While healthcare seems to be enamored of the latest shiny object that is AI, the industry still has to master some of the basics of data-sharing. With more than three decades of healthcare experience, Harold "Hal" Wolf III is well-aware of the industry's need to walk before it can run. Wolf, who took the helm in September 2017 as president and CEO of the Healthcare Information and Management Systems Society, says real innovation will come when the industry becomes more adept at turning data into actionable information. Wolf replaced H. Stephen Leiber, who retired after leading the organization for 17 years. Wolf previously worked for the Chartis Group consultancy and spent 10 years as an executive with Kaiser Permanente. He recently met with the Modern Healthcare editorial team. The following is an edited transcript.
Modern Healthcare: The CMS said that its new MyHealthEData initiative will improve data-sharing. Even though the agency was short on details, what's your take on the announcement?
Hal Wolf: First, I think about the separation between data and information. Data is kind of useless until you turn it into information. How do I bucket it, and how do I take what is ones and zeroes inside a server and make it into something that is an actionable event or a comparable event for information?
Fundamentally, you go from data to information to knowledge management, which is a comparison of information buckets and, ultimately, the clinical utilities. The premise behind what everyone's trying to do—and we've been doing it for a while, but it is wonderful that CMS is pushing in this direction—is making sure that a person's information is available to them. That's step one.
The second step, which is this critical link between the health model and the medical model, is how do we share data and information with each other where it's relevant in the delivery of care, or in motivating individuals to do better?
We're probably accelerating toward the use of information more effectively than we ever have before. Patient engagement in the use of that information is critically important. There's three ways to think about data. One is data ownership, and another is data access and then the third is data usage. I think we're learning very quickly about these three dimensions and starting to put them in play.
MH: Do you think the agency's plan to overhaul meaningful use will reduce what providers say is a heavy burden?
Wolf: I was just in Washington talking about this at the Office of the National Coordinator. The absolute goal is to reduce the burden. We knew from the beginning that as we put electronic health records in place and we put data in place, it can get really hard. It's a big change-management effort. I think we're taking an opportunity now to say, "OK, here's our platform. This is what we've got. Let's make sure everyone's using it and understanding how the information can come together." And the pace is just being pulled back a bit.
MH: There have been some other moves, including the evolution of Apple's Health app, that try to put the patient at the center of interoperability. Is that realistic?
Wolf: It makes absolute sense if the patient has access to their information from multiple points. This is the reason everyone's pushing for the open application programming interfaces. This is the reason we're trying to get the interoperability in place. The challenge we have is in the way that health information exchanges are set up; they're moving in the right direction. If I'm visiting Chicago from Denver and something happens and I wind up at Cook County hospital, it's not easy to get my records. At the same time, it may not be easy if I'm carrying it myself and my phone happens to go missing.
So it's not an either/or.
MH: Do you think that there is still a business case for HIEs?
Wolf: Somewhat yes and somewhat no. All HIEs are not created equal. HIEs are largely based upon transactional costs or volumes, and so it depends on the market that you're in.
The models have improved dramatically. We've seen them through the years. They're getting better, but it still remains to be seen if you can actually connect the whole country in one large HIE without some type of support in order to make it a reality. It's just really hard in the smaller, less traffic-dense areas. And in some cases, that's where it's needed more—where you may not have access to all the care, and the access to information both inbound and outbound on a virtual basis can be the difference between life and death.
MH: AI was a big topic at the HIMSS annual meeting. Are you seeing places where it is actually making a difference?
Wolf: We're on a hype curve with AI. That doesn't necessarily mean it's not viable. I think we're just learning how to use it. Some advances point to small components of AI in clinical-decision support and some of the pieces that are already built into some phone apps. But I think there's a lot of upside to it. I really do. I'll give you a simple example that I think AI will help us with a lot more.
Think about a supply chain. Not in terms of using AI to figure out the cost of a widget, but the consumption of resources when you look at an episode treatment group and the cost of those resources and being able to do comparative models of similar groups on a global basis. That allows you to start to make and find best practices that we couldn't see before. How are we obtaining this outcome with this consumption of resources?
You could actually take it further down into pricing models, inevitably, against those individual pieces. From the time the diagnosis takes place to the end of the treatment, what happened on that journey? How many physicians did they see? What treatment did they go through? What was the cost of that treatment? And then I want to be able to compare that individual's episode treatment group based on their demographics.
MH: You've been in this role for a few months now. What are your priorities going forward?
Wolf: Well, the priority coming in was, first of all, to listen. Both on the employee side and, of course, to our members and to the market in healthcare, overall.
HIMSS is first and foremost an association of people who are dedicated to improving care, and then we've been able to build a number of components and assets around it that helped us achieve that model.
So, in the first eight months, getting my arms around that and understanding how we can use our assets even more effectively to improve health—that's been the ride.
MH: When you say assets, are there things you might shed, or are you looking to grow?
Wolf: If you look in the last 12 months, we acquired Health 2.0, which is a terrific organization focused on identifying and bringing innovation forward and finding opportunities for startups and early generation organizations to get a little bit of limelight and connecting to investors and also to providers so they can see what's occurring. We brought in Healthbox. That also focuses in the investment space around innovation and how to implement it, and they do a little bit of consulting.
We are really extending ourselves in the innovation space. And our goal is to improve care. Our goal is to help transform it.
We're moving into a space of accelerated accessed information. It's going to happen through innovation and change management, and we're aligning ourselves to be able to take advantage of it. And how do we do that globally?
Changing the name of the annual conference to the "global conference" was a big step because we're all trying to solve the same problems in healthcare. There are many lessons we can learn overseas, and overseas is always trying to learn from us.
MH: Speaking of the conference, there are always rumblings about it being too vendor-focused and not being as relevant for provider executives. What are your plans to keep the meeting fresh?
Wolf: One of the things we watch very carefully is that ratio between the professionals coming and the supplier community, and our ratio is actually pretty strong.
The majority of our programs are not vendor-led—they are led by members. And we're going to dedicate 20% of our time to international.
The second thing is to keep recognizing that we have an expanding ecosystem, and how does HIMSS bring clinical-decision support and clinical pharmacy support onto the floor? They've been coming, but we haven't actually had more of a formal relationship, and so that's starting to happen just because of the expansion of the ecosystem.
And then expanding in the provider community and the clinician community on the use of information. Not just meaning a chief medical information officer, but if I'm a nurse practitioner, if I'm a clinician, if I'm a primary-care doctor, how am I going to be thinking about information differently tomorrow than I am today?
And then, finally, our focus on innovation. You'll see that starting to take a more and more prominent view. We're actually creating pavilions on innovation that we're bringing to the main floor. Because we are putting out a very important statement, which is that the use of information and the access to innovation and the new companies that are coming are equally as important a part of the landscape as the market suppliers that are there.