The overarching theme I drew from HIMSS13 is that we’re in the early stages of understanding how to utilize health data for the benefit of patients.   Keynoter Eric Topol drove this point home by dubbing the “show me the money” scene in Jerry Maguire with “show me the data”: http://e-patients.net/archives/2013/03/show-me-the-data-eric-topol-rocks-the-himss13-keynote.html. Take a look; it’s worth the 1.25 minutes.

Another keynoter, former President Bill Clinton, spoke of how he developed the talent for storytelling growing up in Arkansas without television in his early years. Frankly, I think Clinton would have been a gifted storyteller with or without access to television. I summarized Clinton speech in the following tweet:

@janicemccallum: Lack of #transparency and policies & systems that disempower ordinary people need to change were key themes of Clinton’s keynote at #HIMSS13

Obviously, a single tweet can’t replicate a well-crafted story delivered by a master, but let’s highlight his use of the word “disempower” to describe how patients are treated in the current US healthcare system.  “Disempower” forcefully describes how our current system leaves patients on their own to navigate a complex and obscure system that can have devastating consequences to ordinary people if they are not able to advocate for themselves.

Conversely, a key theme in the exhibit hall at HIMSS was “patient engagement”. Let’s compare the power of the two terms when trying to appeal to “ordinary people”. Patient engagement strikes me as a term dreamed up by marketing to indicate that hospitals and other providers want to figure out how to convince patients that the providers know best, whereas disempowered conveys the sentiments of so many people once they step inside the door of a hospital. Which term is more likely to rally ordinary people to demand changes in healthcare that allow them to participate in their own care? I’ll let you be the judge.

Another Clinton quote that was tweeted by HIMSS relates more directly to health data:

‏@HIMSS: Clinton: “Whole promise of #healthIT is to manage data to know what the heck we are doing. You can do it. No pressure.” #HIMSS13

This statement provides a good segue to other themes central to HIMSS. There’s been so much focus on adoption of software and basic standards for the software that the HIMSS crowd has not focused on the critical task of understanding the content that flows through the EHRs and related health IT systems. Meaningful Use Stages 1 and 2 set the foundation for basic population health metrics, but as clinicians and researchers get a taste for how useful secondary data from EHRs can be, I predict an explosion in interest in analytic tools that help harness and mine health data and an overall maturing of the high-growth highly-fragmented health analytics segment.

At present, we’ve just touched the surface of harnessing health data for the benefit of patients. However, I noted good progress in providing patients access to their health records, as required by Meaningful Use at HIMSS. Recently, a colleague of mine was thrilled just to receive a visit summary from her doctor. After all, this is the first time most of us have received anything in writing from our doctors, with the exception of patient handouts written by Pharma companies or a scrawled Rx to take to the pharmacy. Having access to a more complete history of visits and lab test results is orders of magnitude more powerful than verbal communication in helping patients learn from their health data. To those who say that patients don’t have the ability to understand the information in their health record, my retort at HIMSS was “people love reading about themselves” and are more likely to invest time in understanding data about themselves than they would a generic label insert or patient handout.  

Janice surrounded by HITsm Tweetchat participants Jon Mertz, Michael Planchart, Keith Boone, and Chad Johnson at HIMSS13

On a related note, I participated in a live Tweetchat at HIMSS where my topic was:

How can patient-generated data influence medical care, research and patient engagement?

I chose this topic to open up a discussion of what the future may hold as all stakeholders gain experience and learn how to interpret new sources of data. I was pleased that one of the MDs in the audience supported my view that patient registries and patient reported data represent rich new information sources for medical research that can supplement today’s “gold standard” of randomized controlled clinical trials. See: http://www.hl7standards.com/blog/2013/03/06/in-case-you-missed-it-video-of-the-live-hitsm-chat-courtesy-of-hibc-tv/ starting at 5:40 minutes for my segment of the discussion. [Note, I’m not @motorcycleguy on Twitter. In fact, neither is Keith Boone, who precedes me in this video. It should be @motorcycle_guy. Slight typo on my Twitter handle, too. I’m @janicemccallum.]

To sum up my HIMSS 2013 story, I agree with several other analysts & pundits (e.g., Andy Oram, John Moore, Michael Planchart) who expressed sentiments that there was no awe-inspiring technology or great leap forward exhibited at HIMSS this year. In my view, 2013 is a transition year where the focus shifts from technology to data. Remember, after all, the “IM” in HIMSS stands for Information Management. It has taken a long time to build the basic infrastructure for health IT—and we still have many interoperability and usability issues to work out—but we have a foundation on which we can start building business intelligence/analytic models.

So what does this mean for the health IT vendors? One easy prediction: there will be a slew of alliances and acquisitions between healthIT vendors and analytics firms in the coming year or two.  

To increase the likelihood that I’ll get a chance to see friends and colleagues while at HIMSS, I thought I’d share below some of the events I plan to attend. Most events require pre-registration.

Monday, March 4

SearchHealthIT Meetup, 5:00-7:00 pm.

Whiskey Blue Bar at the W Hotel New Orleans
333 Poydras Street

4^th Annual HIT Men and Women Reception, 6:30-8:30 pm.

 J.W. Marriott

 614 Canal Street

 www.hitmen2013.com

Tuesday, March 5

#HITsm Live Tweetchat, 11:00 am - noon.

Social Media Center

I’ll be leading one of the topics in this hybrid live/online health IT-focused tweetchat.

S4PM Brown Bag Lunch, noon – 1 pm

Room 274.

Patient Engagement Meetup & Book Signing, 3:30-4:30 pm.

Social Media Center

New Media Meetup, 6:00 – 8:00 pm

Mulate’s

Julia St.

Wednesday, March 6

Patient Engagement: Transforming the Healthcare Experience, #ePatient Tweetup, 11:00 am – noon.

Perficient booth #1555, Lobby G.

Followed by #TheWalkingGallery meetup.

I’ve left out the Interoperability Showcase events on Monday, which will feature @ePatient Dave, from 4-5:00 pm followed by a tour led by @Motorcycle_Guy Keith Boone. I have meetings that may keep me from these sessions, but will try to make it. Keith and Dave are near neighbors, so I can meet with them locally. They are both knowledgeable and passionate advocates for health IT and the power of data to drive informed decisions. I recommend taking advantage of the sessions and tour if you can.

Contact me via email, Twitter @janicemccallum, or cell phone if you want to try to catch up with me at one of these events at HIMSS or try to squeeze in another time.

My presentation on Big Data was added to Slideshare on Saturday and started trending on LinkedIn and Twitter almost immediately. Clearly, Big Data is a hot topic!  Furthermore, gaining a solid understanding of what Big Data means and what it means to your business is important to publishers of all sorts. This presentation was customized for scholarly publishers, including the top medical publishers, and provides some recommendations for  participating in the high-growth and quickly changing Big Data field.

Many thanks to Audrey Melkin from Atypon for inviting me to speak and for moderating the panel. I look forward to your feedback on the presentation and on continuing the conversation about developments in the field of Big Data and healthcare analytics.

My parting thought for 2012 relates to mobile health (a.k.a. mhealth). There’s general agreement among analysts that mobile devices and mobile communication vastly improve the ability to reach more patients at a reduced cost. There’s also strong evidence that people who use mobile devices to track their activities and vital signs become better at managing their health. Unfortunately, some regulatory hurdles and standards issues stand in the way of optimal sharing of data between stakeholders.  In addition, there’s not much agreement on what business model will prevail in the field of mhealth. My advice for divining the future of mhealth: think of the medical devices, mobile devices, and the data that are produced and monitored by the devices as an integrated unit because it’s the value of the data that will determine the best potential revenue models in the long run. 

We’re entering a phase where medical devices have become digital sensors that collect, transmit and analyze data. At the same time, the technology has advanced to the point where devices can be miniaturized to allow “wearable tech”, that is, devices that can be clipped to one’s clothing, strapped on one’s body, even imbedded into one’s body. Also, mobile phones are adding physical attachments and apps that extend the functionality of smart phones to include tasks that previously   required single-purpose specialized medical devices—including stethoscopes and ECG machines, like the AliveCor ECG pictured at left. Many of the more advanced apps are targeted to physicians. However, it is consumer interest in wearable tech devices for tracking fitness and vital signs that will drive down costs and increase overall demand for advanced health and fitness applications.

Medical device manufacturers that currently sell implantable devices to providers have some thorny issues to work out related to access and control of the data that are generated by the devices. Hugo Campos, who has an implantable cardioverter defibrillator (ICD), has brought these issues to light through his advocacy efforts based on his desire to learn from the data tracked by his ICD.

The future of mhealth devices and data monitoring will be brighter if the consumers who wear the devices have full access to the data generated by the devices and have control over who else is allowed to access their data. I advise the medical device industry to watch carefully what is happening in the consumer fitness and wellness device segment. Companies like Nike with its Fuelband and Motorola with its MOTOACTV device (both pictured at left), which can be worn on one’s wrist and BodyMedia’s Fit Link armband device are measuring much more than early devices that weren’t much more than upgraded pedometers. The mobile technology will likely follow a standard path of further miniaturization and increasing processing power with costs declining over time. It’s rather ironic that portions of our population that have eschewed traditional wristwatches in favor of mobile phones may soon be sporting devices that include orders of magnitude more functionality than early cellular phones on their wrists as fashion items that have the side benefit of helping them stay healthy—and can tell the time. The wristwatch may soon enjoy a renaissance!

References and further reading for this article:

http://www.npr.org/blogs/health/2012/05/28/153706099/patients-crusade-for-access-to-their-medical-device-data

http://www.domusweb.it/en/design/fitness-by-design/

http://thewirecutter.com/reviews/fitbit-ultra-is-the-best-activity-tracker/

http://www.venturevalkyrie.com/2012/12/10/in-car-health-monitoring-lemon-or-lifesaver/4849

http://www.ihealthbeat.org/special-reports/2012/several-forces-driving-explosion-in-mobile-health-care-industry-experts-say.aspx

In many transactions, the price of a good or service is the key variable on which to make a match. In others, price may not be a major factor at all. In fact, the two economists who just won the Nobel Prize in Economics specialize in making markets in areas such as organ donations or matching medical residents with hospitals, where price is not the central variable to match.

Making Markets was the topic of one of the sessions I moderated last week at the Data Content 2012 conference. Data Content has been at the forefront of data publishing advancements over its celebrated 20 year history. In the Making Markets session we focused on the most common and well-understood type of B2B transaction: connecting buyers and sellers.

The three companies represented on the Making Markets panel help connect buyers and sellers in specialty markets: CapLinked in the investment sector, by bringing together potential funders and companies seeking funding; The Gordian Group in the construction sector by matching contractors to job order contracts; and Fabricating.com in the custom manufacturing segment by matching industrial companies with manufacturers of specialty parts.  The speakers emphasized how operating in the “neighborhood” of the transaction creates an opportunity to collect transaction-related data which in turn add more value to the match-making process—creating a virtuous circle.

Other sessions at Data Content touched on how data collection and data management are only a differentiating factor when hard work is put in to cull together hard-to-aggregate data or clean messy data. If it’s too easy to compile the data, you won’t have a defensible resource. But that’s perhaps the most distinguishing benefit of becoming a market-maker: the transactional data that is generated by the match-making process become a unique data asset that cannot be replicated.  These secondary data can be organized and used for industry benchmarks and can be fed back into the matching algorithms to build a continuous improvement loop.

As pointed out by my colleague Russell Perkins in his closing presentation at Data Content, in the era of Big Data, data produced by specialty publishers may just be the special ingredient that helps “solve the ‘ last mile’ problem to make Big Data actionable”. In particular, the trusted and verified contact information supplied by publishers can help make the final connection between buyers and sellers.  In the Making Markets session, we saw ample evidence that structured data supplied by B2B data publishers can be put to use to drive efficient transactions throughout the match-making process.

•         Digital evolution in publishing
•         Search engines, findability and online advertising
•         New sources of machine-generated, user-generated and social media content
•         Semantic analysis and contextual matching
•         Data analytics and modeling to drive decisionmaking

In the coming months, posts will focus on health data trends and opportunities for data publishers and health IT firms to provide new services that plug gaps in the market for health data. Topics of particular interest include:

•     Sources and uses of outcomes data
•     Information asymmetry between patients, clinicians & payers
•     Convergence of business intelligence and clinical analysis in healthcare

These meta-topics will be viewed through a lens of how health data can be applied to add efficiency to healthcare businesses and to improve the overall healthcare experience for patients. Comments are always welcomed on this site, or you can contact me directly here.

Along with ongoing blog posts and other social media commentary, I’ll be speaking or moderating sessions at the following real-world events where these topics will be discussed with experts from healthcare, information technology, information management, big data analytics and publishing:

 
 HealthCamp Boston, Friday, September 14, 2012, Cambridge, MA.    

I am on the organizing committee of this “unconference”, which is attracting a global audience this year in large part because it immediately precedes the Medicine 2.0 conference.

HealthCampBoston is a forum for people with interest in all areas of health and wellness to gather, to generate ideas, and to take practical steps towards building the future of healthcare. HealthCamps are different from traditional conferences where speakers talk at you. At HealthCamp Boston, attendees set the agenda, and all contribute to the event according to their interests.

The Boston area is a center of innovation for all aspects of healthcare, so you can be certain that people at HealthCampBoston will be discussing things like:

- Big Data in healthcare
- Improving engagement and outcomes through mobile devices and social media
- Personalized medicine and translational medicine
- Empowered patients
- Practical impacts of healthcare reform
- and more…

See the registration page for a list of the people who have already registered. You’ll be in good company at this event (and the cost won’t break your wallet). Note, we’re still seeking companies that would like to sponsor HealthCamp Boston and earn a place on a 4x4 panel. 

Data Content 2012: InfoCommerce Group and SIIA’s Annual Conference, October 9-11, 2012,

                              Philadelphia, PA.

Data Content2012 is targeted to data publishers in all industries, not just healthcare. However, most of the best practices and use cases described at Data Content can be applied to healthcare sector and you will certainly meet dozens of other healthcare industry publishers and investors at this event.

Data. Community. Markets.

As DataContent marks its 20th year, we’ll explore the intersection of Data, Communities and Markets. The sessions offered throughout the conference go beyond the data hype, and give you a straight talk on why the data business is the hottest segment of the information industry, and how it will continue to grow. During the conference we’ll identify the trends that are the most profitable and how to incorporate them into your business plan. DataContent will give you a clear understanding of where data fits in your future to help your business grow and to identify new opportunities.

DataContent 2012 also offers a wide array of networking opportunities to help you connect with the right people to get deals done. Enjoy the ever popular speed networking to meet all of your contacts quickly, and follow up throughout the conference during our ample networking breaks, lunches, and at the Excellence in Action dinner and reception. Enjoy the river views offered at our new venue, while meeting with partners, customers and prospects.

Check the events page on the Health Content Advisors website for updates to upcoming live events and recaps of past events. I hope to see you soon in Boston or Philadelphia!

The most rewarding aspect of the day’s program, however, was its emphasis on how the data can be used to add value to business decisions. Consequently, the focus wasn’t on acquiring massive quantities of data (although zettabytes and yottabytes were mentioned!)—or even on the value of organizing big data sets. Instead, the program provided many examples of how analysis of structured and unstructured data in tandem can lead to new insights that can improve business processes and marketing decisions.

Years ago, at InfoCommerce Group we coined the phrase “data that can do stuff” to describe the advantages of well-designed data products. In essence, a data product that is designed to meet a defined need of a target audience becomes a decision tool when analytics are applied. With the era of big data upon us, even textual data and real-time streams of behavioral data can be leveraged via semantic and pattern matching technologies to obtain data that can do stuff. Furthermore, the different types of data can be overlaid to achieve higher levels of insight into customer behavior or patient outcomes, for example.

The takeaway point: data analysis tools and techniques that used to be available only to big life-science companies and search engines are now entering a phase where the costs make the technologies more widely accessible. However, as someone mentioned at the Big Analytics event, Gartner Group places big data at the peak of inflated expectations on its hype cycle curve. I agree with Gartner because of the level of noise surrounding big data. Nonetheless, with proper alignment between the data, business goals, and execution, opportunities to benefit from big data—or should I say big analytics—exist today.

Posting a book review on this blog is a first for me. I am making an exception because this compact volume, Between the Lines: Finding the Truth in Medical Literature, by Marya Zilberberg, MD, MPH, provides an expert’s explanation of many critical issues related to health literacy, evidence-based medicine, and changing models of medical research—all issues that are covered in this blog.

At the highest level, Between the Lines tackles the complex issue of uncertainty in medicine. Dr. Zilberberg presents a framework for assessing the strength of medical evidence in a way that anyone with some basic knowledge of statistics can follow. She uses clear examples that explain, for instance, why a medical test with a 5% rate of false positives could yield a 98% chance of a false positive if the known prevalence of the disease is very low. If these numbers sound irrational, then it’s time you either study Bayesian statistics or read Between the Lines.

In fact, Bayesian statistics are what united Dr. Zilberberg and me. We met via Twitter and our first engaged conversation occurred when she commented on David H. Freedman’s article in The Atlantic: Lies, Damned Lies, and Medical Science. David’s article provoked quite a lot of discussion about the state of evidence-based medicine (EBM), at least based on the type of research we currently consider our ‘gold standard’. His article profiled Dr. John Iaonnidis, who is now chief of the Stanford Prevention Research Center at Stanford Medical School. [1]

When Dr. Zilberberg started explaining the effects of heterogeneity in her blog, I knew I had found someone who had the ability to address important statistical topics in a way that could be understood by a broad universe of readers.

In addition, the book is an excellent resource for non-medical professionals who do have some training in statistics. For me—someone who has experience in econometric modeling and has long been an advocate of Bayesian statistics— but has no formal training in epidemiology, I found the book to be a terrific resource for translating mathematical statistics terminology into medical statistics terminology. All I need now is a self-study guide and comprehension test and I think I’ll feel confident in my understanding of concepts in epidemiology. This shouldn’t be a surprise given that Dr. Zilberberg teaches epidemiology.

I highly recommend this concise volume to anyone involved in peer-review or any aspect of medical communications. I’d even go as far as to say it should be required reading for these groups. And for clinicians and those who determine evidence-based guidelines? Well, I know I’d feel a lot more confident in our healthcare system if I thought that most clinicians could answer the 12 questions that Dr. Zilberberg recommends patients ask before accepting to undergo a medical test or procedure (see Chapter 12).

Finally, I’m confident that Between the Lines will be an important addition to core readings for two groups I highly admire: 1) medical librarians and 2) the Society for Participatory Medicine (http://participatorymedicine.org/).

To obtain a copy of the book, which was published May, 2012, visit the Between the Lines website.

[1] See: http://alumni.stanford.edu/get/page/magazine/article/?article_id=53345 for a recent article about Dr. Iaonnidis’s work.

Scratch Marketing has posted the video of the talk, which was structured as an interactive group discussion, in 8 parts. See their YouTube page for the list of segments: http://bit.ly/H9Wjk9.

See the event recap by Lizzie McQuillan at Scratch Marketing here:

http://scratchmm.com/2012/03/event-recap-let%E2%80%99s-talk-hit-with-janice-mccallum/

Also, for a provocative view, read Marya Zilberberg, MD, MPH’s takeaway from the evening’s discussion:

http://evimedgroup.blogspot.com/2012/03/how-our-healthcare-spending-is-like.html

Thanks again to Scratch and the many Boston-area (stretching all the way out to the Berkshires!) health IT, public health, healthcare publishing, entrepreneurs, and marketing experts who attended and participated in the discussion. Scratch Marketing added Twitter handles to the video, which helps tremendously in identifying each speaker.

At the same time, new levels of collaboration are being introduced between providers, payers, researchers, and patients within tightly or loosely-defined networks that participate in the care of a patient. All of this collaboration requires multi-directional exchange of data. In a guest commentary post on Health Data Management Magazine, I emphasize the importance of employing appropriate security solutions to help build and maintain trust in the integrity of data partners.

To accompany the post, below are links to recent news on the companies I mention in the article:

Amcom Software Enhances Physician Communication With Release of Amcom Care Connect

http://www.amcomsoftware.com/News/02-28-12.aspx

Imprivata Launches Secure Texting App

http://www.imprivata.com/company/press/imprivata-launches-secure-texting-app

PerfectServe Secures $10.9 Million in New Financing

http://perfectserve.com/aboutus/releases/release020212.html

Samsung Selects Voalté Clinical Communications Solution of Choice

http://voalte.com/NewsPressDetail.aspx?Id=56&title=Samsung-Selects-Voalt233-Clinical-Communications-Solution-of-Choice

TigerText Secures More than $8 Million in New Funding

http://www.tigertext.com/tigertext-secures-more-than-8-million-in-new-funding-adds-veteran-life-sciences-and-technology-investors-to-its-board/

Vocera Introduces Vocera Connect for Leading SmartPhones and Cisco Wireless IP Phones

http://www.vocera.com/index.php/company/pressreleases/120215

See also this video interview with Perficient from HIMSS: http://www.healthcontentadvisors.com/blog/2012/2/28/video-interview-from-himss12.html