A HIMSS Event | SANTA CLARA, CA | SEPT. 16-18, 2019

San Francisco, CA
September 16-18, 2019 | Santa Clara, CA

How Health Tech is Shaping the Future: An Interview with HIMSS’ Steve Wretling

By Heather Munro, freelance writer focusing on emerging technology. 

With a month to go before Health 2.0’s Annual Conference, Steve Wretling, HIMSS’s Chief Technology and Innovation Officer, shared his thoughts on where digital health is headed.

What do you think healthcare will look like in 5 years? 10 years? (For patients and  for providers.)

Within five years or less, telehealth will be the new normal in healthcare delivery—the majority of visits will be virtual or asynchronous. For chronic conditions, remote monitoring using medical-grade devices that send data back to patients and providers (integrated into the EMR workflow) will be commonplace. 

Wellness programs will include personalized coaching for those at risk for chronic conditions. For e-visit physicals, Insurance companies and providers will provide consumers with a kit that includes devices like a wireless thermometer, stethoscope, otoscope and blood pressure cuff.


How do you see health tech innovation changing the patient experience? The provider experience? 

More of the patient experience will be virtual, so patients will need to become familiar with what can be triaged via video visits and what conditions require in-person care or emergency care.

For initial diagnosis and triage, patients will interact with intelligent chatbots more frequently. Wayfinding apps, chatbots and voice devices will simplify           navigation inside health facilities. And robot concierges, including self-driving wheelchairs with voice interaction, will guide patients through health facilities. 

Providers will spend more time on video visits and reviewing remote monitoring dashboards. They’ll also regularly review artificial intelligence for clinical decision support and guiding  patient-facing tools like chatbots and voice devices. And of course, they’ll analyze continuous monitoring data for chronic conditions to predict deterioration and need for additional intervention


Healthcare is complex and data needs to remain private. Are there any technologies emerging that the industry or consumers considers controversial?

Chatbots are still controversial but will gain broader acceptance as they improve and show their worth. Virtual reality is just beginning to prove its value in treating conditions like chronic pain. Voice devices have just recently become HIPAA compliant but because the major providers of these devices listen in to conversations to improve their function, trust has eroded.


How is innovation improving value-based care? 

Innovations that support value-based care, which seeks to improve the quality of both care and outcomes, has taken many forms, including public and private alternative care delivery and reimbursement programs, population health management and the development of precision care. Technology innovations that are streamlining health care delivery include artificial intelligence, telehealth, and remote patient monitoring and self-care.

 On the legislative side, the Department of Health and Human Services (HHS) began moving Medicare towards value-based care in 2015, with goals to move a percentage of traditional fee-for-service payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements.

The Medicare Access and CHIP Reauthorization Act (MACRA) provided a new framework for reimbursing clinicians who successfully demonstrate value over volume in patient care. Innovations in horizontal integration, team-based care, culture change, and transparency are also supporting the transition to value-based care.


Where are we now? Has the $3.5+ trillion healthcare market obtained the spirit of Secretary Burwell’s vision of moving from fee-for-service to value-based care?

Results are mixed. According to the HCP-LAN (HHS) APM Measurement Effort, while roughly 1,550 hospitals (55%) will receive a bonus from Medicare in fiscal 2019 under the Hospital Value-based Purchasing Program, these results are a 2% decrease from 2018.

The number of organizations participating in the CMS ACO MSSP also dropped from 622 in 2018 to 518 in 2019. That said, assigned beneficiaries have steadily increased from 2012-2019. Total earned shared savings has consistently increased from plan year 2012-2017, and average quality scores have trended upward, though experienced a 2.25% decrease from 2016 to 2017.

Clinicians, in particular, have reservations about value-based reimbursement. Fewer clinicians (37%) and clinical leaders (39%) than executives (51%) say they think value-based reimbursement will be the primary revenue model of the future. Fewer clinicians (38%) than executives (55%) and clinical leaders (47%) believe that value-based contracts significantly improve the quality of care, and fewer clinicians (36%) than executives (50%) and clinical leaders (42%) think value-based contracts significantly lower the cost of care.

Overall, while adoption of and outcomes with value-based care may not have as much of a clear and steady upward trajectory we would like, the pendulum is swinging in that direction.


What unique outlook does Health 2.0 Annual Conference provide to the expanding health tech industry? 

Health 2.0’s worldwide recognition and reach means it’s regarded as a powerhouse in digital health thought leadership. At the Annual Conference, Health 2.0 and HIMSS connect real people, products and purpose to fuel innovation in healthcare. This year’s program features a full spectrum of early-stage tech, highly-vetted startups, top investors, patient-dedicated programs, policy-focused dialogues and authentic provider perspectives. You’ll find an amplified focus on adaptability, user experience and data-driven decisions behind all of the major digital health trends.


What elements do you look for to shape the Health 2.0 program mix for the variety of healthcare industry attendees? 

We carefully curate high-impact content from industry pioneers who are disrupting outdated health models and introducing innovative solutions across the market. So when we identify programming, we put an emphasis on both the revolutionary ideas and practical solutions behind the technology. We also continually evaluate what providers, startups, investors and patients would find valuable, and work to create an intimate community feel to help our attendees better connect with each other. This year, for example, we’re replacing the traditional exhibition hall with a networking HIVE that includes more opportunities for networking than ever before.


What are some of the Health 2.0 sessions you are most excited for? 

Health 2.0 VentureConnect Competition (Monday, September 16): I am looking forward to hearing the presentations and finding out which early-stage health tech companies will be named the Most Fundable Startup.

Empathetic Tech: Enhancing Human Interactions through Machine Learning (Tuesday, September 17): Poppy Crum, Chief Scientist at Dolby Laboratories, is sharing how we can use technology to make ourselves more human—such an important topic to explore as healthcare becomes more digital.

Launch! (Wednesday, September 18): It’s always exciting to hear from new startups as they demo—and debut—their health innovations.

The Unacceptables (Tuesday, September 17): This audience favorite is also one of mine. This year’s topics are particularly compelling: human trafficking, maternal mortality, and homelessness.


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