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Tech Giants Push Open Standards for Health Network
securitas writes "The New York Times' Steve Lohr reports that 'Eight of the nation's largest technology companies, including I.B.M., Microsoft and Oracle, have agreed to embrace open, nonproprietary technology standards as the software building blocks for a national health information network.' Microsoft, IBM, Intel, Oracle, Accenture, Cisco, Hewlett-Packard and Computer Sciences have formed the Interoperability Consortium to build a health information network proposed by the Department of Health and Human Services (HHS). The network is the first step in moving from paper to electronic patient records and sharing health data between doctors, researchers, insurers and hospitals. Mirrors at IHT and CNet News.com with additional coverage at IDG/ComputerWorld Australia."
Microsoft, IBM, Intel, Oracle, Accenture, Cisco, Hewlett-Packard and Computer Sciences have formed the Interoperability Consortium
This part of the summary (lifted from the article, apparently) mentions "Computer Sciences"; the company is actually Computer Sciences Corporation.
As an aside, the printer-friendly (i.e. less cluttered) version of the CNet link is here.
I want to drag this out as long as possible. Bring me my protractor.
5-10 years? You're being too kind. As of when I left Terre Haute Medlab in the late 90s/early 00s (I forget exactly when), they were still required to transmit their data via bisync modem. It was one of those "We could have saved a lot of money just by burning CDs and driving them a couple hours away if they had allowed us" situations.
But yeah, the paper situation really needs to be resolved. A site that I know from my current job is looking into a system where interviewers conducting research on patients will use tablet pcs with the forms on them. The data is automatically entered from the digital forms into the database, where it can be shared cross site with appropriate access restrictions. No need to have two people enter the data to insure data entry correctness, or anything like that (although you may still want two raters).
Back at Terre Haute Medlab, they had an office of a dozen or so people whose job it was simply to type in to the system printouts of records spit out from a different system. In short, the data was going from the doctor and the patient, to paper records, to a digital record, to a printed record, to a digital record again, which was then transmitted via bisync, often multiple times if there was an error in the batch, each transmission taking overnight... oy, it was just a complete mess.
If you wonder why healthcare costs are so much in the US, you have to at least consider things like this a contributing factor.
People said I was dumb, but I proved them.
I've been following this story for some time now. For me, the cool thing about this quasi-open-source project is that it will be built using source code that was released to the public thanks to the US FOIA (Freedom of Information Act).
This software was built years ago by the Department of Veterans Affairs for its hospitals and clinics. Similar commercial software is easily sold for over US$1 Million. I would love to see more software developed by the US government with taxpayer money released into the public so that the open source community can benefit. If you know of any government software that could be useful, file a FOIA request! (Assuming of course that it does not violate national security, yada, yada.)
For more info on this software and other open source stuff going on in the healthcare world, see these links:
Personally I think the main reason is the malpractice insurance that docs have to pay.
This is certainly part of the problem. Let me give you an example: My mother (a physician), used to love delivering her patients babies. It was one of the high points of her practice. Then one day, we were going over her budget for the practice and we discovered to our horror that every baby she delivered was costing her $200 because of insurance and other costs. Note: she has never been sued either. So, we made the business decision to stop delivering babies. But here is the real galling thing: She has to maintain an insurance trailer that goes down a little every year, until the last baby she delivered turns 21!. Is it any wonder they tried to discourage me from going into medicine? Is it any wonder that physicians are abandoning medical practices left and right in this country? There are also other regulatory issues physicians have to deal with that would boggle the mind. No other business in the US has to deal with these issues to the degree that physicians do.
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It's not just the doctors... it seems to me that many healthcare providers (doctors, pharmacists, nurses, etc.) don't like having their workflows messed with. It is much quicker and easier for any of the above mentioned professions to pull a pen out of their pocket and scribble something on a piece of paper in a chart than it is to find a workstation, log in, and then several mouse clicks later, finally be at a screen where you can type in your note, click on your orders, etc.
:) But, the reality is that it often takes longer to compose your patient documentation on a computer than with pen and paper.
The problem with most EMR (electronic medical record) systems that I have seen is that on the front end, they don't end up saving you any time. The actual data entry into a computer will frequently take more time to enter than if you had scribbled it in a paper chart.
Where you really reap the benefits is more on the "back end" of the process through electronic processing of orders - potentially reducing errors, improved billing/payment procedures, data analysis/mining that can be used to identify quality improvement opportunities (such as improved utilization of resources or decreasing infection rates), etc.
In my experience as a nurse, there is some limited benefit on the "front end" for when you're giving patient care such as lab alerts; graphs showing trends of lab values, vital signs, etc.; and being able to actually read the physician's notes!
Adding to this problem is issue that the healthcare industry keeps asking the providers to "do more with less", but then they want to introduce some computer systems that take more time to use.
There are other issues such as the nursing shortage, the fact that the average age of a nruse is in the mid-40's, and that the aging baby boomer population will soon start to place a crushing load on the healthcare industry as they begin experiencing the onset of chronic disease such as hypertension, heart disease, diabetes, etc.
Also, I have been involved with healthcare information systems for the past several year, and the user interfaces and system configuration tools need a LOT of work! You can put all the nifty infrastructure in place that you want, but if you can't configure an acceptable, efficient workflow and user interface for the user, the system will either fail miserably or be poorly/inappropriately utilized.