For the American Medical Group Association, the success of ongoing outcomes studies hinges on modifying data-collection instruments.
For the AMGA's computer system, data handling continues successfully until someone tries to modify the data-collection instruments.
So there's a conflict for the Alexandria, Va.-based association, which represents large physician-run medical groups.
In fact, the conflict was enough to crimp efforts to assess how medical groups fared in treating certain conditions, says Reuben Richards, director of research informatics for the AMGA's Outcomes Data Consortia program.
But that was before Internet technology entered the picture. Now the entire computer support network for the program is being retooled for a World Wide Web-based approach that will allow instant revision instead of time-consuming tinkering.
Until now, changes in survey forms forced many participating institutions to update their software and make painstaking programming revisions. That process "slows down the whole project," Richards says.
Programming and reporting complexities also have delayed results, which are crucial to keep clinicians interested and reward them for their participation, he says.
Because of such factors, projects have had to be limited to small sets of measures and cycles of no more than a year, the point when data collection usually bogs down. "It's too bad the technology limits what we can do," Richards says. "It should be the other way around; the technology should enable us, not limit us."
A recent agreement with a clinical management software company and an Internet technology company could grant that wish.
Object Products, a San Francisco-based Internet company, announced in May it would team with Conxion Corp. to offer subscriptions to clinical management software linking a centralized computer server to providers via the Internet.
Last month, Object Products and Pfizer Health Solutions formed an alliance to deliver survey instruments to participants in AMGA outcomes programs. The instruments, combined with Web-based reporting tools, will eliminate the association's dependence on conventional information technology, Richards says.
There's no delay in making revisions, because there's no code to change. The technology also makes the information on clinical benchmarking initiatives available far earlier in the study and more often throughout the evolving investigation, Richards says.
It now takes four to six months to produce the first results. With the nimbleness of adaptable data-collection instruments and immediate outcomes analysis, the association will be able to set up a project in a month, conduct it for six months and be done.