The regional healthcare intranet in Dayton, Ohio, patches physician offices into the information systems of a half-dozen area hospitals. It connects with the mainframe computer of Anthem, the Blue Cross and Blue Shield plan in that part of Ohio, and makes access to commercial health plans available through a link from healthcare portal WebMD.
There's more. A recent expansion pulls patient demographic and billing data from hospital business offices via an Internet-style application from IBM called HDN. Secure e-mail lets doctors throughout the region exchange private thoughts, but the intranet also allows public Internet access.
In a lot of markets, such advancement would be a dream come true. But as participating providers get accustomed to the available levels of service, a climate of higher expectations is enveloping the Greater Dayton Area Health Information Network. Now that clinicians have the access, they're asking to get it better and faster.
It's a constant challenge to stay on the cutting edge of technology, says Joseph Krella, president of the GDAHIN and its sponsoring organization, the Greater Dayton Area Hospital Association. The latest goal is to increase the speed and ease of the intranet so doctors and their office employees will embrace its use as routine.
"The connectivity isn't what I would consider ideal," says Paul Jones, chief information officer of Premier Health Partners, a two-hospital system in Dayton. Physicians can connect from their offices or from home, but they have to use a modem. In just a few years, that's become too slow for their expectations, he says.
Even though doctors would have to wait as long as a day to get the same reports by fax or regular mail, "they're not willing to wait a minute for it electronically," Jones says. The difference: Clinicians could be doing something else while waiting for information the old-fashioned way, but waiting for something online gives them a sense that they're wasting time, he says.
Robert Barker, M.D., describes himself as "a technology buff to some extent," eager to try things and keep the services that make his practice more efficient. An early user of HDN, Barker says its ability to extract administrative information from Kettering (Ohio) Medical Center, where he sees a large number of patients as a critical-care specialist, is a big advantage. The application saves time for his office staff, though Barker calls the HDN response time "a little slow."
The GDAHIN is racing to remedy the connection-speed problem by striking a deal with a provider of high-speed service, Krella says. An agreement with Darwin Networks, a Louisville, Ky.-based communications company, will make high-capacity digital subscriber line service available to physician offices through regular telephone lines.
Jones says the introduction of DSL makes high-speed Internet service affordable -- $39 to $49 per month including Internet access. And unlike dial-up modem connections, which are on-again, off-again during the workday, the upgraded service is a continuous, all-day connection, he says.
But that higher capacity -- the ability to send hefty files up to 100 times as fast as the fastest modemÃonly gets users thinking about other things they want that are suddenly within reach.
Barker is enthused but also frustrated about Kettering's initiative to digitize all X-rays using Internet technology, which would make them more widely available instead of restricted to special computer workstations -- as long as network lines are brawny enough to carry the huge files, and quick enough to suit busy doctors.
The private intranet established within the Kettering healthcare system does the job, and it's accessible through the regional intranet to authorized clinicians. But even at the fastest modem speed it's impractical for GDAHIN users to download images from locations outside the Kettering network, Barker says. All that changes with DSL service. "The new link they've set up with Darwin is a huge benefit," he says.
GDAHIN participants also see new levels of benefit in the eventual regional deployment of the HDN application because of its potential to make patient information routinely accessible to physicians. Combined with budding plans to use hand-held computers to access the regional intranet, "Physicians could go into a hospital and retrieve information as they walk in the door," Jones says.
If access were independent from wired computers, the envisioned wireless option would free doctors to get the data they want wherever they want -- from the physicians' lounge, for example. "These are the types of projects that can leverage the GDAHIN to make it beyond what it is today," Jones says.