSS18 show floor. It was the pixie dust that blanketed everything.”

Yet after speaking with many vendors, it became apparent to me that the term was being used very broadly to include: machine learning, data mining and rules-based workflow. Worse, a few vendors I spoke to were unable to describe how the addition of AI made their products incrementally better than what they offered before. Will “AI” go the way of neural networks, hydrogen cars and 3D TV? Doubtful, but it is concerning how quickly the term has become a marketing buzzword.

Fewer brochures handed out

In years past, you couldn’t walk down the aisles at HIMSS without vendors handing you nicely printed marketing brochures. This year, there was a noticeable lack of brochures. Several vendors had no paper handouts whatsoever, electing instead to email materials directly to booth visitors rather than force bulky paper brochures into their hands.

In my mind this is a win-win-win. The environment wins because fewer trees are transformed into glossy brochures with smiling doctors staring at computer screens. HIMSS attendees win from not having to carry heavy brochures. HIMSS exhibitors win from not having to print and ship brochures.

Fewer tchotchke’s, more in-booth experiences

One of the staples of HIMSS has been the amazing promotional items given out by vendors in the exhibit hall. This year, however, vendors scaled back their giveaways, opting instead to invest more on in-booth experiences. I counted no fewer than 20 podcasting stations and 15 video/livestream setups embedded in vendor booths. The soundproof podcast studio in the Cerner booth was amazing.

Also notable were the number of in-booth theatres that dotted the exhibit floor. I stopped counting after reaching 250. What impressed me was that it was not just sales presentations that were happening on these stages. Many vendors featured panel discussions and live interviews of industry thought leaders as part of their programs.

In my mind the hands-down winner was the CDW Healthcare Jeopardy station. Every day there was a crowd of people actively participating in a game-show style contest that pitted up to 6 teams of participants against each other. The show host was particularly charming and engaging. He really got the crowd excited. Bonus: the questions were all healthcare based.

Special shout out to @MedicaSoftLCC @FogoDataCenters @NextGate @emedapps for gathering donations for SafeNest an organization that helps victims of domestic abuse in Las Vegas.

Booth Models becoming extinct

It’s one thing to hire an entertainer like a magician or look-alike to attract people to your booth. It’s quite another to hire an attractive model to do nothing more than to stand in your booth and be attractive. At HIMSS18 I noticed very few of these hired helpers. There were certainly models who were hired to play the part of a patient in mock exam rooms, but there were no scantily-clad flamingo girls or bare-chested tuxedo men handing out company brochures like in years past when HIMSS was in Las Vegas. I’m hoping this downward trend continues.

Smaller Booths

The most surprising aspect of the HIMSS18 exhibit floor was size of the booths themselves. There were the usual giant footprints from industry titans: Epic, Cerner, Allscripts and IBM Healthcare. But other than the new Change Health booth, it felt like most vendors chose smaller booth sizes. Salesforce, Oracle, Microsoft, Google, Amazon, DellEMC and Verizon had moderately-sized booths at HIMSS18 relative to the size of those companies.

Healthcare IT has never been about glitz and glamour. Despite being held in Las Vegas – the city that is the epitome of glitz – the vendors in the #HIMSS18 exhibit hall showed restraint and practicality. Hopefully this is a trend that continues next year at #HIMSS19

#HIMSS18 First Day:  A Haze Of Uncertainty

Posted on March 7, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Entering the HIMSS exhibit area always feels like walking straight into a hurricane. But if you know how to navigate the show, things usually start to come into focus.

There’s a bunch of young, scrappy and hungry startups clustered in a hive, a second tier of more-established but still emerging ventures and a scattering of non-healthcare contenders hoping to crack the market. And of course, there are the dream places put in place by usual suspects like Accenture, SAP and Citrix. (I also stumbled across a large data analytics company, the curiously-named splunk> — I kid you not – whose pillars of data-like moving color squares might have been the most spectacular display on the floor.)

The point I’m trying to make here is that as immense and overwhelming as a show like HIMSS can be, there’s a certain order amongst the chaos. And I usually leave with an idea of which technologies are on the ascendance, and which seem the closest to practical deployment. This time, not so much.

I may have missed something, but my sense on first glance that I was surrounded by solutions that were immature, off-target or backed by companies trying to be all things to all people. Also, surprisingly few even spoke the word “doctor” when describing their product.

For example, a smallish HIT company probably can’t address IoT, population health, social determinants data and care coordination in one swell foop, but I ran into more than one that was trying to do something like this.

All told, I came away with a feeling that many vendors are trapped in a haze of uncertainty right now. To be fair, I understand why. Most are trying to build solutions without knowing the answers to some important questions.

What are the best uses of blockchain, if any? What role should AI play in data analytics, care management and patient interaction? How do we best define population health management? How should much-needed care coordination technologies be architected, and how will they fit into physician workflow?

Yes, I know that vendors’ job is to sort these things like these out and solve the problems effectively. But this year, many seem to be struggling far more than usual.

Meanwhile, I should note that there seems to be a mismatch between what vendors showed up and what providers say that they want. Why so few vendors focused on RCM or cybersecurity, for example? I know that to some extent, HIMSS is about emerging tech rather than existing solutions, but the gap between practical and emerging solutions seemed larger than usual.

Don’t get me wrong – I’m learning a lot here. The wonderful buzz of excited conversations in the hall is as intense as always. And the show is epic and entertaining as always. Let’s hope that next year, the fog has cleared.