They do things bigger in America, but even allowing for the size of the US health system, this year’s big health IT trade show in Orlando was staged on a truly epic scale.

Organised by the Health Information Management and Information Systems Society (HIMSS) the eponymous HIMSS 2008 has had approximately 27,000 visitors to the Orange County Convention Centre.

In the giant exhibition halls over 900 vendors displayed their wares with stands ranging from small booths to multi-story structures larger than an average house. Many firms spend big at HIMSS; GE staff were provided with maps so as not to get lost in their own stand.

Ironically, the HIMSS’ rules mean that first timers are restricted to a modest sized space, so Google – here for the first time though probably the most talked about firm at the show – had a tiny stand.

To be noticed among the crowd most firms went for high tech and gleaming, while other stands, including that of EPIC Systems (which includes chrome gargoyles), were highly idiosyncratic. Everywhere vendors were keen to demonstrate their products.

One vice president of a vendor exhibiting told EHI they spent at the show because it consistently delivers a very significant pipeline that they can be confident will translate into sales. In the diverse US healthcare market a lot of customers are buying a lot of different systems.

Exhibitors are this year offered a bewildering range of products and services all with catchy acronyms, including: electronic patient records (EPR), enterprise master patient index (EMPI), e-prescribing (eRX), radio frequency identification devices (RFID) and business intelligence (BI). As well as wide range of hardware on offer products on show included portals, connectivity, data warehouses, security and biometrics.

Almost every technology category or type appears to have multiple vendors, with some having dozens. For instance, the HIMSS specialist group for EMR vendors has over 35 members.

According to the HIMSS CIO leadership survey there was no one single hot topic this year, with CIOs saying their priorities were pretty evenly spread over implementing Electronic Medical Records (EMRs), and systems to support quality of care and reduce medical errors.

HIMSS president Stephen Lieber told E-Health Insider that the lack of a clear hot button issue in the survey was a sign of the industry reaching a phase of growing maturity. “Some of the top three topics have been in the list for several years now. There comes a point where it’s just everyday business. These areas – like EMR – have now just moved into regular practice.”

One of the areas being widely talked up was the need for business intelligence and analytics solutions – systems that can analyse data to improve performance and enable healthcare organisations to more effectively manage their business. Almost every major supplier of clinical systems and a number of specialists appeared to have a BI product on offer.

The argument is that with more health IT systems now being installed and used, there is a growing need to use the data effectively to manage the business. A promise repeated by different suppliers is “to provide a single view of the truth.”

Also featuring prominently were tools and approaches based around the patient or consumer. These ranged from patient portals that enable consumers to manage their health benefits, through to personal health records (PHR), able to empower patients to take control of their health.

In Tuesday’s keynote address Steve Case, ex-head of AOL, spoke of the vital need to trust and involve the consumer in healthcare decisions. Case believes that the healthcare industry is on the cusp of being transformed by consumers over the next 10 to 20 years. His new venture, Revolution Health, has become the number one US consumer health website in just 12-months, overtaking WebMD.

Case argued that placing the consumer at the centre of the healthcare system was the only way to begin to re-engineer a healthcare system spiralling out of control, where annual costs are now over $2 trillion.

But it was the PHR plans of the current undisputed leader of the internet, Google, that generated the greatest interest in Florida this week. Can the firm that dominates the online search industry bring its technical knowledge, financial strength and commercial savvy to patient controlled records? It’s far too early to tell, but just the fact that firms the size of Microsoft and Google are ramping up their investments tools for consumer-focused health speaks volumes about where they think the market is going and the opportunities that exist.

That said, it’s worth remembering that some of the hot topics of past years have failed to live up early promise. Only a few years ago Regional Healthcare Information Organisations (RHIOs) were seen as the way to tackle connectivity and data flow in the US health system. But several years on after seed corn funding from the government they appear to be seen as a busted flush.

If, as HIMSS claims, the healthcare industry is maturing on the familiar institutional systems of EMR and clinical systems for hospitals and clinics, it is just at the beginning of providing tools that will enable consumers to getting fully involved in their healthcare.

At HIMSS 2009 in Chicago it will be interesting to see how many new products are being offered in the consumer health arena and whether Google will have graduated from being a token newbie presence.


Jon Hoeksma