Harry Nelson

HIMSS16 Reflections: Buying, not being sold, healthcare IT solutions

Healthcare Reform

Last Thursday morning, I gave a walking tour of the various expo halls at the HIMSS 2016 conference in Las Vegas to a junior colleague, Adam. My first goal was to introduce him to the broad healthcare IT challenges the industry is grappling with, from interoperability and data security to leveraging data analytics. My second was to give him an appreciation for the overwhelming array of IT choices that our healthcare provider clients have to navigate.

You have to ask Adam for an honest review of how I did as a tour guide. What I wanted to share here were some reflections that came out of our tour on the latter topic — provider choices on health IT. There are a vast range of IT options for providers of all types, from larger and smaller post-acute hospitals and behavioral healthcare organizations, to middle market and small providers.

The first thing that jumps out when you visit HIMSS is the overwhelming array of choices in every category. HIMSS16 featured over 1,300 vendors spread across three stories of conference space and 13 halls — showcasing different themes like interoperability, connected health, cybersecurity, population health, revenue cycle, clinical and business intelligence, intelligent health, and disaster preparedness. The various expo halls displayed numerous environments showing real use cases in different care settings and progress towards adoption of standards to improve patient care. There were 45,000 people there — over 2,700 were employees from Epic, the 800-pound gorilla of electronic health records (EHR).

The sheer number of choices — no matter what category of healthcare IT you are talking about — was huge. Interested in healthcare data analytics? I counted more than 220 different exhibitors offering analytics products. Adam asked me to help him understand the distinctions between the products, and we stopped to quiz more than a few analytics product sales people. Some products embedded data analytics for particular kinds of care management, while others offered a platform for health systems to leverage their own data.

Clinical decision support was another category with a staggering number, roughly 700 products across subcategories like outcomes and quality management, preventive, testing, surgical, and medication decision support. Consultants? A frighteningly long list, from ICD-10 to integration/interoperability consultants.

So while it is exciting to imagine next generation healthcare IT networks and to ask big questions about how hospitals can leverage big data analytics to improve care outcomes, there is a more fundamental question for HIMSS newbies. How do healthcare provider navigate the mob scenes of sellers in deciding what to buy?

When the number of choices in every single category are in the hundreds, differentiating between them becomes a gargantuan task. It’s easy for a provider to decide that their shopping list includes EHR, a data security solution, and a tool to use data analytics for better care management. But how can they possibly choose the optimal solution through all of the noise?

There is no escaping how confusing and risky each choice is. It’s no wonder so many healthcare organizations get stuck in analysis paralysis, simply to avoid a mistake. Meanwhile, other providers make choices that they come to regret, overspending and then being in the miserable position of being stuck with a suboptimal solution and having to decide whether to make the best of it or scrap the mistake and start over, armed with the lessons of failure.

As we walked the halls, I was also struck by the many talented sales reps who engaged us and offered the spiel for their solutions. They used the right motivational buzzwords. We heard about the power of cloud connectivity, about transitioning to an environment that empowers patients, and preparing for the volume to value shift. We heard about analyzing health data to improve outcomes, reduce costs, and advance clinical guidelines. All in all, I heard some great pitches trying to differentiate products that at first glance seemed awfully similar.

In the process, I was reminded of the old adage, “If all you have is a hammer, everything looks like a nail.” The healthcare IT marketplace is so broad that, no matter what problem you are trying to address, from ambulatory labs or pharmacy to home health information systems, you have a multitude of choices. Every company selling a product or service sees itself as the right solution for you. The talented sales reps who populate HIMSS exemplify this as they pitch their products with complete conviction that their tool is the one you need.

If a healthcare provider goes shopping without having first formulated a clearly defined strategy and list of priorities, the provider is a sitting duck waiting to be sold on the various solutions.   This is a recipe for being reactive and for being sold on a solution that is suboptimal, not to mention overspending, and making mistakes that will need to be fixed down the road. Or becoming paralyzed and not making any choice at all. As I tweeted at HIMSS, “In a time of transformation, healthcare orgs without a real strategy for navigating health IT options are road kill.”

The problem is not the mere number of solutions and deciphering each of their benefits and drawbacks, but the difficulty of  choosing between wholly different tactical approaches to the same underlying challenges.  For example, the problem of preventing or reducing hospital readmissions is a top-of-mind challenge for both hospitals and post-acute providers.  HIMSS16 featured solutions that addressed the problem by improving connectivity and remote communications between patients and providers, and other solutions that addressed the problem through  data analytics by flagging at-risk patients for an intervention in advance of the hospitalization trigger.  Both are valuable ideas that take on the same challenge in different ways.  Which one makes more sense?  Which one is a better value? The answers to these questions will be different for different providers, and in some cases, the answer will be neither — in favor of yet a different solution, be it technological, training, or process-focused.

So what should providers do? First, start with a clear healthcare IT strategy. Healthcare IT choices need to flow from a strategic plan and not be reactive. You need to inventory where you are as an organization and then make some hard choices to prioritize how your organization needs to adapt in order to thrive and compete. It takes work to get buy-in. But once you’ve done this work, you are armed to be a smart buyer and not get sold.  It is important to be talking to others about their direct experiences and to find the right advisors with experience to navigate the choices.

To use data security as an example, it means beginning with an organizational self-assessment and developing a long-term plan. Being an effective buyer means not getting distracted by the latest and greatest, by the bells and whistles in the Cybersecurity Command Center at places like HIMSS. The shopping experience is very different if you start off from a perspective of meeting your needs rather than test-driving what’s being sold.

My suspicion is that, if providers do some careful planning, some of the fancy offerings of next generation healthcare IT may be more like “dessert” at a time when the organizational priorities are “meat and potatoes.” Most healthcare providers have some fundamental work to do before they are ready for, say, population health analytics and many other whistles and bells. By investing time and energy into strategic planning in advance of healthcare IT decisions, providers can be effective buyers and avoid being sold.


Stay tuned this week and next for forthcoming posts reflecting on HIMSS16, including thoughts for healthcare IT solutions providers and the challenges ahead in 2016.

One comment to “HIMSS16 Reflections: Buying, not being sold, healthcare IT solutions

  1. Jon Warner

    Great article-given all of this overwhelming choice any provider that does not have a strategy is destined to either miss the revolution or “drift” their way to a solution that may be a very poor fit it seems.

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