I was in Las Vegas at HIMSS this last week, which, for the uninitiated, is a veritable orgy of health information technology (HIT). Someone from HIMSS leadership told me that over 42,000 people had shown up and they were expecting closer to 45,000. It’s a long way from 1998, I’ll tell you. Back then HIT was a dirty word, given up for dead. Today HIT is, to echo an old Steve Martin routine, the all being, master of time space and dimension. People are so hot for HIT that they actually think it will make people obsolete in medicine. While there are a few individuals I can think of who deserve that fate, I’m pretty sure the majority of us will remain somewhat necessary, even if only to plug in our machine overlords.
Unfortunately, however, the HIT landscape has become somewhat of a scene from Groundhog Day, as was so aptly put by someone who attended a small breakfast I attended. There were about 25 people at the breakfast and everyone went around the room with the charge to answer this question, “What new and exciting thing have you seen at HIMSS so far?”
You know that scene in the movie Groundhog Day where every single morning Bill Murray wakes up at the same exact time to the same exact song, “I’ve Got You Babe?” It seems that a lot of what can be seen at HIMSS is just like that. Although, if Murray had been filming at HIMSS the song would have been “These Boots Are Made for Walking” because you need some good walking boots to traverse the massive conference floor at HIMSS. The most overheard phrase, after “AI, AI, Blockchain,” is “Ow, my feet hurt, I need to get my flip flops.” If someone could just develop AI for blister management, they would never be hungry again. Entrepreneurs, heed my words: put a bucket of free flip flops in your booth and you will be mobbed.
But there were, actually, some new things at HIMSS this year as noted by the breakfast club. And I’m not talking about the keynote by Jared Kushner, telling the world about this Administration’s commitment to interoperability (TRUE! He was actually there since he had a day off from testifying I guess). Come on Jared, we know you have the Russians working on it and maybe that’s a plus – they seem to have this IT thing figured out.
Alex Azar, the new Secretary of HHS did actually did give a well-received speech during the same week as HIMSS (though not at HIMSS) that made it sound like he believes in the promotion of widespread patient access to their data, as well as to real financial transparency in healthcare; man, it would be great if movement is made on these fronts. One hopes he hangs on to his job long enough to get us there since access to data and financial transparency are not exactly the hallmark of his current Washington leadership.
One of my fellow breakfasters noted that one of the biggest changes between HIMSS now and HIMSS past is the appearance on the scene of big pharma. It may have taken them a long time to recognize that HIT could bring value to their industry, but having figured that out, they have arrived with hungry minds and open wallets. It’s amazing to see the efforts underway to integrate data workflow into and around pharma discovery and delivery and nearly everyone in from that part of the industry is all over it like pasty skin on programmers. More power to them. The medical device guys are barely getting started.
Another noted new thing at HIMSS is the presence of some very unusual partnerships as the world of HIT becomes mainstream. For one, we have Apple and Amazon and Google on the scene and with them a variety of partnerships that seemed unlikely at one time. Odd bedfellows among pharma and HIT, consumer and HIT, even among tech companies once considered rivals or in different areas of the value chain are coming together and figuring out how dogs and cats can not just get along, but create better, more cuddly offspring.
One other notable new thing, as observed at breakfast: telemedicine has come out of the dungeon and onto the main floor of HIMSS. The dungeon is, so to speak, the subterranean floor of the Las Vegas Convention Center where no light enters and conference denizens fear to tread; I’m pretty sure it’s because they worry that if they pop their head out, there will be 6 more weeks of winter. The dungeon is also where all the earliest startups doing the newest, least adopted things tend to hang out. And, so it is written, with reimbursement and actual customers and a public company doing really well in their midst (Teladoc), the telemedicine folks have arrived on the main level. It’s been a long time coming and the fresh air is clearly invigorating because suddenly every health system has a telemedicine strategy after most scorned it for years.
As for new technology, diners agreed that blockchain is the new black at HIMSS. With AI replacing the Big Data of a few years back, let it be written that the buzzword void has thus been filled. I heard two distinct conversations at the conference: 1) Blockchain is the best things since pocket protectors and will revolutionize healthcare by Tuesday! and 2) Blockchain is sort of interesting but it will be at least a zillion years before anyone in healthcare actually adopts it. If history has anything to teach us here, I suspect it’s closer to 2, than 1. Just ask the telemedicine guys since you can talk to them without going into the dungeon. And because we were in Vegas, I’m gonna put my money on, “Take a deep breath and be patient, because have you seen a sloth move through the trees? That’s what IT adoption in healthcare looks like.” Don’t believe me? Great, I’ll take the bet; just save us all some time and push those chips over here, will ya? I got things to buy.
One breakfaster commented, and all others agreed, that one of the biggest trends he had noticed at this HIMSS was how many people had changed jobs since last year’s conference. There does seem to be a musical chairs thing going on, with tech companies grabbing known healthcare talent and HIT startups sucking up people as fast as they can. I’m guessing that, having been down this road before to find a dead end (Google, Microsoft), the non-healthcare guys are finally recognizing they can’t make their industry play happen without some healthcare talent around the table, so they are hoovering it up left and right. I’m also seeing lots of turnover at younger HIT companies that have been at it a while and are still waiting for their sales ship to sail. It’s a long road to success (see paragraph above) and it’s tough for talented people to wait around at young companies to watch the end game arrive. Actual lyrics from I Got You Babe:
They say our love won’t pay the rent
Before it’s earned, our money’s all been spent
From the investor front, the newest thing they are seeing at HIMSS is the beginning of a return to valuation rationality. I got a pretty unanimous agreement from the investors I spoke with that there are seeing prices come down and some of the tulip-like HIT frenzy begin to fade. Maybe they visited the dungeon and remembered how long it took prior companies to get out, but math is math. If you overpay for a company that takes too long to gather momentum, you usually lose money. Great companies will always get funded but not every company is a great company. And so many HIT companies have been created in the last 5 or so years that the phrase, “Show me the money!” Is taking on new meaning for HIT investors, especially in Vegas.
I made a quick $300 at the Venetian craps tables one night at HIMSS and probably took less risk than I take in my actual day job; and the return was made in hours, not years. Much like Vegas, it’s easy to lose your money in HIT – it just takes longer and the stakes are higher. But when you actually hit the jackpot by funding a great company, you get the same rush and actually make a difference. That’s why people like me keep coming back to HIT. Note: biggest difference in playing craps during the Consumer Electronics Show vs. HIMSS is this: At the Consumer Electronics show last year (and this is true) I played craps with Hip Hop sensation 2 Chainz and Redfoo, the big haired guy from LMFAO (he’s sexy and he knows it). At this HIMSS I played with a bunch of HIT software sales guys; fyi they don’t wear nearly as many gold chains and not a leopard thong among them, at least not visibly so.
It will be interesting to see what next year brings. Given all the industry dynamics, will HIMSS be smaller or larger yet? Will the dungeon still be full of aspiring new blockchain companies? What will the new buzzword be and what will it replace? My HIT buzzword bingo board, originally created for a HIMSS 6 years ago (and updated in 2014), needs to be migrated to an etch-a-sketch to be able to keep up with the latest trends. It still won’t be interoperable with any EMR, but perhaps we can get Jared working on that.