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After many years of promises, information technology is beginning to show real progress in the effort to improve the quality and lower the cost of healthcare. Although IT is used extensively in many healthcare settings, it is often deployed in isolation, with little integration between the many systems and devices found in the typical hospital or clinic. Medical records, which are at the center of patient care, are still too often paper-based, making it difficult to realize the benefits of integration.
Now this situation is changing, as industry standards are beginning to make interoperability a reality in healthcare. This was the message heard at one of the largest gatherings of healthcare IT professionals in the world: the Healthcare Information and Management Systems Society’s (HIMSS) annual conference in New Orleans during the last week of February, 2007. HIMSS, founded in 1961, provides global leadership for the use of IT within the healthcare industry. The conference boasted an attendance of approximately 25,000, with nearly 850 vendors populating the exhibit hall floor.
The conference sessions and vendor exhibits clearly illustrated that the healthcare industry is deeply committed to increasing the quality of medical services through the use of information technology. For instance, over 200 of the vendors showcased new IT products designed to assist medical teams in diagnosis and treatment, increase the quality and confidentiality of patient medical records, simplify healthcare administrative management, and generally increase the overall quality of medical care for patients on a global basis.
The Interoperability Showcase
One of the most notable examples of the advances currently in progress in IT healthcare was demonstrated at the Interoperability Showcase. The showcase highlighted the continuing advances being made in the Integrating the Healthcare Enterprise (IHE) initiative that has been in progress for the past few years. The goal of IHE is to assist in the development and adoption of an IT standards-based framework for the seamless passing of medical information among care providers, enabling enterprise, community, regional, and national health information networks to improve the quality of care at lower administrative cost.
In all, 76 vendors participated in the Interoperability Showcase, touted by the conference as the "largest multi-vendor interoperability prototype in the world." One of the most impressive demonstrations at the showcase involved a dramatization of a patient entering the emergency room with chest pains. The live performance illustrated how the standards-based framework could transmit patient data seamlessly between various departments and medical devices to ensure the highest quality of patient care. If surgery is required, all of this data can be sent to a central dashboard in the operating room, where it is updated on an ongoing basis to ensure that the surgical team has all the information it needs to maximize the chances for a successful medical procedure.
The Katrina Phoenix Project
The choice of New Orleans for the 2007 HIMSS conference was made intentionally to help advance a key HIMSS Foundation initiative known as The Katrina Phoenix Project. The project is a collaborative effort focused on rebuilding physician practices damaged by Hurricane Katrina and transitioning medical records from paper to electronic format, using systems donated by hardware and software vendors. Computer Economics was invited by the HIMSS conference to visit two of the clinics involved in the project.
The Primary Healthcare Associates clinic, run by the husband and wife team of Dr. Shelton Barnes and Dr. Janet Barnes, was devastated by Hurricane Katrina. The clinic lost approximately 5,000 paper medical records that were ruined by water damage. Because of the loss of records, the clinic was shut down for 10 months. Through the assistance provided by HIMMS and a few key IT vendors, Primary Healthcare Associates now has an electronic healthcare records (EHR) system and the clinic is back in business.
The EHR system would have cost the clinic over $100,000, but as a result of assistance from the Katrina Phoenix Project the clinic paid less than a third of the total price tag. Dr. Shelton Barnes said, "The cost of doing this on our own would have been nearly impossible because of the losses we had suffered." However, Dr. Barnes noted that now that the EHR system is installed, it is clear that the ROI on the full cost of over $100,000 would have been recouped in less than three years.
When asked if his patient load had returned to its pre-Katrina level, Dr. Barnes replied, "Before Katrina there were about 4,800 medical doctors in the greater New Orleans area; now there are just over 1,600. Some of our hospitals are barely operational and those that are fully operational are running between 95% and 100% capacity...Because of the shortage of doctors, I could take on many more patients if I had the capacity."
Another focus of the Katrina Phoenix Project is the Common Ground Health Clinic, situated in the Algiers district of New Orleans. The clinic opened in a donated mosque only a few days after Katrina hit the area. Medical personnel and volunteers who originally opened the clinic were forced to run blockades to get to the area. The clinic is staffed almost entirely by volunteers, and all pharmaceuticals, medical devices, and IT equipment are provided through donations.
Today, the Common Ground Health Clinic resides in a converted corner market and sees over 200 patients per week, most of whom have no health insurance. During the HIMSS conference, where the clinic team was highlighted on stage for its unselfish work for the community, several vendors offered cash donations and a variety of medical and IT equipment. Although the clinic is still a long way from having an EHR system or other sophisticated IT systems in place, the efforts of the HIMSS Foundation, HIMSS general membership, and several committed IT vendors mean that the Common Ground Health Clinic will continue to serve the citizens of New Orleans for many years to come.
Keynote Speakers Call for Faster Acceptance of IT Healthcare Standards
Despite the advances being made by the IHE initiative, the reality is that only a few major hospitals and clinics are even close to implementing a seamless IT infrastructure. Throughout the conference, the keynote speakers gave impassioned addresses on the need for quicker adoption of standards and the need to continue making advances in IT healthcare to keep up with the growing demands being placed on the industry. These keynote speakers included such distinguished guests as General Colin Powell, Microsoft CEO Steve Balmer, and Tennessee governor Phil Bredesen.
In his keynote address, Steve Balmer noted that "There is going to be an explosion within the next decade in the amount of data for healthcare providers and consumers. There's only one path to deal with all that, and it is automation." He went on to say that healthcare is the largest industry in the world and one of the fastest growing segments of the economy. However, he also said, "Despite the size of the healthcare industry, it lacks the standardization that can be found in other industry sectors, such as banking."
Continuing on the theme of IT standards in healthcare, Governor Bredesen said, "The industry must establish simple standards, reduce the scope of e-health into a manageable project, and find ways to get physician practices to adopt e-health technologies."
Bredesen, who is co-chair of the National Governor's Association, is taking a close look at issues impacting electronic healthcare information exchange. "The standards issue has been mired in too much complexity," he said. He pointed out that the Internet is a good example of how communication and content networks can be designed using universal protocols. Bredesen suggested choosing one area of healthcare, such as pharmaceuticals, as a beach-head for implementing an e-health solution to get something working.
In his keynote address, Gen. Colin Powell focused on the need to convert paper records into electronic record systems. His focus stems from the fact that he is now a partner in Revolution Health Group, which is heavily focused on putting patients in control of their own healthcare management. Revolution Healthcare Group boasts a board of directors that includes well-known Silicon Valley players such as Steve Case, Jim Barksdale, and Carly Fiorina.
Gen. Powell said, "Moving paper records into electronic networks is challenging, and people will be concerned with privacy and security. However, we should not be afraid of the challenges and difficulties, or fear imperfection along the way as long as we are moving forward." He went on to say that the cost and availability of healthcare in the United States will be a challenge for years to come, and that if these issues are not addressed they will threaten our prosperity.
Hurricane Katrina--A Silver Lining for IT in Healthcare
The selection of New Orleans as the venue for the HIMMS conference was an appropriate choice. With the devastation of Hurricane Katrina, many regional healthcare providers have had to rebuild medical facilities--effectively forcing some of them to start with a clean slate.
As seen in the Katrina Phoenix Project, this has given them the opportunity to rebuild medical systems and processes on a foundation of new technology, based on industry standards that promote interoperability of medical systems. As a result, because of these investments, these providers should be able to ultimately deliver a higher quality of medical care to their patients at a lower cost. If so, the losses suffered in New Orleans will have a silver lining, by producing a showcase of the ways in which information technology can advance the quality of medical care.
This article is a brief summary of our full report, Seamless Networks for Healthcare Information Are on the Horizon, which is available on our website at https://www.computereconomics.com/article.cfm?id=1213 (click for pricing).
For IT spending and staffing metrics in the healthcare industry, please refer to our most recent IT Spending, Staffing, and Technology Trends study, which includes a chapter on the healthcare sector. A free executive summary is also available.