Despite nearly two decades working in healthcare IT, I actually hadn’t been to HIMSS since 2016. With that time and distance, I was struck by how the physical changes I noticed on the HIMSS floor directly reflect the changes in our industry. Subjective observations of HIMSS are interesting, but the statistics tell a larger story. To tell that story, I conducted an analysis with numbers sourced directly from HIMSS. The takeaways were eye opening.
Observation #1: Non-healthcare players have arrived in a big way.
While the headlines are filled with stories of big tech and others coming into healthcare, consider this: When I was last at HIMSS in 2016, Google, Amazon, Microsoft, Salesforce, Uber, Lyft, Leidos and NetApp collectively occupied 5,780 square feet of floor space at HIMSS (Google didn’t even have a booth). This week in Orlando, those same companies combined took up 25,300 square feet. That’s a 4.3x increase in just three years.
As a point of comparison, Epic, AthenaHealth, Allscripts, Cerner, eClinicalWorks, Optum, NextGen, and Change Healthcare combined occupied 107,600 square feet on the floor this year. Some quick napkin math indicates that these big tech newcomers occupied fully one-quarter as much floor space as these HCIT well entrenched companies.
Whether it’s machine learning models to predict sepsis, AI-enabled virtual health assistants, tech-enabled medical transportation, or cloud-based information sharing, it’s clear the HCIT industry is being reshaped by large technology companies, and there are numbers to prove it.
Observation #2: Interoperability needs less copying / moving and more using of data.
In 2016, there were 260 exhibitors that described themselves in the HIMSS guidebook as focused on interoperability. In 2019 that number exploded to 431, an increase of 66%. It’s clear the combination of technical standards like SMART on FHIR, together with the work of the Commonwell Alliance and policy makers (e.g. last week’s notice of proposed rule making regarding information blocking prohibitions), and demand by individual stakeholders, are driving significant activity and focus on this critical aspect of the HCIT ecosystem.
What’s less clear is whether the majority of these firms are using the latest technological thinking about interoperability. Most of the firms and efforts I saw were about making the data translatable and transportable from one system to the next. While this is a huge step forward, it still necessitates huge data scrubbing efforts, large enterprise data warehouses, and multiple copies of data flying around the ecosystem. I’ve heard this data-copying approach to interoperability referred to as lower case “i” interoperability. In other industries, it’s common to share applications and analysis tools that access data at rest in its native environment, as opposed to copying and moving the data. This next-generation interoperability approach often powers an order of magnitude improvement in efficiency. Some refer to this as capital “I” interoperability.
So while it’s exciting to see very significant progress and increased focus on interoperability, I’m hoping by my next HIMSS more people are thinking about capital “I” interoperability to reduce “friction” in healthcare.
Observation #3: Cybersecurity vendors looks like miners in a gold rush.
Just like the California Gold Rush in 1849 and the Klondike Gold Rush in 1899 flooded those territories with new residents, cybersecurity is bringing hundreds of new entrants into the HCIT ecosystem.
During my last HIMSS year in 2016, there were 324 vendors included in the “Privacy and Security” category. There were more than 500 this year. That statistic combined with the increase in cybersecurity educational presentations and security-specific dedicated exhibit floor space is fully indicative of the escalating cybersecurity challenges faced by healthcare stakeholders.
In a less quantitative comment, I will say that most of the vendors looked to me like gold rush miners touting what amounted to better picks and shovels. Essentially these were point solutions attempting to solve just a little portion of the cybersecurity puzzle. While we need these innovative and focused companies, I was disappointed that I only saw a few entrepreneurial companies attempting to solve the broader challenge for healthcare stakeholders. Certainly some of the larger horizontal security companies like Symantec portend to offer a comprehensive set of services and products, but these generally haven’t been purpose-built for healthcare. If you know of some, I’d love to hear about entrepreneurial companies taking a broader approach to this critical issue.
Observation #4: The cloud is the new place to do old things.
More than 200 vendors touted “cloud” in some capacity this year, either in their name or in a description of their services. Yet while the cloud is new in healthcare, it seems to be stuck in a box as a new place for hosting legacy applications. I saw several examples around solutions like credentialing, patient marketing, and cybersecurity log analyzers.
Moving to the cloud makes things faster, easier and cheaper. But moving from a vast array of on-premises point solutions to a vast array of cloud point solutions isn’t transformative. Neither is investing solely in cloud at the infrastructure level with one of the big tech players. What’s missing is a cloud platform that changes the way businesses and people interact, within organizations and externally. Even if it wasn’t evident on the HIMSS floor, that revolution is clearly on the horizon. I am excited for the change platforms will drive in the industry as we look beyond cloud point solutions to the power of cloud platforms.