Publication
Date: June 20, 1997
Integrated Health
Information Networks:
A Prescription for Continuity of Care
By Sue Mellen
More than two
decades ago, in response to spiraling costs and
tightening regulatory controls, health care
providers and insurers began a consolidation
process that has led to fewer, larger
institutions. Today, hospitals, long-term care
facilities, outpatient centers and private
physician practices are tied together in
corporations that often span several states.
While the health
care sector as a whole lags other industries in
the use of information technology, some of these
massive entities are now building networks to
share all kinds of information, ranging from
patients’ medical histories to financial and
insurance data. And some already have seen
improved continuity of care and cost savings
growing out of their information-sharing
networks.
The Memorial
Health Care System
Memorial Health
Care is the largest health care system in central
Massachusetts, a region noted worldwide for its
medical facilities. The system comprises three
hospitals -- the former Medical Center of Central
Massachusetts, Memorial Hospital and Hahnemann
Hospital -- along with medical centers and
physicians offices across Worcester County. A
pending merger with neighboring University of
Massachusetts Medical Center promises to create a
gargantuan system. As negotiations with UMass
continue, Memorial Health Care’s senior vice
president and CIO, Richard F. Bretagne, is busily
effecting alliances of his own.
In one nearly
completed, year-long project, Bretagne and his
department are using Internet technology to
network all physicians in the Memorial system.
The IS professionals are connecting
physicians’ offices to Memorial’s
intranet, providing training, and supplying
member offices with a tool set that includes
Windows 95, Microsoft Office and communications
software.
Bretagne says he
specifically chose the "generic" tools
rather than applications custom-designed for
physicians or health care institutions. "We
wanted our physicians to decide on their own how
to use the tools. We also wanted to stimulate
collaboration between physicians’ offices as
they decide how to make the tools work for
them," he says.
Physician response
to the project has been uniformly positive, he
says, with communiques and patient documents of
all sorts flying across the phone lines between
offices. And the project has benefited small and
remote facilities, such as the family health
center -- now a Memorial satellite facility -- in
tiny Barre, Mass. (population 4,667), situated 20
miles northwest of Worcester. As part of the
Memorial system, the Barre physicians and
administrative staff can access the same network
and tools available to their urban counterparts.
According to Kathy Silva, the center’s
office supervisor, she and co-workers now have
immediate access to all the patient billing and
demographic information on the system’s
central database. They can also communicate
electronically with any physician or
administrator on the system, avoiding the games
of phone tag that previously occupied so much of
their time, she says.
"This is a
small, rural health center which, on its own,
simply wouldn't have had the resources to
effectively use this kind of network," says
Bretagne.
Outside its own
network, Memorial is using Internet technology to
share information with insurers. For example,
staff at Tufts Health Plan post member enrollment
information to a bulletin board on an extranet
connecting the two organizations. The information
is then retrieved by Memorial staff to keep
patient eligibility information up-to-date.
But, as Bretagne
points out, the biggest roadblock to the creation
of a more extensive network remains outside the
realm of technology. "Ideally, we’d
like to see medical centers connected with
pharmacies and school health offices. That’s
when you'll really see continuity of care. The
technology certainly exists to do that. Now
it’s up to the community at-large to
determine how much information should be
available, to how many people, in the interest of
better health care."
Creating a
Health Information Infrastructure
The Massachusetts
Health Data Consortium, based in Waltham, Mass.,
is one organization dealing with the raft of
issues surrounding health information networks.
The group sponsors a number of work groups
exploring electronic data interchange (EDI) in
health care. It also has initiated a project
called the Affiliated Health Information Networks
of New England. Its goal is to build an
information network from systems already in place
at member institutions, rather than creating a
central data repository that could carry a price
tag in the tens of millions of dollars. Project
engineers are developing network standards that
would allow communication among the various
enterprise systems.
Dr. Alvin R.
Tarlov, chairman of the Massachusetts Health Data
Consortium and executive director of the Health
Institute at New England Medical Center, hopes
his group’s project will ignite similar
efforts across the country.
"Health care
providers spend millions of dollars on systems
that don’t talk to one another. By
converting to a comprehensive, integrated system,
the U.S. health care system could significantly
reduce its overhead costs. This kind of system
could reduce paperwork, lower administrative
costs and enhance efficiency of both patient care
and security of confidential information,"
he says.
Sue Mellen writes from
Tyngsboro, Mass.
Related article: Pharmaceutical
Sector Putting IT To Work
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