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The benign chaos of HIMSS 2016

At times, it was hard to distinguish between the blinking slot machines on the dazzling casino floor of the Sands Expo and Convention Center and the tech-stocked booths of the country’s biggest health IT event.

This year’s edition of the annual conference and exhibition of the Healthcare Information and Management Systems Society, HIMSS 2016, unfolded in Las Vegas, of course, making the show even wackier and more chaotic than usual.

It was instantly clear that the kitschy culture of this city of dreams was going to leak into HIMSS when Frank Sinatra’s crooning delivery of “Mack the Knife” was part of the audio intro to the opening night keynote by Department of Health and Human Services Secretary Sylvia Burwell, the nation’s top healthcare official.

While HIMSS is often thought of as a vendor show, it actually draws together all the disparate tribes of health IT, including many provider organization CIO types on shopping missions.

But the federal government also usually makes it presence felt, and at HIMSS 2016, despite a lame duck administration, the federales were intent on showing the private sector who was boss, or at least trying to be.

Burwell went on a virtual jeremiad against “information blocking,” the alleged practice by vendors and providers of erecting barriers, either financial or technological or both, to the exchange of health data.

And she unveiled a closely guarded announcement of an industry-wide pledge against information blocking signed even by some of the entities widely thought to be engaging in it, such as EHR behemoth Epic Systems Corp.

Although some attendees admired this sudden coming together for a noble cause, employees of other signatories, including executives of one well-known vendor that signed on, and some reporters, privately dismissed the gesture as a toothless PR ploy.

One health IT star, outspoken Boston’s Beth Israel Deaconess Medical Center CIO John Halamka, even derided the purported practice of information blocking on stage in a packed hall as somewhat like the Loch Ness Monster, “often talked about but seldom seen.”

Another federal official, Acting CMS Administrator Andy Slavitt, made the rounds disseminating the widely accepted notion that meaningful use as we know it is on the way out, even though ONC will still be certifying EHR technology used for federal reimbursement.

Got that?

ONC national coordinator Karen DeSalvo, M.D., was usually with Slavitt, promoting another dream a lot of health IT people like to talk about, but few practice: interoperability.

Otherwise, the HIMSS 2016 experience was often jarring, especially for many of the 40,000-plus conventioneers forced to wade through smoky casino floors in the maze-like resorts that dominate the city. Wow. People in Las Vegas can light up just about anywhere.

The city’s monorail, and its retro-futuristic passenger pods, was an amusing throwback, ignored by most show attendees. They appeared to prefer to wait in endless lines for the armies of taxis that patrol the city in the desert, and also for the Uber drivers intent on taking business away from them.

The main show halls on the Sands’ second floor were vast and airy and populated by the likes of blue-chip companies such as Epic, Cerner Corp., IBM Watson Health, Lexmark International, Inc., SAP and many others. The short-ceilinged first floor, or “dungeon” as some vendors that inhabited it called it, was considerably less glamorous.

Quarters there were cramped, and a bit musty. Even so, one big vendor that was situated there — perhaps because as a non-native health IT player, it had not yet paid its dues enough at HIMSS — made the best of it, with cheery employees, and a sizeable and well-appointed booth.

This was Salesforce, which even though stuck on the first floor, made sure to plaster its promo ads hawking its new “Health Cloud” CRM for healthcare system on nearly any available free wall surface at the Sands.

Another common complaint was the exhibition hall’s wireless system’s frequent crashes, which sparked dismay in booths where no wireless meant no flashy demos.

And, in a phenomenon that afflicted many attendees, rampant overscheduling left show-goers sprinting amid mobs of people between booth appointments and panel sessions they had put on their calendars without checking the vast distances often needed to navigate between stops.

As for myself, I employed a rationale for being a bit tardy at times.

I’d say: “I’m on HIMSS time, aren’t we all?” Thankfully, most attendees trying to negotiate “HIMSSanity” agreed.

Another refrain often overheard on the teeming show floor: “My feet hurt.”