The American Hospital Association last week detailed plans to play a catalyst's role in the standardization of information technology in healthcare, speeding up the glacial pace of progress among many industry groups.
It's part of a larger aim to improve the ability of IT and computerized data to support the AHA's six-pronged agenda for reforming healthcare, said Neil Jesuele, the association's executive vice president of leadership and business development.
Those six areas, if dealt with successfully, can have a dramatic effect on efficient and effective delivery of care, Jesuele said (See chart).
But when the AHA leadership began to chart a course of advocacy and development in each of those areas, "we kept bumping up against the area of information technology," Jesuele told the gathered staff of Modern Healthcare last week.
For example, progress in building a foundation for patient safety depends greatly on supplying access to timely, comprehensive and accurate information, including but not limited to creating an electronic medical record from many sources of healthcare data.
The same computer foundation was just as important in areas such as disaster readiness and facilitating broad access to healthcare services. "Something had to be done about information technology," Jesuele said. "It's at the core of a lot of these areas."
The IT initiative is "not of a commercial nature," said Jesuele, whose duties include developing revenue-boosting services. "It's very pure in its design and intent," he said. "This really has to be kept at that level, because we're asking people to join forces and do what's right for the field."
AHA leaders recognized that there was "not a lot of momentum" behind the use of such technology in healthcare institutions, said Richard Wade, senior vice president of strategic communications.
And a major obstacle appeared to be the lack of industrywide standards for employing IT products and sources of information for similar purposes, he said. That deficiency drove up the cost and undermined the value of applying computer solutions to business problems.
Last July, AHA officials brought together a focus group of providers and vendors with a stake in reaching agreement on standard methods of developing and using software and innovative computer tools, Jesuele said. "We did not meet up with a lot of resistance," he said. "I think the light has gone on that we need to move in a different direction."
The challenges of making products compatible in the industry can be addressed by convening key groups of vendors, providers and leaders of existing standards efforts, Wade said.
Healthcare's standardization challenges are thorny and complex, however, because care delivery consists of a multitude of processes dependent on a wide range of products.
To tackle the barriers of incompatible IT products, healthcare standards advocates have to resolve differences in many product areas rather than focusing on a single obstacle that compromises communication. And attaining standardization in one area of healthcare can create incompatibility in another.
For instance, years of effort among manufacturers of electronic medical images resulted in a breakthrough standard called DICOM. Meanwhile, a group wrestling with the myriad methods of organizing medical data in computer transmissions engineered a swappable standard format called Health Level Seven. But those standards were incompatible with each other, which complicated the objective of making the diagnostic process efficient: Doctors could not see the medical image and radiological interpretation on the same computer screen.
That prompted another round of standards collaboration in 1997, led by the Healthcare Information and Management Systems Society and the Radiological Society of North America. Vendor displays of integrated medical images and radiologists' interpretations were a feature of the RSNA convention exhibit last November in Chicago.
The AHA plans to concentrate first on standards for using scannable bar codes to conclusively identify medical products such as drugs and associate them with the correct patient during treatment.