Medical errors and cost concerns push new data management models

Partnerships and alliances abound at HIMSS meeting

Processes and services, not systems, were all the buzz at the annual meeting of the Health Information Management and Systems Society (HIMSS) in Dallas last week. From the IHE (Integrating the Healthcare Enterprise) demonstrations to the plethora of dot.coms and application service providers on the show floor, the emphasis throughout the five-day meeting seemed to be to convince healthcare providers, hospital CIOs, and potential partners that the new Internet-based data-management tools and models can overcome the remaining barriers to information sharing and achieve true systems integration.

Many of these discussions centered around the potential for ASPs to drastically reduce capital-equipment costs and stimulate the adoption of electronic medical records and other clinical information systems. The idea is that by focusing more on workflow processes than hardware solutions and offering healthcare providers a less expensive, more modular way to access, transfer, manage, store, and analyze electronic data, they will be more inclined to invest in the technology and adjust to a new way of practicing medicine—one that eliminates the need for paper and film.

Thus, in addition to the numerous dot.com ventures launched at the HIMSS show, virtually all the major modality and systems vendors are now hawking ASP models as well. These companies include GE Medical, Siemens, Philips, Cerner, Dynamic Healthcare, ADAC, and Lernout & Hauspie. Several EMR vendors are now taking an online approach also, including Data Critical, QuadraMed (see p. 5), and MedicaLogic (HNN 4/5/00).

Despite the industry’s apparent commitment to ASPs, however, there are concerns that end users may not be so quick to respond. In addition to ongoing questions about security and patient privacy, it is not clear whether most CIOs will ultimately be willing to give up control of their organization’s data, no matter how much money it may save them. It is also not clear whether the ASP model will prove financially viable, especially for vendors. Most agree that it will be at least another six months before they begin to see any returns.

In the meantime, many companies are leveraging last November’s Institute of Medicine report on medical errors as validation of the need for new clinical workflow products, particularly those that offer decision support and data capture and analysis at the point of care. The IOM reported that tens of thousands of patients die each year in the U.S. as a result of medical mistakes that occur after they are admitted to a hospital, and that even more are injured to some degree by the treatment they receive in hospitals. The report stressed the need for new systems to prevent, detect, and minimize hazards and the potential for errors, and recommended that all hospitals and healthcare organizations adopt proven medication safety practices, such as computerized drug ordering systems.

This was music to the ears of companies offering EMRs, clinical information and documentation systems, and the various wireless point-of-care tools just coming onto the market. In the latter category, many vendors are initially targeting electronic prescription ordering with personal digital assistant (PDA) devices and applications that run on the Palm or Windows CE platform (or both).

Security-oriented products and services developed in response to the pending HIPAA (the Health Insurance Portability and Accountability Act) regulations were also big news at the HIMSS meeting. While some vendors and end users are apprehensive about HIPAA’s potential to turn into another Y2K phenomenon that bogs down sales and installations of HIS, RIS, PACS, EMRs, and related products for the next two years, others see it as the systems integration jumpstart the healthcare industry has needed for some time. By forcing healthcare organizations to adhere to a federal set of standards with regard to electronic data sharing, the government is in essence requiring them to ensure that all their disparate systems adequately and appropriately communicate with one another.

It is also worth noting that, at a conference best known for large-scale information systems outside of the clinical environment, there were more PACS and clinical image-management companies than ever before, and reportedly more interest in their products. Some vendors believe this new enthusiasm stems from IHE and related systems-integration efforts, while others point to new marketing strategies that emphasize the scalability and modality-specific capabilities of their PACS products. The new ASP models being offered by many PACS and EMR vendors also appear to be stimulating interest among end users, especially smaller organizations that previously have balked at the capital equipment costs associated with traditional PACS installations.

HIMSS 2000 also hosted a flurry of new partnerships and product strategies. With many companies refocusing product development and marketing efforts on their core competencies, along with the continued emphasis on standards development and systems integration, vendors are joining forces in related technology and market niches to offer their customers more turnkey products and services and, in some cases, create an Internet presence. Among the new relationships announced at the show were:

• A strategic partnership between StorComm and SwissRay whereby StorComm will market SwissRay’s digital x-ray products and SwissRay gains access to StorComm’s image management software;
• The merger of Neoforma.com, Eclipsys, and Healthvision, with the new company retaining the Healthvision name and focusing on e-health products and services for clinical, financial, and supply-chain applications;
• A partnership between Philips Medical Systems’ Integrated Clinical Solutions group and Force 3, a network integrator with nearly 10 years’ experience in military healthcare installations worldwide, to enhance Philips’ PACS installations and sales;
• An alliance between Mesite and Speech Machines to make medical transcription services available over the Internet;
• A merger between A4 Health Systems and Nine Rivers Technology to facilitate the introduction of new integrated desktop EMR systems for ambulatory and acute-care environments;
• A strategic alliance between Cerner and DoctorQuality.com to provide new online products that reduce medical errors;
• A co-marketing agreement between Axolotl (formerly AccentHealth) and iPhysician Net to provide Web-based clinical messaging on a common platform to physicians’ offices;
• A joint effort between Computer Sciences Corporation (CSC) and Software Technologies Corp. (STC) to provide healthcare payers and providers with an integrated, Web-enabled approach to complying with the HIPAA guidelines.

A more detailed summary of the products, services, and vendors at HIMSS 2000 will appear in the May 3 issue of HNN, including an overview of the IHE demonstration.

© 2000 Miller Freeman, Inc., a United News & Media company.

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