HIT National Editor

CHICAGO – The annual conference of the Healthcare Information and Management Systems Society (HIMSS; Chicago) always has quite a bit more emphasis on fun than your standard healthcare gathering.

On the exhibit floor, for instance: a chance to win a Vespa, a Wii game or various other goodies – here, there and everywhere; one exhibitor featuring a sports bar – and nearby an island-looking kiosk serving more firewatery drinks; a magician/comedian attracting attendees to an exhibit, barker-style – the crowd staying for the product pitch; still lots of swag to pick up – the kibosh not yet put on in this sector; and on Tuesday night, a special musical event for attendees – only a long stone's throw away on nearby Navy Pier.

And like previous HIMSS conferences, the clinical presentations tend to look futuristically at things we're likely to see in the electronic healthcare sector, or many happening already under our noses and pointing to future possibilities.

Computer gaming, for instance, was one of the more offbeat – and upbeat – topics, and one that will probably result in the older dogs at HIMSS looking less cynically at kids spending hours and hours at this pastime.

But they need to be the right kind of games, according to futurist Douglas Goldstein.

While adjacent large rooms were only sparsely populated to listen to methods for "IT integration," Goldstein drew a near-capacity crowd to the huge South Grand Ballroom of McCormick Place.

His topic: an overview of how computer games are offering large healthcare benefits, from Wii Fit, a "game" that gets you up on your feet and exercising, to Brain Age, one that exercises the grey matter by putting you through various mental workouts.

Goldstein began by noting on the medical horizon three important developments for healthcare therapeutics: genetic engineering and the manipulation of DNA, the development of nanotechnology, and "virtual" technologies, noting that genetics and nanotech are still in the distance while virtual technologies, via computer gaming, are already providing a variety of significant health benefits.

One of his primary examples of this is a game called ReMission, to be played by kids with cancer and allowing them to battle nasty cells inside a human body. And Goldstein cited research indicating that kids who play ReMission are more likely to be compliant with their prescribed therapies.

He said that in 2005 there were just 33 games in this category, now more than 600, the varieties matching the various stages of the health/disease continuum: from wellness to at-risk, and on to acute, chronic and catastrophic disease.

Importantly, he said that these games – such as Brain Age, for instance, or other brain exercisers – also could be used to bolster the efficiency of healthcare workers, citing studies that playing such games can help them focus on their tasks and retain, or even improve, mental acuity.

He noted also, however, that the makers of these games want to avoid having their products classified as "medical devices," suggesting that this would give them a stigma reducing their acceptance.

Such systems he offered as a way of moving healthcare out of hospitals and doctors' offices into the home, saying that U.S. healthcare is presented as a "wholesale" model and needs to go "retail."

If healthcare specialists don't do this, someone else will, he said, as a sort of throw-away threat (though unlikely to scare many providers).

An equally tantalizing presentation was made by David Cowan, MS, executive in residence at the Health Systems Institute of the Georgia Institute of Technology (Georgia Tech; Atlanta) and president of Management Systems Consultants (Atlanta).

Cowan noted that his most recent Christmas list included requests for those robotic sweeper units that scurry back and forth over your floors, substituting for, or at least reducing, normal vacuuming time by humans.

His presentation, "An economic model for the next big thing: healthcare robots and other emerging health technologies," offered an economic-based prediction concerning when similar types of robot devices will commonly carry out a variety of basic tasks for the elderly and disabled, thereby saving healthcare costs by allowing them to remain independent and in their homes.

Many of these devices are currently being tested in Georgia Tech's experimental Aware House. The emphasis of this lab is on robots that do "repetitive tasks," with ongoing attempts to engineer the more advanced features of "flexibility and sensitivity," Cowan said.

The result, he said, will be "carebots" that can do more complex domestic tasks and even work with human caregivers.

In his economic model, he predicted three to eight more years of development, five to 10 years in initial beta model testing use, eight to 12 years for commercial model offerings and a minimum of 15 to 20 years for "ubiquitous" presence.

He outlined a variety of things to be achieved to reach the point of general usage in the home:

• Their costs will have to come down, comparable to or less expensive than the expense of training service dogs and monkeys – which he put at about $17,000 – or the annual cost of nursing home care – which he put at $30,000.

• they will have to be extremely easy to use;

• and they will have to have an appearance – perhaps like Rosie, the Jetson's robotic maid – that doesn't "frighten" the elderly, Cowan noting that current devices tend to have a look even scarier than those that so bothered Will Smith.

He said these robotic systems probably won't achieve general use until they are available "at Best Buy or online."

And as with any other medical devices he noted the need to convince CMS and other third-party payers that such devices reduce the large costs of chronic care and nursing home stay, so as to entice, for instance, up to the 80% reimbursement won by the mobile wheelchair/scooter sector.

Cowan put the market of the disabled and the elderly that could benefit from carebots at "many millions" and "big enough to make [their development] worthwhile."

A breakthrough point for these systems, he said, likely will come when, like motorized wheelchairs, "you see them everywhere, and people will say, 'My grandparent needs one, or one day I'm going to need one of these.'"