Transformation of healthcare's computer underpinnings is a risky business, with many years separating a reasonable premise from a reasonable return on investment.
The federal government, saying it recognizes that risk and potential reward to the economy, has given 16 healthcare information-technology projects a total of nearly $70 million to help tide them over.
The grants from the U.S. Commerce Department's National Institute of Standards and Technology will be matched by approximately the same amount of money from a range of businesses, public-sector agencies and healthcare providers that are locking arms to push the pace of computer integration.
Two of those projects account for about $30 million of the grant total and take a comprehensive view of simplifying the task of transferring healthcare data.
Other projects are tackling:
The integration of stand-alone computer systems to combine data-collection potential and make information transfer workable.
The implementation of medical practice guidelines to make them practical and tie them to treatment cost data.
The reorientation of computer emphasis away from managing sites and toward tracking patients throughout a diverse network and through an episode of illness.
The NIST cash infusion is the Commerce Department's second wave of healthcare funding within a month. It follows the $3.5 million ripple of funding by the National Telecommunications and Information Administration, another Commerce agency, to improve regional data transmission (Nov. 7, p. 68).
A spokesman for the NIST's Advanced Technology Program said the purpose of the grants is to develop innovative technologies that involve high risk for investors but have the potential to make a strong impact on the U.S. economy. The program, in partnership with industry, aims to accelerate promising projects that otherwise would be stalled.
HOST Consortium.A project launched by more than 30 organizations in healthcare delivery and technology is really four projects in one. Each is coordinated and underwritten by a major sponsor. Results of the four efforts will be run through a central "open systems laboratory" that will provide common research-and-development services and ensure that the resulting solutions mesh.
Convened by the South Carolina Research Authority, the Healthcare Open Systems and Trials Consortium proposes to:
Devise "effortless" technologies to simplify adoption of modern commerce technologies by small healthcare organizations. Task leader is General Electric Information Services.
Develop technologies and tools to support the use of remote and distributed clinical databases, plus vocabulary-translation computer tools to capture and use clinical data in medical information systems. Task leader is Coleman Research Corp.
Develop tools to analyze business processes and work flow in multiple-site healthcare enterprises. Task leader is Microelectronics and Computer Technology Corp.
Develop tools and procedures for creating bases of medical-specialty knowledge, plus software components that allow providers to design custom interfaces for recording clinical data. Task leader is TransQuick.
Each project developer will be paired with a healthcare site for immediate assessment of the work, said a spokeswoman for the American Hospital Association, one of the 35 sponsors.
The NIST grant is expected to be about $16 million, with an equal amount raised by the four project leaders, the AHA spokeswoman said.
Health Informatics Initiative.The C.
Everett Koop Institute has assembled a coalition of 14 companies and institutions with expertise in healthcare, information technology and business re-engineering. Their task is to analyze healthcare from the broad perspective of modern information management, and to make the best use of the Internet and other electronic data transfer structures.
The Hanover, N.H.-based institute expects to get $15.4 million from the NIST program. Total estimated cost is $30.1 million.
Connecting information systems.Two
projects aim to tie together the fragments of an electronic patient record that are now dispersed among multiple information systems unable to communicate with one another.
A venture led by First Data Corp.'s health systems group proposes to create a "virtual computer-based patient record" using computer-to-computer access innovations, data-security features and data-integration tools to combine information from all the original patient record systems in a health network. The NIST will contribute $4.8 million toward the $9.7 million project cost.
A $9 million project by 3M Co. seeks to develop a common medical data "dictionary" to tag and retrieve all medical information in a collection of computer systems making up the health network's store of data. The NIST has pledged $1.9 million.
Medical practice guidelines.Three separate projects propose to help track clinical costs and identify the best ways to treat conditions.
The 3M Co. and Solon Consulting Group plan to create a software package to group patient treatment into episodes of care, which will help administrators estimate costs more accurately.
Cerner Corp. will develop information tools to automate, validate and distribute clinical practice guidelines for mass use-by transferring written guidelines to "expert" systems and packaging them for wide distribution to a variety of information systems.
American Healthware Systems will use Columbia-Presbyterian Medical Center in New York as a test site for automating care plans so they're convenient for physicians and can be easily tailored to individual patients.
Redefining caregiver roles.A venture consisting of Health Data Sciences Corp., the New York City Health and Hospitals Corp., and the consulting firm of Arthur D. Little proposes to replace an unconnected group of department-centered data systems with an integrated system centered on patients moving through the system.