The KHIT Blog: #health2con 10th annual conference recap and photo gallery

Monday, October 3, 2016

#health2con 10th annual conference recap and photo gallery

The slide in the photo above neatly poses the summary questions: "The New Delivery System? What's The Future of Tech-Enables Services?"

Recall my slide shot from Day One.

Those comprise the core questions and challenge, no?

BTW, mark your calendars. Next up, January 11th, 2017.

I will certainly be there again.

OK, I had to put all this stuff down Friday to resume my ongoing weekly role as the world's most overeducated Senior Dog Rescue Shelter volunteer laundromat attendant at Muttville.org, now that Jaco is back home safe after having gone missing for 12 excruciating days.

One bonus: I finally finished this book while on BART:

Excellent discussions of neuroscience (and "philosophy of science" more broadly), evolution, and cultural/social anthropology, from the perspective of a "neurophilosophy" educator and researcher. Fits nicely with other recent reads of mine. See, e.g., "Evolution, science, technology (including Health IT), and the future of cognition."
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Santa Clara conference media coverage note. Every day I'd search Google News for "Health 2.0" reportage, and was dismayed to see only a handful of daily "news" items about the conference -- most of them lazily and uncritically regurgitated brief press releases.

On September 30th, however, we finally got some meat. Props to MobiHealthNews.

In-Depth: News recap of Health 2.0's Fall Conference

This week in Santa Clara marked the 10th anniversary for Health 2.0, a health tech conference held every year in Silicon Valley to explore the progress being made in the digital health space and the challenges that remain. MobiHealthNews was onsite all four days of the conference and below we’ve rounded up our coverage of the event, plus quite a few presentations and bits of news that didn’t make the newsletter earlier this week.

Snake oil revisited

Though the buzz has finally started to fade from the news cycle, Health 2.0 cofounder Matthew Holt couldn’t resist bringing American Medical Association CEO James Madara on stage to take him to task for his now famous “snake oil” comments from the Spring.

“Last year, you sat here in this chair and you were super nice to us,” Holt joked. “Then, I’m on my vacation in Vietnam and my Twitter feed starts blowing up with this snake oil stuff. Do you love us or do you hate us?”

Madara responded that “there is love and there is hate”, citing the AMA’s work with Omada Health as an example of a digital health intervention he loved and the troublingly inaccurate blood pressure app Instant Blood Pressure as one he hated.

“Why raise a siren now with this intentionally used term ‘snake oil’? The reason now is I think we’re in a period of criticality for [digital health]. The criticality is that there’s no regulatory framework. I think digital health is going to be part of the transformation of healthcare. But if this is so important for healthcare, does anyone think that it’s going to continue to be unregulated?”

Madara thinks the industry needs self-regulation of apps and connected devices that’s robust enough that HHS will grant legitimacy to those efforts. He thinks relying too heavily on the FDA could result in regulations that are “heavy-handed, they overreach, and they’re one-size-fits-all”...

Yeah. Recall my May post "Is the Fitbit "For Entertainment Purposes Only"?

apropos, also from MobiHealthNews:

Digital health VCs talk strategy, trends, and a plea for an end to metaphors

...Sven Lingiaerde, a managing partner at Swiss firm Endeavour Vision, said he wanted to see fewer fitness and beauty apps navigating into the so-called ‘gray line’ into healthcare.

“No more free yoga apps,” he said. “Wellness in general, I’m not convinced you can be that profitable. Direct to consumer products have to have a lot of money in the beginning and you have to be very close to the people who you are offering your product to. We want to see more business to business.”

What investors also want, they said, is more focus on behavioral health analytics, more hospital-focused innovation, and investment strategies wherein funders are carefully aligned to offset the inevitable future friction as the company matures and, possibly, ends up with a different mission from which it set out with....

See also my prior post "Digital Obesity."

JONATHAN BUSH

OMG. The Robin Williams of Health IT.

Again, citing MobiHealthNews:

Health 2.0 move over, Health 3.0 is here
A few days before the conference, healthcare investor Dave Chase and athenahealth CEO Jonathan Bush teamed up to pen an editorial arguing that Health 1.0 — healthcare before computers was inefficient, but healthcare today (Health 2.0) has lost the human touch and made doctors spend too much time in service of EMRs and documentations. The next era in healthcare, they argue, will combine the best aspects of the two, and make technology serve patient care, rather than the other way around.

Bush took the stage on Wednesday and expounded on some more of the specifics of that idea, saying that it would take large EHR vendors committing to a real connectivity to allow the real value of digital health technologies to scale.

“You’ve got all these ideas, you do the demos, they make sense,” he said. “But they don’t explode, they don’t lift off. I think people will get out of enterprise software or the enterprise software companies will remake themselves. You’re already seeing the Mad Hatter talking about pulling the various instances of Epic together, making it more of a network. As that happens, that concept of an internet makes the ability to really blow out, to make money quickly a possibility in healthcare.”...

I hope someone posts video of this hilarious encounter between Jonathan and Matthew. Worth the price of admission. See Jonathan Bush and Matthew Holt at HIMSS15, YouTube.

Note: After citing the late Robin Williams analogy above, I had second thoughts in the wake of reading "The terrorist inside my husband's brain," just written by his widow. Achingly sad. The repeated misdiagnoses, man... I never knew Robin, but I do have a tangential connection. What a terrible loss.

OMICS, INTEROP, UX, WKFL, AI, CLINICAL PEDAGOGY, POLICY & LAW

Those remain core topics of interest to me. First, will genome-based "personalized medicine" live up to its hype any time soon? One of my abiding concerns, irascible old-school lab QA guy that I am:

See my prior posts on the topic. Again, what of genetic assay QA and clinical dx competency?

Also, given the huge volumes of "GATTACA gibberish" data, Personalized Medicine will require both "AI" and "IA."

This session didn't provide much comfort. Precious little on the actual applied analytical science.

Interop?

Yeah. "Standards."

How about "Standard Data"? Will the maturation of APIs essentially congeal into interoperable and n-dimensionally cross-platorm, iteratively/recursively durable, (and transactionally frictionless) "standard data" exchange? The "Type-O blood" of health care? That whole "information is the lifeblood of medicine" thing?

Redox claims that their product turns an entire EHR into an "API."

"We empower healthcare applications to read, write, and query clinical data with any healthcare organization's
electronic health record system. The bridge to interoperability is open."

Allscripts touts its Open API Developer Program.

MU3 snips:

Patient Electronic Access to Health Information
Measure 1 – More than 80% of all unique patients seen by the EP (i) The patient (or patient-authorized representative) is provided access to view online, download, and transmit their health information within 24 hours of its availability to the provider; OR (ii) The patient (or patient-authorized representative) is provided access to an ONC-certified API that can be used by third-party applications or devices to provide patients (or patient-authorized representatives) access to their health information, within 24 hours of its availability to the provider...

Coordination of Care through Patient Engagement
Measure 1 – For more than 25% of all unique patients seen by the EP actively engage with the electronic health record made accessible by the provider. An EP may meet the measure by either: (i) patient view, downloads, or transmits to a 3rd party their health information; or, (ii) patient access their health information through the use of an ONC-certified API that can be used by third-party applications...

We shall see. Recall my post of two years ago "Interoperability solution? HL7® FHIR® -- We ® Family."

I had a nice chat with the crazy smart Erik Kins of Allscripts. He just posted here:

Electronic health records (EHRs) are the backbone of health IT infrastructure, but they can’t be all things to all people. For truly connected communities of health, EHRs must talk with other applications and solutions.

Integrating separate technologies has not always been easy. Traditionally, these projects require committee meetings and complicated interfaces that can take months, or even years, to complete.

Allscripts has redefined the paradigm for health IT interfaces. With an open platform, clients can customize their EHRs in a matter of weeks, days – and lately, even minutes...

BTW: I'd reached out to MI7 (Redox competitor?) prior to the Conference. They did not attend.

I will certainly probe them further.

WKFL?

I guess if you want serious meat on "workflow" (care delivery processes) you need to attend the annual Lean Healthcare Transformation Summits. (See here as well.) While the word "workflow" got loosely bandied about a good bit at the Health 2.0 conference, process QI is really not the focus.

GOVT/POLICY PEEPS

ONC National Coordinator Dr. Vindell Washington

Veterans Administration CIO and Assistant Secretary Laverne Council

Requisite lofty keynote and interview rhetoric aside, we're in a bit of an actionable policy leadership lull these days as we lurch toward 2016 election day. Should Hillary Clinton win -- and -- Senate control shift to the Democrats, we stand a good chance of seeing revitalized federal activism on the health care fronts.

Then, alternatively of course, there's Donald Trump.

A RANDOM PHOTO GALLERY

"Blockchain"

The "E-Patients"

The always fabulous Alexandra Drane

Dr. Mike Painter and Esther Dyson

Keynoter Ian Morrison

That's enough for now. I have more.

I am gonna have to figure out an efficient way to capture photo caption info for every shot I take. Stuff goes by too fast, and I can't stop and jot down names etc every time I click the shutter. Then, in the blur of activity, I frequently forget who was exactly whom amid those people I don't already know.

I do the photography mainly to give you a visual sense of what it's like to be there (and, because historically it's how I roll, going back to my days as the go-to "20 Feet From Stardom" photographer in Vegas). All of the other Health InfoTech reportage is pretty much standard journalism "text-only" -- e.g., the excellent MobiHealthNews article cited above. I first covered these kinds of Health Care / Health IT events in Feb 2012 when HIMSS, to my utter surprise, gave me a press pass. Even though I retired from my Meaningful Use REC in May, 2013, I continue to do this simply because it's important -- and personally interesting. I've never tried to "monetize" the effort. I launched this blog simply as an online episodic (and sometimes irascible and snarky) work "diary" in 2010 shortly after hiring on for the REC initiative.

I started this post on Saturday (it's now Monday morning), but came down ill with some enervating bug. Stayed in bed pretty much all day yesterday.

I still have to go back through my notes spread across my little old eClinicalWorks notebook and scribbled through the conference program and session handouts. So, there will be more upon which to reflect.

BTW: Another (relatively brief) piece of reportage has appeared, via MediCityNews:

From smart socks for diabetes to hand rehab: Health 2.0’s most interesting startups
October 1st

One tradition of Health 2.0 is that it offers a launchpad for digital health companies that are rising above the radar into public view. Referred to as LAUNCH!, it spotlights as many as 10 companies. The most interesting companies spanned physical therapy, the microbiome and fraud...

CODA

This post has run so long that prior #health2con 2016 posts in the KHIT blog feed don't show when you scroll down. So, chronologically...

I guess one summary take I have with regarding much of what I witnessed at the 2016 conference -- with respect to the endless onslaught of emergent app demos, anyway -- is that I kept having a "yeah, Trivago / Compare.com" reaction. You know; the ongoing blizzard of web- and smartphone based consumer offerings we see on TV every day, all promising E-Z frictionless, inexpensive instant gratification for your every need.

The "Look & Feel" aesthetics UX was pretty much all bright and shiny. Great use of colors and artsy layouts, I have to say.

A hell of a lot nicer looking than the typical mainstream EHR. But, given the relative niche narrowness of each new app, that's a much easier lift. And, I find the assertions that "we are now in a post-EHR world" (which I heard proffered more than once at the conference) just a tad fatuous.

Still a lot of "Free Beer Tomorrow" syndrome in place. But, in terms of health infotech maturities, we are likely at numerous places on the "transformative" exponential progress "hockey stick" curve.

The health tech space is not unique in this regard. "Keep Calm and carry On."
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UP NEXT

Among other topics, some new book reports shortly.

Finished both Liminal Thinking and Breakpoint. Just staring Pre-suasion.
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More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
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"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
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"'Solutions' exist only in mathematics."

- Karen Martin
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"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
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"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Monday, October 3, 2016

#health2con 10th annual conference recap and photo gallery

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