HIMSS Wrap-up: Digital health news and views from the annual conference

By MobiHealthNews
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This week was the HIMSS Annual Conference, the biggest week in Health IT. We’ve been covering some of the major digital health news from the conference right along, but today we’re bringing it all together in one wrap-up of the event.
 
We started off the conference with our own event (in partnership with the Personal Connected Health Alliance), the Digital and Personal Connected Health event, where we heard from a number of providers working on digital health projects. Read all about that event below, and then read on for a roundup of more news from the show.
 
Digital and Personal Connected Health
 
Adrienne Boissy, Chief Innovation Officer at Cleveland Clinic, kicked off the event talking about her approach to patient engagement, giving several specific examples of how Cleveland Clinic is realizing those ideas.
 
“Patients should be defining their own engagement,” Boissy said. “If you are designing technology that doesn’t capitalize on patients’ own values and preferences, we’re going to miss the mark." More
 
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Walgreens Digital Division Vice President Greg Orr and Michael Taitel, senior director of health analytics at Walgreens, shared data about Walgreens’ Balance Rewards for Healthy Choices program, a set of web, app and text-based programs designed to improve medication adherence, activity and immunization, among other things.
 
“Every second we fill a prescription from a mobile device scan, we get 8- to 10,000 pharmacy chats through the smartphone and we have over 40 partners on the platform,” Orr said. “We’ve now had over 3 billion points awarded and over 1.25 million connected apps and devices and about $3 million in discounts given out to people purely from tracking their behavior.” More
 

 
Pamela Landis, VP of Information and Analytics Services at Carolinas HealthCare System shared data from four small studies of the MyCarolinas Tracker remote patient monitoring platform for diabetes, heart failure, cardiac rehab, and whipple surgery recovery. Most of the studies were on small groups of 8 to 11 patients, but the diabetes study looked at a group of 39. In that study, patients were enrolled and were given no devices -- they could either enter their blood sugar manually or bring their own connected glucometer. Just from three months of monitoring, 81 percent of the group reduced A1C and the average reduction was 17 percent.
 
The cardiac rehab trial -- which used a connected blood pressure cuff and scale -- found that most patients lost weight, their blood pressure and heart rate stayed in recommended ranges, and only one of the 10 patients was readmitted, and that was for a non-cardiac reason. The whipple surgery study, using Fitbit Flex devices, found that the more steps a patient got, the fewer complications they experienced. They also found that the Fitbit was motivating to patients. More
 
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On a panel discussing the business case for digital and connected health, speakers from various backgrounds and specialties shared how their organizations approach, implement and evaluate such technological infusions into their work. Bringing digital tools into health systems may be welcomed for the improved continuity of care and patient engagement, the panel opined, but adding value in a way that improves the financial bottom line is an unavoidable necessity as well.
 
“When we look at business models for digital health, there is the obvious idea of putting sensors on people and trying to do something valuable with that data, but the cost and the roadblock of trying to imagine all the massive amounts of data is a barrier,” said Medtronic General Manager Chris Landon. “So, if we can make an additional, up-front investment that allows us to scale the monitoring infrastructure of multiple streams of data coming in, we can re-leverage that investment by creating more services and value on top of each data stream.” More
 

 
Cedars-Sinai Director of Health Services Research Brennan Spiegel spoke about his experiences using virtual reality to help alleviate patients’ pain and allow them to virtually escape the confines of the hospital during their recovery. He also talked about when virtual reality doesn’t work.
 
“We’ve now done this with well over 300 of our patients and we have been learning a lot about when it works and when it doesn’t work,” Spiegel said. “How effective is this for managing conditions like pain, managing depression, managing anxiety, even managing hypertension?” More
 

 
Children’s Health, a system of pediatric hospitals in the Dallas, Texas area, turned to Proteus Digital Health’s ingestible sensor when other kinds of remote monitoring weren’t quite getting the job done for a population of post-organ transplant teenagers. Julie Hall-Barrow, the vice president of virtual health and innovation at Children’s Health, discussed the project.
 
“What happens when you’re 15 or 16?” Hall-Barrow said. “You want to start driving, making decisions, you’re independent, your mother is not on your hip 24-7. But the problem with this population is their mother had to be on their hip 24-7. It’s an extreme disease that requires a lot of regimen, and for a lot of kids the transition from Mom or Dad doing these things to doing it themselves is the transition from child to adult.” More
 

 
It may be more challenging to make healthcare consumer-focused and tech-enabled than other industries, but that doesn’t mean some of the same design and usability sensibilities that work so well in other services can’t be applied. In a panel discussion, innovation specialists shared what strategies they have used to make mobile apps, connected devices and other digital health tools work for their organizations, and what they’ve learned from missteps along the way.
 
“What patients are really telling us is, ‘Make it easier and get out of my way’," Carolinas’s Pamela Landis said. “We sometimes put up a lot of barriers in the process.” More
 
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Dr. Joseph Kvedar, Partners HealthCare VP of connected health, talked about how far advances like telemedicine and remote patient monitoring have come, how far they still have to go, and how the industry can clear the final hurdles between today’s early adopters and widespread, mainstream adoption.
 
“I have to look at it and say, maybe this thing is just happening, is it like a snowball rolling down a hill at this point?” Kvedar said “Is innovation required? Because if it is, leadership needs to step in, but if it isn’t, we should get out the way and let it happen.” More
 

 
Chanin Wendling, Geisinger Health System’s AVP of Informatics shared how the physician-led health system, which serves 45 counties throughout rural Pennsylvania and New Jersey and also has a health plan, decided to develop a system-wide plan to bring in customer relationship management software as the core technology to facilitate personalized service at each and every patient interaction.
 
“What we want to do is be able to look at you and know you and be able to tailor and deliver that care based on what we know,” said Wendling. “Some people like to use technology, some don't. Some prefer a lot of data and analytics from the doctor to take them through their options to their care, some just want doctors to tell them what to do. Some prefer handholding. Some respond better to the drill sergeant approach.” More
 

 
Todd Dunn, director of Innovation at Intermountain healthcare, closed the conference by discussing the key requirements of innovation including empathy, curiosity, and good observational skills. He shared a particular example of innovation at Intermountain: An app for measuring wounds that they worked with startup Tissue Analytics to implement.
 
“They understood the job to be done because a doctor at Johns Hopkins was trying to innovate around wound dressings to see whether or not they were making wounds better, but then he realized the measurements were so inconsistent and the data was so disconnected, they didn’t have the insights they needed to make inferences,” Dunn said. “So now we have an app on a phone that measures the wound, that colors the wound, that tracks it over time. You can do it at home, at the clinic, at the hospital, so you have a longitudinal record.”
 

 
Haipeng “Mark” Zhang, a clinical informaticist at Brigham and Women’s Hospital in Massachusetts, spoke about his experience creating an app to connect local physicians to burn specialists in the area. Although the feature of the app that the team focused on was the ability to page a specialist in Massachusetts, they found that they were getting downloads from all over the country and the information and resources section was seeing a much higher utilization. Now, they are reworking the app to be more focused on resources and to target it to a national audience.
 
“When we released the burn application, we weren’t expecting the resources to be popular for more than just the local attachment area around the Brigham,” Zhang said. “But they were and it’s really defined our next step, which is to push us out further to a more national stage. So it’s really important to be flexible.”

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Building a patient-centric, interoperable and digitally connected healthcare ecosystem takes a lot of collaboration, and the technology is often the easiest part. Dr. Lynda Chin, who leads the University of Texas System’s Institute for Health Transformation, shared how her organization developed a digital health platform working with a team that included hundreds of different people – local care providers and patients, private companies like AT&T and IBM Watson and research institutions. They built trusted frameworks to establish transparency between partiers and the community and began creating infrastructure for data sharing and analytics. They then launched a program to monitor, prevent and manage diabetes and obesity in Brownsville, Texas, which is a rural, low-income, largely Latino population.

"We started in a place where we had to design system that is applicable and affordable, because that creates commonality where you can take a platform and generalize it,” said Chin. “The idea was to integrate with existing systems and enhance access and value while having data flowing through an open digital ecosystem. It’s more than just a health IT project. It’s not hard to build it, but it is very hard to get it to work together.”