A computer link between physicians and their hospital is considered essential to a successful information network, and a significant number of hospitals already are testing the connection.
That's a principal finding of a survey investigating the climate for community health information networks. It was conducted by a new association formed to support their formation.
Of the 133 hospitals responding, 57% said they had a computer link with physicians' offices. Four in five respondents with such links reported that their systems were able to transmit lab results, patient demographics, and admission and discharge information.
Of those that had no link, 29% said they plan to add a tie-in to physicians' offices.
There was a 9% response rate on 1,500 questionnaires mailed to hospitals with 200 beds or more, facilities that the association considers large enough to support network formation.
"The hospital-physician link is at least on the minds of all our hospitals," said Pamela Hanlon, president and executive director of the Atlanta-based Community Medical Network Society.
A closer look at operating hospital-physician links, however, showed that they have a long way to go before they're comprehensive enough for a health information network's requirements.
Nearly 50% of the hospitals had fewer than 25 physicians linked to them, a fraction of the average medical staff of about 350 physicians, Ms. Hanlon said. It's clear hospitals have been forming links only with those physicians who provide the bulk of admissions instead of wiring all clinicians for transferring information.
Only 30% of the existing links offered two-way communication between physician and hospital, which is critical to the foundation of a community network, she said.
Much of the existing framework, however, dates to a time when hospitals were competing to fill beds, and "they needed to own and control the admitting process," Ms. Hanlon said. Now, the focus has changed, as hospital executives realize they must bring physicians in as partners and make them more effective in an integrated environment, she said.
The importance of enlisting physicians first in the network stems from the key strategic objectives identified by respondents. Satisfying the medical staff, responding to managed competition and dealing with case management and quality issues were named the top three challenges.
Asked how they would meet those challenges, 94% of respondents agreed that improving communication among physicians for clinical and referral purposes was an important objective. And 90% agreed that using outcome measurements to evaluate quality and performance was important.
"You've got to take care of physician connections, or outcomes (measurement) won't even exist," Ms. Hanlon said.
But a major issue among providers continues to be a clearly defined cost benefit, mentioned by 90% of the survey respondents.
"If there's not some type of cost-benefit analysis completed, then the resources are pulled from the project and put somewhere else, and the project fails," Ms. Hanlon said. If an effort to link physicians stalls after tying together a handful of offices, results of the efforts won't be evident, and it will be easy for competing factions to say the effort isn't justified, she said.