An Australian perspective on HIMSS 2019

Pulse Series: As part of the 21st Century Series on Australian Healthcare, David Pare, CTO for DXC Healthcare and Life Sciences in Australia and New Zealand, will focus on news, start-ups and developments within the industry — what’s happening, what’s being done to drive innovation, and what’s new or newsworthy.

Despite the 15 years I have spent in this industry, 2019 was my first visit to the massive HIMSS conference. It lives up to its reputation as a mega gathering, with 45,000 attendees and a mile long (1.6 km) exhibition hall, filled with flashy booths — many with neon signs, some two-storeys high with screens and offices built into them. It is an overwhelming experience. According to some of the organisers, it is one of the few conferences where attendees actually come as much for the sessions as for the vendor exhibition hall.

As I spent most of my time wandering the exhibition hall, talking to vendors, start-ups, clients and market research analysts, it makes sense to focus this blog on what I experienced in that main exhibition hall. Although pockets of everything can be found in every corner, three themes really stood out for me, which fit with the global trend on value-based care.

Data and analytics:The first and most prevalent theme of this mega space was data and analytics. This includes artificial intelligence (AI), machine learning and all forms of predictive analytics. Large electronic medical records (EMR) vendors were in attendance, demonstrating their new artificial intelligence/machine learning capabilities as part of their vertical stack. Many start-ups also provide these capabilities in the form of an add-on widget to existing EMRs. And, given the emphasis on improved patient outcomes, there was also a big focus on providing clinical decision support to clinicians on medication management, i.e., adverse effects, recommendations on best drug to prescribe, etc.

At the same time, there also was a plethora of large and small vendors providing solutions sitting on the edge of or above traditional EMRs. Most of these are designed to ingest data from payer, provider and even life sciences applications and then apply artificial intelligence and machine learning models to generate clever insights and predictions to various roles, inside and outside of the hospital. I found these expensive and quite specific — in other words, difficult to adapt these to markets outside the United States.

The patient experience: Secondly, there was widespread emphasis on the patient experience and engagement as integral aspects of population health, care management or care coordination. This is a flooded market, with many technology vendors — from start-ups to large vendors — providing capabilities that are designed to go beyond the walls of the hospital. As many of these companies have a niche market, it is questionable which of these will still be around in 5 years.

Focus on integration: The third stand-out theme was around health integration, including systems integration as well as business process integration. To no one’s surprise, everyone is showcasing their new set of Fast Healthcare Interoperability Resources (FHIR) APIs, intended to promote interoperability. This is particularly interesting coming from the large EMR vendors, as they are known for being difficult to integrate with and not wanting to “play ball”.

Still investing in hospital clinicians

Beyond the three themes discussed, which take population health and care coordination beyond the hospital, it was notable that most large technology vendors are still very focused on the clinician inside the walls of a hospital or specialist clinic.

As an example, IBM Watson Health showcased a platform for clinicians that applies natural language processing (NLP) to digital imaging reports to find diagnoses of certain conditions (in free text) and compares that information to what is captured in the EMR. The findings are then used to point clinicians to information that has not been identified or coded in the EMR but that was found in the data. The objective is to provide deeper and more intelligent clinical support.

Another example at the event was a platform developed by Philips for oncologists and pathologists, aimed at streamlining and simplifying their workflow. This platform takes data out of the lab or genome sequencer and applies AI and machine learning to provide workflow recommendations to the specialist within a tailored user interface.

It was fascinating to see the investment on such specialised tools, focused on improving clinician workflows while, on the other hand, there is growing investment in managing the care of patients beyond the walls of the hospital. It is somewhat of a dichotomy, but it also speaks to the reality and diversity of healthcare.

An ANZ perspective

So, what does HIMSS mean for the Australia-New Zealand (ANZ) market? One thing is certain — no matter how fragmented and challenging our healthcare environment is, I realise now just how much more complex and fragmented the U.S. healthcare market really is.

How then do we import these new capabilities and ideas into the ANZ market, given the huge differences? Unfortunately, there is no easy answer to this question. Many vendors that enjoy huge success in the United States will have a niche state or geographic area with a population bigger than Australia. Their product is so tailored for these customers that it would be hard or cost prohibitive to adapt to ANZ.

Considering the size of our market, I anticipate that many of these new platforms which support better care models and aim to improve patient health outcomes will largely be unavailable in our region. Technology vendors are commercial organisations and will invest in regions where the money is. At least for now, I believe this will potentially create an imbalance or inequality for our region, reducing our ability to access these new capabilities quickly.

Outside of these specialised niche platforms and solutions, there weren’t many ground-breaking or mind-blowing innovations — or at least nothing that swept me off my feet. Perhaps the biggest difference is the speed and extent to which the boundaries between payer, provider and the life sciences industry are blurring in the United States compared with Australia. Although also happening here, it seems to be happening faster over there.

As the industry becomes more complex, it will be vital that all three facets of our industry work together for the well-being and care of the patient to provide the cost-benefit that’s needed to deliver effective and efficient healthcare.

To get another perspective on HIMSS and the dynamics emerging from the meeting, please read the blog by my colleague Damon Auer.

David Pare is the chief technology officer for DXC Healthcare and Life Sciences in Australia and New Zealand. He is an innovative thinker with 20 years of experience in business and technology management consulting, helping organisations through their digital transformation.


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