Two technology associations in healthcare have taken on the task of prime mover in the lagging effort to integrate various incompatible forms of information systems.
The initiative, called Integrating the Healthcare Enterprise, seeks to work out technical problems, which, for example, prevent caregivers from using the same computer to view diagnostic images and related clinical reports.
The project also integrates the efforts of the Healthcare Information and Management Systems Society and the Radiological Society of North America -- two giants in technological realms that up to now have not overlapped.
Both associations sponsor annual conferences that can be staged only at the nation's biggest convention venues. Last week's HIMSS convention in Orlando, Fla., drew 20,000 attendees. The most recent RSNA convention, in Chicago last December, attracted 65,000 people.
Those conferences will become the forums for demonstrating integration progress during the next several years, says Robert Greenes, M.D., a member of the RSNA electronic communications committee.
"We hope to show that compatible linkages between healthcare information systems, imaging and other health information resources are feasible by conducting demonstrations of the technology at future meetings of RSNA and HIMSS," says Greenes, a professor of radiology at Harvard Medical School, professor of health science and technology at the Massachusetts Institute of Technology and director of the decision system group at Brigham and Women's Hospital, Boston.
Greenes says "relatively modest" progress toward integration of image access and clinical report access is anticipated at the next RSNA conference late this year.
The conference will begin a phased series of increasing connection capability and system integration. The series will be handed off to the HIMSS conference next year and continue to bounce between the two venues, he says.
Beginning in 1992, RSNA promoted a single standard within the radiology field for transferring medical images among computers. The association used tactics such as encouraging imaging vendors to demonstrate the technology in action on the convention floor.
Greenes says the imaging standard, called DICOM, since has gained widespread acceptance among equipment manufacturers, radiologists and other healthcare professionals.
The RSNA convention might adopt the same strategy with the new IHE initiative, possibly by expanding a dedicated area for noncommercial demonstration of industry innovations, Greenes says. Called InfoRad, the "meeting within a meeting" now occupies about 60,000 square feet of space, he says.
To promote the initiative at the HIMSS convention, the association might set up the demonstration area to be similar to one used by the Department of Defense for military information technology breakthroughs during the past two years, says John Page, HIMSS executive director.
At that point, HIMSS would publish the test set of standards established, so any information systems vendor could participate, he says.
The standards then could be commercialized within months, Greenes adds.
The initiative's goal is not to invent new technical standards but to accelerate the meshing of existing ones. A number of standard-setting efforts are under way, Page says, but "there's no galvanizing force getting them to converge."
The two associations will solicit the participation of existing standard-setting organizations as well as vendors, other trade organizations, healthcare information system managers and groups promoting medical uses of computers, or clinical informatics, Page says.
If IHE standards are accepted to the point that customers demand systems that comply, acceptance by the healthcare information systems industry will follow, he says.
In the meantime, physicians and nurses will have to go back and forth between computer systems that are incompatible or not linked, says Cynthia Spurr, corporate director of clinical systems management at Partners HealthCare System in Boston and president of HIMSS.
"For example, users have to go to one place to see the written report of an X-ray examination and another place to see the X-ray itself," Spurr says. "Through this partnership, HIMSS and RSNA are exploring ways to link these repositories of information, improve access to important medical data and optimize patient care."
Integration of medical information also could improve security and protect the confidentiality of patient information, Spurr says. "Providing linkage between existing information systems can reduce the number of hands through which information must pass to get to the decisionmakers," she says.
"It also is easier to build security measures, such as passwords and audit trails, into an electronic system that has one access point," Spurr adds, "so that authorized access is monitored and unauthorized access to medical records is curtailed."