What went down at HIMSS (Apr. 6-7)
Health Information Management Systems Society, the annual conference is part trade-show, part education, part schmoozing. This is the first time I went. Epic is close to Chicago, so it made practical sense this year to send bus loads of cheery, bright-eyed kids (I'm sure that's what we looked like, anyway) to the conference. No not in school-buses, although that also would have fit.
I had the opportunity to attend Monday and Tuesday. In order to maximize my time there, my schedule was a bit unique. I took the early bus (5:15 am) on Monday and stayed at the convention center (the huge McCormick Place in downtown Chicago) until 5. I Stayed with a friend in town instead of riding the bus two more times. On Tuesday I started at 8 at the center and left with the Epic Group on a bus at 6:15 pm.
Getting to McCormick Place
As I mentioned, Epic chartered Badger Coaches to take us. All other expenses were ours to bear, since we were going voluntarily as learners and not exhibiting. This was a good combo as I had all the priviledges of being an exhibitor without the requirement to stay at a booth all day. My girlfriend Heidi (what a trooper) dropped me off at Epic in time to catch the bus. I sat next to Zach, a trainer. He used to be on my team but decided Technical Services was not for him. I'm glad he decided to find a suitable role rather than leave; he's a good guy. We chatted about various software things for an hour until we both dozed off.
We crawled through Monday morning rush hour and reached the site at 8:30. I was only vaguely aware of the next half-hour. I had the initial shock of a large convention. It has been two years since I went to ACEN. And this is bigger - much bigger. HIMSS claimed that over 26,000 people attended this. I just followed a group of Epic people to get badges, then to the keynote.
Key Note
George Halverson is an important man. He is the head of Kaiser Permanente, Epic's largest customer. And he is very supportive of our mission. They gave this guy a very impressive, almost over-the-top, introduction. This fits the tradeshow aspect but it reminded me more of an intro for Steve Jobs at E3 or someone winning their TED prize.
After this intro, and the playing of "Oh, Yeah" by Yello (I'm sure I'm the only one who noticed) as Halverson took the stage, he talked about the state of healthcare and what we need to do. He said healthcare is the fastest growing sector in the U.S. economy. He talked at length about costs, saying that 80% of the money is being spent on 20% of the patients He mentioned some of the specific ways KP has worked to reduce the cost of patients with chronic conditions like diabetes and how treating these illnesses correctly in the first place can prevent costly hospital stays.
He observed that there are thousands of database codes for procedures and treatments but not one code for a cure. He said that he was appalled that the National Institute of Health set a goal that by 2020, 90% of patient care would be based on scientific evidence. He said, "Imagine if computer programming was based 90% on computer science?" Indeed. My question is, when it comes to healthcare, what are you using instead of evidence-based medicne? (footnote 1)
Halverson talked about the electronic healthcare - he didn't mention Epic directly. In fact, nobody is allowed to outside of the exhibition hall. But when prodded off-stage, they will. And Epic receives a lot of positive recommendations at HIMSS. But Halverson did emphasize the importance of electronice order entry, seamless access to the patient's medical history (through a trusted source - not a Personal Health Record. More on PHR's later.) He highlighted the utility of a patient accessing the system from their home (MyChart) and being able to communicate with physicians, make appointments, refill prescriptions, and access lab results. He also mentioned home monitoring solutions, specifically for diabetics.
It was a good talk overall, although the overall tone was that we need to address probelms today before we run out of time. This zeitgeist was present all over HIMSS - that if something isn't done soon, socialized, government-run healthcare is on the horizon.
Monday Sessions
After George Halverson's key note address, I attended an "education" session. I randomly picked one that sounded interestting - for me, it wasn't. I heald a project manager talk about implementing a "universal viewer" system to replace their legacy computerized systems. They pushed and pushed to get this "viewer" thing up and running, but in the end, they had to bring back their legacy systems because the "viewer" was not customiziable to the degree the end-users wanted.
The "viewer" itself sounded a lot like a clinical data repository - CDR - along with a snapshot report. This would be one small part of a fully-installed Epic system. I struggled to see why they spent so much time and money on such a small part of the system, especially when it failed in the end. I can imagine how Epic's staff would have responded in the same situation - to make sure they could "cut the cord" from their old systems and start doing everything in Epic. But not every vendor is like Epic.
I attended a later session, mostly because I was tired of standing and walking. I don't remember much from it.
Walking the Floor
I spent most of Monday walking the exhibition floor. HIMSS is so big that there were two halls, one larger than the other, connectied through the "Grand Central Concourse Hallway of Doom." I only got through the bigger hall on Monday, and checked out the other on Tuesday. I was curious to see who was there - Microsoft, Google, IBM, Motorola, AT&T, to name a few that most readers are familiar with. Many of our big competitors were there, and many small shops who are our "competitors" were also there.
I was walking past one of our "competitors" - I don't even know who, because I literally was walking past. The girl at the booth called out to get my attention. She seemed very friendly, asking who I was with. I said, "Epi-". She immediately gets all defensive and says, "I can't talk to YOU!" I shrugged and moved on. How rude of her! At least people at Microsoft and others were friendly and inviting. Or they had no idea why my badge said "EPIC Exhibitor".
I talked to a variety of vendors who don't compete with Epic. VMware, Citrix, APC. Several vendors who make all-in-one workstations; keyboards you can put in a dishwasher; tocuh-screens; computers for the battle field. Most of these people were very impressed to learn where I was from. They were excited to talk to me.
The DoD had a booth. It had a cool camo theme, and a group of officers were wandering around the conference in full desert camo, boots even. I talked to one for a bit - he is stationed in Europe. Since the DoD is partnering with healthcare organizations to develop their version of Epic, I decided NOT to ask for a demo. I got the impression from them, and from Microsoft, that they were marketing to the wrong crowd.
Epic and our major competitors show demos that highlight the nitty-gritty. Those cool funcitons that blow people away, provided they understand something about healthcare IT. Microsoft, the DoD, and others demod the electronic health record at a very high-level, the way USA Today would run a story on it. The way a wikipedia entry would discuss it. That's the audience they were going after? I had to laugh out loud watching some of these demos because they were talking about "a complete list of allergies and medical history in one place" like it was the best thing since sliced bread. Many of the smaller guys out there demo like this, but it surprised me to see a few big ones - who until recently haven't been in the healthcare IT business - do the same thing.
Tuesday Sessions
Before the two sessions I attended, I explored the other exhibition hall. It was more of what I saw Monday.
The first session on Tuesday was a "debate" between a guy named Kim Slocum and a lady whom I have forgotten. I think they were supposed to represent a "pro" and "con" concerning personal health records (PHR.) But they mostly agreed on the challenges of PHR adoption. Kim had a lot more to say. When the debate ended, he didn't. He just moved off the stage and kept talking.
On multiple questions, he started by saying "the question we should be asking is" and then went into one of his points. One good point Kim made on stage was about the fearmongering going on about personal health records. How these claims of unprotected health information are unsubstantiated. He also pointed out that PHR's are useless if physicians can't trust the data. The whole concept of a PHR is a gimicky toy that <1% of the population is going to use voluntarily.
Off the stage, Kim was able to open up more. He saw me and another Epic guy, ponted at us. He said, "But you people are doing it right." He explained that he has worked with Judy in the past and agrees with her on the best approach. That it is more important to get the doctors online first, and get trustable data into the system, and then provide patients a portal to it. He is extremely skepitcal of people adopting and using other vendors' PHR systems without their doctor being online first.
He also had chilling words to the effect of "this is our last chance to get it right" before outright socialization of healthcare in America.
I didn't know who the next speaker was but stayed in the room. As Fate would have it, the next speaker was Kevin Mitnick. The world-famous computer hacker in the flesh! Kevin also had an over-the-top movie-like introduction but I think he deserves it. What got me was that the geeks in the room, like me, were still in the minority. Imagine your doctor or nurse in the room - these people were scared to death by this talk!
Kevin went through a very solid presentation, complete with demos from his laptops, on various ways to get information and hack an organization. It was an overview of his book about social engineering. It had very little information specific to healthcare, but it was 100% relevant. He showed how easy it is to get someone's social security number; how to impersonate as a bank employee to another bank; how to spoof caller ID (totally legal by the way); how to dumpster-dive. He told the unbelievable story of obtaining source code from a company by impersonation over the phone, and finally teaching a secretary how to use winzip and ftp to send the data to a remote server! Amazing talk, and hopefully an eye-opener for many in attendance.
It was time to leave HIMSS. But one more thought - I didn't discuss the Epic booth. But one of the cool things was bringing the "Epic bubble" to the convention. Stepping out of the booth was stepping into an ocean of old white men in suits. Now, that's not being fair, because the population at HIMSS was pretty diverse. But I am spoiled by the level of diversity at my own company and I didn't know this until going to HIMSS.
Going Home
I was sore and exhausted. It was time to head home. I ended up sitting with Phil on the ride home. Phil is one of our sales reps (we have only a handful) but also a friend and, dare I say, collaborator? We worked on a customer install together in 2006 and we are always interested in each other's opinions. He let me play with a demo system for about an hour on the trip home, and I pointed out various things I liked about it. He is very excited about the next release of the system, as am I. I like Phil; he has a great "get it done" attitude.
Missed Opportunity
So, why did I pick the Greenspan-Bernake icon for this post? Well, just to give you an idea of how big this conference is, on Wednesday, the key note speaker was former Fed Chairman, Alan Greenspan. I am sorry I missed hearing him. But it is probably a good thing. If I had gotten near a microphone, I might have given him a piece of my mind. Or worse. Plus, I would have complained endlessly about how a) boring and b) wrong he was, regardless of what he talked about.
----------
1. The answer is woo. And the folks at this blog are doing a good job to rout out the woo.
I had the opportunity to attend Monday and Tuesday. In order to maximize my time there, my schedule was a bit unique. I took the early bus (5:15 am) on Monday and stayed at the convention center (the huge McCormick Place in downtown Chicago) until 5. I Stayed with a friend in town instead of riding the bus two more times. On Tuesday I started at 8 at the center and left with the Epic Group on a bus at 6:15 pm.
Getting to McCormick Place
As I mentioned, Epic chartered Badger Coaches to take us. All other expenses were ours to bear, since we were going voluntarily as learners and not exhibiting. This was a good combo as I had all the priviledges of being an exhibitor without the requirement to stay at a booth all day. My girlfriend Heidi (what a trooper) dropped me off at Epic in time to catch the bus. I sat next to Zach, a trainer. He used to be on my team but decided Technical Services was not for him. I'm glad he decided to find a suitable role rather than leave; he's a good guy. We chatted about various software things for an hour until we both dozed off.
We crawled through Monday morning rush hour and reached the site at 8:30. I was only vaguely aware of the next half-hour. I had the initial shock of a large convention. It has been two years since I went to ACEN. And this is bigger - much bigger. HIMSS claimed that over 26,000 people attended this. I just followed a group of Epic people to get badges, then to the keynote.
Key Note
George Halverson is an important man. He is the head of Kaiser Permanente, Epic's largest customer. And he is very supportive of our mission. They gave this guy a very impressive, almost over-the-top, introduction. This fits the tradeshow aspect but it reminded me more of an intro for Steve Jobs at E3 or someone winning their TED prize.
After this intro, and the playing of "Oh, Yeah" by Yello (I'm sure I'm the only one who noticed) as Halverson took the stage, he talked about the state of healthcare and what we need to do. He said healthcare is the fastest growing sector in the U.S. economy. He talked at length about costs, saying that 80% of the money is being spent on 20% of the patients He mentioned some of the specific ways KP has worked to reduce the cost of patients with chronic conditions like diabetes and how treating these illnesses correctly in the first place can prevent costly hospital stays.
He observed that there are thousands of database codes for procedures and treatments but not one code for a cure. He said that he was appalled that the National Institute of Health set a goal that by 2020, 90% of patient care would be based on scientific evidence. He said, "Imagine if computer programming was based 90% on computer science?" Indeed. My question is, when it comes to healthcare, what are you using instead of evidence-based medicne? (footnote 1)
Halverson talked about the electronic healthcare - he didn't mention Epic directly. In fact, nobody is allowed to outside of the exhibition hall. But when prodded off-stage, they will. And Epic receives a lot of positive recommendations at HIMSS. But Halverson did emphasize the importance of electronice order entry, seamless access to the patient's medical history (through a trusted source - not a Personal Health Record. More on PHR's later.) He highlighted the utility of a patient accessing the system from their home (MyChart) and being able to communicate with physicians, make appointments, refill prescriptions, and access lab results. He also mentioned home monitoring solutions, specifically for diabetics.
It was a good talk overall, although the overall tone was that we need to address probelms today before we run out of time. This zeitgeist was present all over HIMSS - that if something isn't done soon, socialized, government-run healthcare is on the horizon.
Monday Sessions
After George Halverson's key note address, I attended an "education" session. I randomly picked one that sounded interestting - for me, it wasn't. I heald a project manager talk about implementing a "universal viewer" system to replace their legacy computerized systems. They pushed and pushed to get this "viewer" thing up and running, but in the end, they had to bring back their legacy systems because the "viewer" was not customiziable to the degree the end-users wanted.
The "viewer" itself sounded a lot like a clinical data repository - CDR - along with a snapshot report. This would be one small part of a fully-installed Epic system. I struggled to see why they spent so much time and money on such a small part of the system, especially when it failed in the end. I can imagine how Epic's staff would have responded in the same situation - to make sure they could "cut the cord" from their old systems and start doing everything in Epic. But not every vendor is like Epic.
I attended a later session, mostly because I was tired of standing and walking. I don't remember much from it.
Walking the Floor
I spent most of Monday walking the exhibition floor. HIMSS is so big that there were two halls, one larger than the other, connectied through the "Grand Central Concourse Hallway of Doom." I only got through the bigger hall on Monday, and checked out the other on Tuesday. I was curious to see who was there - Microsoft, Google, IBM, Motorola, AT&T, to name a few that most readers are familiar with. Many of our big competitors were there, and many small shops who are our "competitors" were also there.
I was walking past one of our "competitors" - I don't even know who, because I literally was walking past. The girl at the booth called out to get my attention. She seemed very friendly, asking who I was with. I said, "Epi-". She immediately gets all defensive and says, "I can't talk to YOU!" I shrugged and moved on. How rude of her! At least people at Microsoft and others were friendly and inviting. Or they had no idea why my badge said "EPIC Exhibitor".
I talked to a variety of vendors who don't compete with Epic. VMware, Citrix, APC. Several vendors who make all-in-one workstations; keyboards you can put in a dishwasher; tocuh-screens; computers for the battle field. Most of these people were very impressed to learn where I was from. They were excited to talk to me.
The DoD had a booth. It had a cool camo theme, and a group of officers were wandering around the conference in full desert camo, boots even. I talked to one for a bit - he is stationed in Europe. Since the DoD is partnering with healthcare organizations to develop their version of Epic, I decided NOT to ask for a demo. I got the impression from them, and from Microsoft, that they were marketing to the wrong crowd.
Epic and our major competitors show demos that highlight the nitty-gritty. Those cool funcitons that blow people away, provided they understand something about healthcare IT. Microsoft, the DoD, and others demod the electronic health record at a very high-level, the way USA Today would run a story on it. The way a wikipedia entry would discuss it. That's the audience they were going after? I had to laugh out loud watching some of these demos because they were talking about "a complete list of allergies and medical history in one place" like it was the best thing since sliced bread. Many of the smaller guys out there demo like this, but it surprised me to see a few big ones - who until recently haven't been in the healthcare IT business - do the same thing.
Tuesday Sessions
Before the two sessions I attended, I explored the other exhibition hall. It was more of what I saw Monday.
The first session on Tuesday was a "debate" between a guy named Kim Slocum and a lady whom I have forgotten. I think they were supposed to represent a "pro" and "con" concerning personal health records (PHR.) But they mostly agreed on the challenges of PHR adoption. Kim had a lot more to say. When the debate ended, he didn't. He just moved off the stage and kept talking.
On multiple questions, he started by saying "the question we should be asking is" and then went into one of his points. One good point Kim made on stage was about the fearmongering going on about personal health records. How these claims of unprotected health information are unsubstantiated. He also pointed out that PHR's are useless if physicians can't trust the data. The whole concept of a PHR is a gimicky toy that <1% of the population is going to use voluntarily.
Off the stage, Kim was able to open up more. He saw me and another Epic guy, ponted at us. He said, "But you people are doing it right." He explained that he has worked with Judy in the past and agrees with her on the best approach. That it is more important to get the doctors online first, and get trustable data into the system, and then provide patients a portal to it. He is extremely skepitcal of people adopting and using other vendors' PHR systems without their doctor being online first.
He also had chilling words to the effect of "this is our last chance to get it right" before outright socialization of healthcare in America.
I didn't know who the next speaker was but stayed in the room. As Fate would have it, the next speaker was Kevin Mitnick. The world-famous computer hacker in the flesh! Kevin also had an over-the-top movie-like introduction but I think he deserves it. What got me was that the geeks in the room, like me, were still in the minority. Imagine your doctor or nurse in the room - these people were scared to death by this talk!
Kevin went through a very solid presentation, complete with demos from his laptops, on various ways to get information and hack an organization. It was an overview of his book about social engineering. It had very little information specific to healthcare, but it was 100% relevant. He showed how easy it is to get someone's social security number; how to impersonate as a bank employee to another bank; how to spoof caller ID (totally legal by the way); how to dumpster-dive. He told the unbelievable story of obtaining source code from a company by impersonation over the phone, and finally teaching a secretary how to use winzip and ftp to send the data to a remote server! Amazing talk, and hopefully an eye-opener for many in attendance.
It was time to leave HIMSS. But one more thought - I didn't discuss the Epic booth. But one of the cool things was bringing the "Epic bubble" to the convention. Stepping out of the booth was stepping into an ocean of old white men in suits. Now, that's not being fair, because the population at HIMSS was pretty diverse. But I am spoiled by the level of diversity at my own company and I didn't know this until going to HIMSS.
Going Home
I was sore and exhausted. It was time to head home. I ended up sitting with Phil on the ride home. Phil is one of our sales reps (we have only a handful) but also a friend and, dare I say, collaborator? We worked on a customer install together in 2006 and we are always interested in each other's opinions. He let me play with a demo system for about an hour on the trip home, and I pointed out various things I liked about it. He is very excited about the next release of the system, as am I. I like Phil; he has a great "get it done" attitude.
Missed Opportunity
So, why did I pick the Greenspan-Bernake icon for this post? Well, just to give you an idea of how big this conference is, on Wednesday, the key note speaker was former Fed Chairman, Alan Greenspan. I am sorry I missed hearing him. But it is probably a good thing. If I had gotten near a microphone, I might have given him a piece of my mind. Or worse. Plus, I would have complained endlessly about how a) boring and b) wrong he was, regardless of what he talked about.
----------
1. The answer is woo. And the folks at this blog are doing a good job to rout out the woo.