Hal Wolf of HIMSS talks about digital health, data privacy and equity

Before addressing the World Health Organization, he spoke with Chief Healthcare Executive about the need to invest in technology to improve health around the world.

When it comes to advancing digital health around the world, Hal Wolf says the time is now.

Wolf, the president and CEO of the Healthcare Information and Management Systems Society (HIMSS), is speaking about digital health this week at a World Health Organization event in Tel Aviv, Israel.

Before heading to Israel, Wolf talked with Chief Healthcare Executive about the pressing need to invest in digital health. He talked about the opportunities ahead, the need to improve data privacy and cybersecurity, and improving health equity globally.

“No one is walking into this from a naive point of view,” Wolf said. “Everyone absolutely recognizes that we're at the threshold of a critical change and investment that has to take place. And it’s a very short runway.”

Wolf recalled a speech he gave five years ago, shortly after taking over HIMSS. Then, he recalled, he said that there was a five-year runway. “I really didn’t know that it was going to be so true,” he said.

“We’re at a point right now that the world has seen that we’re all connected,” Wolf said. “This is not the only pandemic that we are going to face. They’re going to come more often because the world is far more mobile. We also identify things earlier and faster. And the infrastructure that has to be built for both sharing and driving forward with digital health is recognized on the world stage.” (Here are excerpts from our interview with Hal Wolf. The story continues below the video.)

Finding a place to start

The COVID-19 pandemic, and the prospect of other pandemics, reinforce the need for greater sharing of health data globally, Wolf said.

In the pandemic, hospitals and health systems around the world engaged in digital health more than ever before, quickly launching telehealth services, remote patient monitoring, and even acute care delivered at the home.

Wolf said the challenges in the United States and Europe are similar in many ways.

“We have an exceedingly big population, and a growing aging population,” Wolf said. “We have improved diagnosis of chronic disease management. We have the effects of long Covid which we don’t fully understand yet that are coming.”

“And of course during the pandemic, we all, in the United States or in the most beginning developed nation, all got caught with data shortages and information that just simply wasn’t readily available to turn into actionable information,” Wolf said.

At the WHO Regional Committee for Europe conference, Wolf said he’ll be stressing the importance of all nations investing in digital health to help manage population health and track data such as immunization, even if some nations are only just beginning their efforts.

While different nations are at different stages of their digital health efforts, Wolf said, “There isn’t a single nation that doesn’t have challenges.”

“You can’t do everything at once,” Wolf said. “So the great challenge that everyone will have will be: What do I need to do and how do I need to do it given where I’m starting from, and what does that long-range vision look like?

“I think that’s the big challenge in front of all the world leaders who have to satisfy both people at home and recognize they’re part of a global community,” Wolf said. “At the risk of sounding a little corny, we're all in this together. That’s the reality of mankind.”

Digital health can also help nations deal with a shortage of healthcare workers, which is a global problem.

‘We have a capacity challenge,” Wolf said. “The capacity challenge in every single country is we’re not going to have enough physicians, we’re not going to have enough clinicians, we’re not having enough nurses. And so, how do we supplement the staff shortages and the facility shortages, and how do we use digital health to move them forward? That’s really the challenge on the table for each and every one of them.”

Wolf said nations and health systems need to act with a sense of urgency, since other pandemics are undoubtedly coming.

“Pandemics don’t have borders,” he said. “So the big challenge in sharing information, and utilizing partners, outside partners, not just going alone when you’re at the individual country level, that’s a huge and important element, for the WHO Europe in particular.”

Protecting data

While health information must be exchanged more easily, Wolf said the need to protect private health information is paramount.

Hospitals and health systems are facing more and more cyberattacks. Ransomware attacks on hospitals are rising. Hundreds of breaches of patient data have been reported this year.

“There’s nothing more important to an individual than probably two pieces of information: your health information and maybe your financial information,” Wolf said. “We all look at that with great care.”

“Every organization is having conversations with each other about establishing cybersecurity and data security, because they do recognize the information has to be exchanged,” Wolf said.

While it’s critical to do more to protect health data, Wolf said that can’t be an argument for slowing down the exchange of health information between hospitals, insurers, and governments.

The sharing of information is critical to manage growing health threats, Wolf said.

“We can’t go back into a hardened shell that says, ‘I’m going to keep my information strictly in my country.’ Or we have to create cloud solutions that allow them to maintain their data.”

“Cybersecurity is growing,” Wolf said. “Let’s be very clear. Any time you build a really good lock, there’s going to be someone that comes behind you to create a lock pick.”

HIMSS has focused on setting consistent government standards for the sharing of information. Wolf said that will also help bolster data privacy.

Ultimately, Wolf said the U.S. government is going to need to invest more in helping hospitals and the healthcare industry protect data and improve cybersecurity.

But he said it’s not just a matter of pouring money but targeting it properly.

“The single most important thing you can do is invest in data interoperability and consistency,” Wolf said. “Because when you have the same language transport and infrastructure from a security standpoint, it makes it much, much easier to tie it down.”

The U.S. government has pushed for consistent information sharing in reporting data.

“One of the reasons HIMSS has been so adamant about standards for interoperability and cybersecurity is to ensure that the transportation of data is clean, locked down and does not leave any doors open, because we know we need to exchange this,” Wolf said.

Plus, Wolf said standardization will make the effort less expensive. “The more standardization, the lower the cost,” Wolf said.

The U.S. government will need to work with Europe as it improves its own data sharing.

“Europe is trying to figure that piece out as well,” Wolf said. “One of the points that I was making and I have made in the past, we do need to continue to talk very closely with Europe. When they set a standard, ahead of us, and it’s not a bad thing, but when they set that standard, we inevitably will have to respond to it, and be a part of it.”

Health equity

Digital health solutions like telehealth are offering the chance to expand health services particularly to underrepresented groups.

However, health leaders have also talked about the importance of designing digital health solutions in ways that don’t exacerbate disparities in health outcomes. Black, Hispanic and Asian patients have been less likely to use video telehealth services than white patients, according to a federal study released earlier this year.

Health systems can ensure digital solutions improve health equity by stressing simplicity, Wolf said.

“If you build networks and you build solutions that are 3G compatible and up, then you have a much, much, much broader opportunity to deliver digital health solutions to individuals no matter where they are,” Wolf said.

If digital efforts are all geared to 5G networks, Wolf said, that raises the risk of leaving some people behind.

Digital health solutions can offer greater opportunities to close disparities in healthcare than simply building new facilities.

“If we think about healthcare strictly as an encounter-based paradigm, where it’s delivered because I walk into a facility, then you’re not going to improve health equity,” Wolf said.

“First of all, even if you wanted to build all the hospitals and clinics you could, you can’t staff them,” he continued. “So digital health will be significantly important in delivering health equity, and sharing centers of excellence and sharing information.”

Coming tomorrow: Hal Wolf offered his thoughts on hospitals and health systems and their digital transformation efforts.