Healthcare alliance VHA has set out to connect a key combination of information systems that together constitute the clinical core of healthcare delivery networks.
The plan hinges on an agreement among five information system companies to create a single integrated package of computerization capable of operating as one system -- passing data freely and allowing healthcare professionals to move from one to the other on a computer screen.
The Irving, Texas-based alliance already has all the participants in the fold under separate business and marketing agreements forged since 1995. That's when VHA began to cast its lot with vendors it deemed the best choice for specific pieces of a vast range of computer capabilities, all needed to capture and coordinate data in a healthcare delivery network.
But healthcare executives are finding that the acquisition of multiple software packages is only half the project, said Dave Miller, VHA's director of integration. The next challenge is to integrate computer applications across the continuum of care that healthcare networks are constructing, not just the inpatient operation.
And though VHA was filling in software niches and striking favorable purchase terms for its 1,500 member organizations, buyers were faced with putting the pieces together through expensive network-integration efforts, Miller said.
Studies also showed that the magnitude of the integration effort has created a strong preference for a single source -- either one vendor or a "general contractor" -- to assume the burden for health-network computerization and offer "one-stop shopping," he said.
VHA is positioning itself for that role by masterminding the cooperation among the five companies in the effort (See chart).
Those ambitions cast VHA as a competitor of industry giant HBO & Co., which has acquired a dozen or more companies in the past several years to fill out its own lineup of software across inpatient, outpatient and contract-management operations of a healthcare organization.
A darling of Wall Street, HBO & Co. has pursued the "one-stop shopping" strategy to the hilt and last year became the first information company in healthcare to exceed $1 billion in revenues.
To make the strategy work, however, HBO also must complete the second half of the project: integrating all the disparate systems it has acquired, said Michael Samols, a healthcare analyst with BankAmerica Robertson Stephens in San Francisco. "We have known for years that this is the risk in their story," he said.
Miller said VHA is angling to compete on the integration promise, adding enough progress is being made to demonstrate a "proof of concept" at a VHA conference in April.
The demonstration will include a cutting-edge technology that synchronizes multiple computer applications to call up patient-specific data simultaneously (See related story, this page).
"HBO talks a lot about doing this, but they haven't made much progress (in integrating products)," Miller said.
That assertion is disputed by Duncan James, vice president of marketing for HBO & Co. He said the company has completed work enabling all its inpatient, ambulatory and care-management systems to "feed" its data repository.
In addition, about 80% of its software systems have been re-engineered to present information on the computer desktop the same way from system to system. And about 90% of its products have been brought into compliance with a standard that allows a user to gain access to all of them by signing onto a computer only once, he said.
A fundamental framework for those integration efforts is a single "data model" governing the way all data is defined and their relationships with all other elements in each product line. James questioned whether VHA could make all its vendor partners conform to the same data model.
"Their challenge will be more significant to integrate their business partners than it is for us to integrate the products and employees that are our own," James said.
But Miller said the alliance is doing only what its members would have to do on their own by choosing from several vendors. And VHA can offer more flexibility to members by giving them the option to buy the complete integrated package or continue to buy systems separately under what's known as the "best of class" procurement philosophy.