A grand vision to build a regionwide electronic data-transfer network in metropolitan Chicago is being scaled back to line up better with the current needs of provider organizations.
Conceived as a way to connect the information systems of a range of healthcare-related players, the Metropolitan Chicago Community Health Information Network was proposing something that didn't exist when it began organizing in 1994.
But within a year of its official launch early in 1995, "we found out the market is moving so fast that it moved right past where we were aiming," said Harold Jensen, M.D., chairman of the MCCHIN board and vice president of medical affairs at Ingalls Medical Center in suburban Harvey.
The CHIN late last month decided to regroup, disbanding a not-for-profit operating company formed to test and market a set of technologies and services that was in development for about 18 months (March 4, p. 12). Daily operations and implementation were turned over to the ChinAlliance, an eight-vendor coalition hired to build and sell the data-transfer network.
"The project is not dead. It is very much alive," Jensen said. But he added, "It is truly on another course than we visualized."
What the CHIN company found was that healthcare networks were primarily concerned with developing smaller-scale CHIN-like connections covering just the facilities and physician affiliations of their regional lineup.
Those were the same types of technologies and services MCCHIN was developing for internetwork data transfer. On the positive side, the products it was testing could fill either regional or corporate needs. But a number of fast-moving corporations weren't waiting for the CHIN's efforts to mature, Jensen said. They were going ahead with other newly available software and technology.
And once the individual networks finished their connection work, they'd already have most of what they need to send data from network to network. "By the time we had our machine ready, people were already doing something else down the street that they had cobbled together," Jensen said.
At the other extreme, a number of hospitals, physician practices and other potential customers were poorly prepared to participate in the CHIN because their "rudimentary" base of information systems was not able to accept the sophisticated requirements for exchanging data, Jensen said.
That barrier became apparent during presentations to prospective participants, said Michael Kreitzer, a representative of the ChinAlliance's systems integration partner, Coopers & Lybrand. Many organizations weren't yet equipped to exchange data within their own operations, he said.
"We should have recognized that sooner, and we hope to be able to apply the ChinAlliance products and services to help them in their CHIN readiness," Kreitzer said.
Instead of creating a separate electronic network, the CHIN's progress may hinge on getting healthcare organizations and other potential customers such as insurers to create the internal networks that serve their own needs. Then the CHIN can provide a means to get data to and from those new networks, and by then it would have the software targeted as most useful to customers, he said.
The need to make data available to all healthcare organizations and community-minded interests will still be there, Jensen said, and it's up to the MCCHIN board to keep that goal in mind as organizations go about their internal buildup.
Jensen said the regional initiative will remain an advocate of the moral obligation to patients and the public to exchange data outside individual health systems. "The community health information network is the right thing to do," he said. "The way we went about it was wrong."
Part of the problem with the CHIN's focus couldn't be foreseen, he said. For example, the Internet went from "a blip on the screen" to a viable vehicle for regional data transfer in just one year.
The Chicago initiative's revised strategy now lines up with the tack taken by another developing CHIN effort sponsored by the Massachusetts Health Data Consortium (Jan. 1, p. 52).
The regional affiliation of 16 provider and managed-care organizations is working to forge a consensus on critical decisions that go into the construction of internal data networks. The results of four consensus efforts on emergency medicine data, patient confidentiality, eligibility for insurance benefits and common identification of provider locations will be unveiled March 28.