Questions and uncertainty cloud normally sunny HIMSS

ORLANDO, Fla.—Members of nearly every corner of the healthcare sector all seemed to share the same uncertainty during this year's Healthcare Information and Management Systems Society convention.

The sprawling HIMSS show—in prior years used by officials from the CMS and the Office of the National Coordinator for Health Information Technology as a forum to explain new rules and tout federal health IT policies—was a virtual showcase of unanswered policy questions this year.

The ONC in particular faces delays in rulemaking while awaiting its new leader.

Some of the uncertainty pertains to adding regulatory flesh to the 21st Century Cures Act, passed last year. The Cures Act calls on the health IT industry to reach for interoperability and steer clear of “information blocking.” That provision has some vendors worried, since the language of the act is fairly broad, while the penalties are severe—up to $1 million per incident for developers, networks and information exchanges.

The law leaves it to HHS entirely to draft penalties for providers who block data. Absent a clarifying rule, the data-blocking terms in the statute are “susceptible to variable interpretations” and could lead to “frivolous complaints,” said Eric Helsher, vice president of client success at Epic Systems Corp.

“It could create confusion,” added Dr. David McCallie, senior vice president of medical informatics at Cerner Corp. Vendors will have to wait to see how the ONC handles such language in rule-making.

Though the office is doing what it can under acting coordinator Dr. Jon White, it also is hampered by congressional budgetary constraints. The federal government currently operates under a continuing resolution, which limits spending to what the ONC has already been working on, White explained. That may curb spending on new programs or panels, such as the Health Information Technology Advisory Committee, which replaces two committees that previously handled health IT policy and standards.

Interoperability remains elusive and top of mind for all healthcare folks because health data are so difficult to standardize—whether it's moving information between competing companies or getting computers to speak each other's language.

Problems also arise from a lack of data-sharing agreements between healthcare organizations. Tools to obtain this holy grail abounded at HIMSS—at the familiar Interoperability Showcase and vendors' booths and as a topic of discussion in educational sessions. Seminars included a daylong pre-conference symposium, “Interoperability and Health Information Exchange—Making It Work.”

Precision medicine and genomics were also front and center at the conference, with their own symposium and multiple educational sessions led by pioneers in the field, including Inova, Intermountain and Geisinger healthcare systems as well as Oregon Health & Science University.

Philips, the Netherlands-based electronics conglomerate that's expanding its healthcare footprint, had a genetics lab set up on the exhibition floor. Meanwhile, giant computer chipmaker Intel Corp. showed off its precision medicine work, in partnership with molecular test maker Qiagen, in a virtual reality game.

As healthcare data move into the cloud, payers, providers and others stressed the importance of cybersecurity. Though the cloud “introduces complexity,” said John Walsh, chief technology officer of Horizon Blue Cross and Blue Shield of New Jersey, it is possible people are overestimating its dangers.

Kaveh Safavi, senior managing director of Accenture's global healthcare business, predicted that health data will eventually move to the public cloud, which is more secure than the private cloud. The idea is that public cloud providers such as Amazon, which sell services to clients, have more resources to dedicate to security than their private-cloud counterparts, usually run by a company itself. But, he added, “Security is a barrier to greater healthcare transformation.”

Attendance at this year's show was up slightly from last year, to 42,287 people. That's just under the 43,000 HIMSS conference organizers expected.

At 39.5% of attendees, providers made up the largest group of show-goers. Almost a third of attendees were C-suite executives, and about a fifth each came from IT and senior management. The rest were government employees, academics, clinicians and those from other fields