Tackling health inequity was one of the main themes at the Healthcare Information and Management Systems Society show last week, with health information technology experts sharing ideas on how to remove algorithm bias and use data to address issues such as food and drink insecurity. housing security. Other topics included cybersecurity, the role of telehealth in the healthcare ecosystem, and data sharing in the public health sector.
HIMSS22 took place last week in Orlando, Florida, just seven months after last year’s show in August, which was rescheduled from March 2021 due to the COVID-19 pandemic.
Here are five highlights that Modern Healthcare saw at HIMSS22.
1. Fighting algorithmic bias. While many health and technology experts have touted the benefits of artificial intelligence and other analytics tools, questions have been raised about how to ensure that algorithms deployed in clinical care do not have unintended biases or unexpected consequences for patients.
In a session on the ethical and security implications of AI, Jessica Newman, director of the AI Security Initiative at the UC Berkeley Center for Long-Term Cybersecurity, cited a 2019 study that found a widely used algorithm for managing public health, a predictive model. that does not use AI underestimates the medical needs of the sickest black patients.
Bias and fairness are “a ubiquitous issue for AI systems as they typically learn from imperfect datasets that include human and historical biases,” she said.
During a session on health equity, U.S. Secretary of Health and Human Services Xavier Becerra said he had directed the Office of the National Health Information Technology Coordinator to “take a deep look” at algorithmic bias. During a separate meeting at ONC City Hall, ONC head Miki Tripathi said his team is looking into algorithmic bias, focusing on the role played by electronic health record software.
“EHR data is increasingly being used for training and algorithm development,” he said. “It is a tool that embeds the results of the algorithms…into administrative and clinical decision-making.
2. Cybersecurity is about people, not just technology. Hospitals should think about cyberattack preparedness the same way they think about other disaster preparedness plans, creating a comprehensive business continuity plan that outlines what to do if an organization is attacked by a hacker, said Julie Chua, head of risk management program division. . in HGS.
This should include a plan to continue providing medical care and communicating with the public, as well as developing and implementing it prior to an actual cybersecurity incident. She added that it is important for everyone in the organization to know who is responsible for each part of the incident response plan.
“Cybersecurity risk is not just an IT issue,” Chua said during a panel discussion on cybersecurity.
“As hospitals face an increasing number of ransomware attacks that can interrupt and delay patient care, it is critical to educate physicians not only on cybersecurity best practices, but also on how to continue treating patients during system downtime,” said Dr. Christian Dameff, clinical informatics scientist and security researcher at UC San Diego during a session on cybersecurity and patient safety.
Everything from electronic medical records to imaging technology can go down during a cyberattack, he said.
“It’s about building disaster recovery and resilience among your clinical staff,” Dameff said. “You have to teach them how to use the tools around them when the technology is gone.
3. The potential of telemedicine to renew the healthcare ecosystem. The use of telehealth skyrocketed in the early days of the COVID-19 pandemic as the Centers for Medicare and Medicaid Services eased restrictions on telehealth significantly. Since then, the number of telemedicine visits has stabilized at a lower level than in 2020, but is still noticeably higher than before the pandemic.
Telemedicine isn’t going anywhere, according to HIMSS22’s healthcare executives.
But this technology should not be used as a substitute for in-person care, said Jodi Lesh, director of transformation at Kaiser Permanente, during a panel discussion on healthcare transformation. “It will create a different ecosystem,” Lesh said. “But it’s hard to see right now because we’re in these incremental steps.”
John Glaser, head of Harvard Medical School and another panelist, likened this to how cars not only replaced other slower modes of transportation, but ultimately paved the way for suburban existence as people could live further. where they worked.
“What’s the second-order effect here?” Glaser spoke about telehealth, suggesting that more virtual care could lead to large-scale inpatient home care programs.
4. Incorporate social determinants into care plans. Healthcare organizations discussed how they are using data to inform programs that address the social determinants of health, including the University of Virginia Health System’s program to send healthcare workers to areas with high rates of chronic disease and the Highmark Health program to screen patients for housing. , food and other problems.
According to Kelly Cronin, Associate Administrator of the Center for Innovation and Partnerships at the HHS Community Life Administration, there has been an increase in the number of contracts between healthcare organizations and community organizations in recent years, which is in line with the shift towards value-based care. , during a social protection session.
These contracts may provide for the sharing of IT systems so that hospitals can send electronic referrals directly to public or social organizations.
For hospitals, the first step in such programs is to collect data on which patients may need support from a community organization and then determine how to refer those patients to appropriate resources. Submitting these referrals requires organizations to use compatible software and common data standards.
Groups like the Gravity Project develop and set standards for social determinants data.
The ONC also adds social determinants to its data standards, including the US Core Data for Interoperability guidelines and interoperability standards.
Cronin said the industry needs to figure out funding for healthcare programs that refer patients to community organizations, as many community organizations don’t have the money to invest in IT tools and may not even have the manpower to take on additional referrals. . ACL in 2020 launched a call encourage community leaders to partner with healthcare organizations to develop successful and scalable approaches that the agency is still working on.
5. Compatible for public health. ONC’s Tripathi and Dr. Daniel Jernigan, Associate Director of Public Health Science and Surveillance at the Centers for Disease Control and Prevention, discussed efforts to improve the IT infrastructure for public health facilities, dubbed the North Star Architecture.
ONC and CDC officials have previously said that a lack of interoperability between health and public health organizations hinders the response to COVID-19.
As part of the agency’s efforts to modernize public health data systems, ONC is helping CDC develop a cloud environment that will facilitate the sharing of information between state, territory, local and tribal health departments and the CDC, including common tools and applications that are available across agencies.
“We think of them as building blocks,” Tripathi said of basic infrastructure applications such as patient matching and data normalization that can be used across institutions.
The program will also tie into existing ONC data exchange work such as the Trusted Exchange Framework and the Common Agreement.