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E-health gurus still expect to transform your world
A visit to a recent trade conference finds the movement to computerize health care going full speed into the electronic future.
You don't have to be much of a pessimist to find plenty of rain clouds hovering over the movement to computerize health care.
Many of the companies that want to connect providers, patients, and payers on the Internet are on a perilous financial footing. Moreover, some potential customers may be scared off by HIPAA, the federal law that threatens dire sanctions for failing to safeguard medical data.
Nevertheless, optimism was the order of the day at the annual conference of the Healthcare Information and Management Systems Society, held February in New Orleans. Despite marketplace jitters, 675 exhibitorsthe most everfilled the cavernous convention center. Although barriers to e-health received their due, the conference focused on the many burgeoning (though sometimes stumbling) efforts to exchange online data within and between health care organizations. What emerged was an industry that's moving full speed ahead.
One theme sounded often at HIMSS was the need for health care entities to standardize electronic communications. For instance, the HIMSS organization is now in the third year of an initiative called "Integrating the Healthcare Enterprise." The goal is to get medical technology and software vendors to provide seamless transmission of clinical data in a standard format within hospital systems. As an example of the progress that's been made, about 30 companies participated in an impressive demonstration of how radiology images are being transmitted within four health care systems that use multiple vendors.
Insurance carriers are learning to work together, too, and the New England Healthcare EDI Network showed conference attendees how to do it. Using proprietary connections between physicians and hospital systems, the network enables thousands of doctors to transact business online with more than three-quarters of their payers.
Some companies that belong to HIMSS are trying to wire health care players on a citywide basis. In Winona, MN, a software vendor called Cerner has partnered with the Community Memorial Hospital Center and Hiawatha Broadband Communications to create a network for that town's medical community. A secure, Web-based messaging system now connects the hospital, most of its 50 doctors, five of its seven pharmacies, two labs, and the community. More than 1,000 patients have signed up for access to online health records containing physician-interpreted data, such as lab results.
But will physicianswho often grouse that computers slow them downtake full advantage of these networks? Some observers bet that personal digital assistants, or PDAs, will win reluctant doctors over to e-health. Already, many tote these handy gadgets, but don't yet take full advantage of them. At the moment, doctors use PDAs primarily to download medical information and write prescriptions, which they either print out, or zip off to pharmacies as computer-generated faxes.
HIMSS made it clear that the future of the PDA in medicine is much broader. Services like ParkStone and PocketScript are gearing up for direct transmission of scripts to pharmacies, plus lab results, dictation, coding of reimbursable services at the point of care (otherwise known as "electronic charge capture"), and more. Automated charge capture (already offered by AllScripts to IDX users) should prove especially appealing to doctors. With a manual system, "up to 20 percent of a doctor's charges are lost because of coding errors and misplaced encounter forms," says ParkStone Senior Vice President John Mora. But with a PDA, that offers charge capture, a physician would simply enter the diagnosis and CPT codes, and the software would check them against each other and record the charge for later input into the doctor's practice management system.
Physicians will also appreciate new features such as PocketScript's voice recognition, which allows them to literally call up a medication's name along with drug interaction data at the point of care.
Other new technologies and applications showcased at the conference also promise to be doctor-pleasers. An e-health connectivity company called Axolotl gives physicians high-speed Internet access via satellite. This space-age way to reach the Internet offers data transfer rates and costs comparable to those of DSL, and it's available in far more areas. Park City Solutions enables doctors to mold their own Web site content without help from computer techs. And two vendorsscheduling.com and Vitalzprovide doctors with the ability to schedule patients online for tests, procedures, and office visits.
Only some of these initiatives will succeed. Some worthy efforts will fail to find a market or make money fast enough to satisfy investors. But if the ferment and enthusiasm at HIMSS are any indication, e-health is becoming an unstoppable force that will eventually find its way into every doctor's office.
Ken Terry. Computer Consult: E-health gurus still expect to transform your world. Medical Economics 2001;9:20.