Few things have impacted the US healthcare industry like the Health
Insurance Portability and Accountability Act (HIPAA). Since it was signed into law in
1996, healthcare providers, payors, and vendors alike have been deeply impacted by
HIPAAs goals, which include ensuring the portability of insurance coverage between
jobs, simplifying the administrative function of receiving and paying for healthcare
services, and protecting the privacy of patient information. To address the last two
points, both Congress and the healthcare industry have agreed that standards for the
electronic exchange of administrative and financial healthcare transactions were needed to
improve the efficiency and effectiveness of the healthcare system as well as to protect
the integrity of information.
Since then, national standards for electronic healthcare transactions have encouraged
electronic commerce in the healthcare industry that will simplify processes and result in
savings by reducing the administrative burdens on providers and payors. Until HIPAA,
healthcare providers and plans that conducted business electronically had to use many
different formats for electronic transactions (about 400 different codes exist for
healthcare claims alone), which often led to confusion and unnecessary delays in
reimbursement. With the national standard for electronic claims and other transactions,
providers can submit the same transaction to any health plan in the United States, and the
plan must accept it. Likewise, health plans can quickly send standard electronic
transactions, such as remittance advice and referral authorizations, to providers. These
national standards are helping to make electronic data interchange a preferable
alternative to paper processing, an outdated process that, for years, has been holding
back the productivity and efficiency of the healthcare industry.
Although these elements of HIPAAespecially those related to health
payorsare very focused on the United States, the issue of standardizing both
clinical and financial healthcare information is one that has gained worldwide prominence,
specifically when talking about developing national health information infrastructures to
reduce medical errors. Electronically connecting providers, payors, pharmacies,
laboratories, and physicians so that complete electronic medical records (EMRs) are
accessible anytime, anywhere could help eliminate errors, increase efficiency, and improve
care in any country. For example, the Institute of Medicine (IOM) estimated in 1999 that
between 44,000 and 98,000 patients in the United States alone die each year due to
preventable medical errors. The group recommended that information technology (IT)
solutions be established to help reduce avoidable mistakes, such as illegible handwriting
and miscommunication. Last year, the US Department of Health and Human Services
commissioned the IOM to design a standardized EMR; this year, President Bush called for
broader implementation of EMRs in his State of the Union address. Given the number of
medical errors that can be prevented, lives that can be saved, and cost savings that could
accrue, the movement toward a standardized EMR has grown strong in the United States and
in developed countries around the world.
Global organizations, such as DICOM, HL7, IHE, and ICD 10, are dedicated to creating
healthcare standards so that information can be communicated electronically without regard
to the IT system used. It is essential that industry leaders, like Siemens Medical
Solutions and others, commit to developing flexible systems that can easily accommodate
the standards of any country.
For example, a standard user interface that provides one common language, look, and
feel for all medical imaging tasks, applications, and systems anywhere in the world (ie, a
Windows for healthcare) could have an enormous impact on improving the quality and
efficiency of care. An obvious benefit would be the reduction in training time for
clinical teams that are often understaffed and have little time to spend learning new
software systems. Imagine a radiologist who must be proficient in multiple software
systems to view results depending on which technology an exam was conducted inCT,
MRI, X-ray, and more. All of these systems might have different commands, icons, and
platforms that can become confusing with an abundance of patients but a shortage of staff.
Its easy to see how much time is wasted deciphering multiple systems and how
diagnosis errors are overlooked. Having a common user interface means less time learning a
variety of software systems and more time focusing on patient care.
Another benefit of a standardized system is the quick access to complete patient
information from anywhere within a hospital, a home office, via a PDA, and the like. This
24/7 access saves time that would otherwise be wasted collecting records, and it leads to
more informed clinical decisions. From a technical perspective, a solution that
standardizes all imaging equipment and IT systems helps radiologists fully leverage the
value of radiological data. A radiology department might have an effective combination of
imaging modalities, but a common platform allows these modalities to communicatean
ability that heightens the sharing of data across modalities and results in a reduced risk
of errors and improved workflow.
The concept of using technology to help improve workflow in healthcare is still new but
has rapidly become a theme in the industry. Healthcare has traditionally lagged behind the
rest of the world when it comes to adopting IT; however, in the past decade, healthcare
has taken cues from the manufacturing and finance industries that are seeing significant
productivity and quality improvements by marrying sound business processes with the right
technology. There are now IT solutions built with a workflow enginea tool used often
in manufacturingto proactively facilitate processes and help ensure that the right
clinical and administrative tasks are completed when they should be. Furthermore, these IT
solutions can be built upon a standard software look and feel, similar to the medical
imaging systems, extending benefits of standardization beyond the radiology department and
into the entire organization.
In this age of increased government involvement in healthcare, the new generation of IT
solutions are designed to help healthcare providers comply with standards regulations,
such as HIPAA, which undoubtedly will lead to faster reimbursements and improved workflow.
But as we all know, technology aloneno matter how well adoptedis useless
without the right processes in place. Process improvements combined with the right
technology solutions will help us realize the ultimate goal of higher quality care and
lower costs in healthcare around the globe.
Tom McCausland is the president and CEO of Siemens Medical Solutions USA (Malvern,
Pa).