The American Medical Group Association is planning to show off the first phase of its long-awaited clinical database at its annual meeting later this month. The pilot will include about 800,000 fully
encrypted patient records that AMGA officials say can be used to advance a host of healthcare cost and quality improvements.
Named Anceta, after the Roman goddess of healing, the ambitious data-warehousing project aims to collect 3 million to 4 million patient records by March 2004. This data will allow for a deeper, more longitudinal understanding of treatment and outcomes history, in addition to operational economics, than can be gleaned from any other electronic catalog, Anceta principals say.
"You'll get a look at a patient that includes primary care, inpatient care and lab and radiology results," says Anceta CEO Kevin Brown.
"As these medical groups install more advanced software-electronic medical records, ICU systems and home healthcare systems-we will be able to pull still more data."
Anceta has completed loading information from one of three multispecialty groups that signed on for the pilot and continues to collect data from the others. The advantage of large medical groups, some integrated with inpatient and other facilities, is the wealth of clinical data available, such as operating room information and pharmaceutical claims records.
Although fundraising has moved slowly, Anceta backers are confident that the critical mass displayed in the pilot will demonstrate the usefulness and feasibility of the project.
Currently, AMGA owns 85% of the private, for-profit company. Aventis Pharmaceuticals and Accenture, the consulting firm that devised the Anceta business plan, are two other equity partners.
"This is the Holy Grail of medicine," says Phil Sarocco, director of health economics and outcomes research at Aventis. "Technology has provided a unique nexus right now. It can integrate what was difficult to do before because of fragmentation. That's where we saw huge potential right from the start."
Medical groups are the most important constituents to satisfy, Brown says, followed by pharmaceutical and medical device manufacturers, where he sees great promise in selling information to expedite clinical trials.
Eventually, Anceta could use the data to provide a range of health information products, through standard and customized reports, to all kinds of healthcare providers and services.
Brown says he is sensitive to the privacy red flags such data sharing raises. Having been criticized in the past about the potential for patient privacy violations, he stresses that Anceta has put tested protections in place.
"Anceta does not receive any fully identified patient data," Brown says. "The identifier of every patient record is encoded and encrypted, and only the medical group holds the key. Anceta, AMGA and any customer of the database will have absolutely no access to any identifying information or the ability to identify any patient. And that will never happen. That is part of our policy."
Another Anceta principle is to protect individual physicians and groups. Brown says only aggregate physician or group data will be provided, and it is up to each medical group to decide how they might use comparison data for benchmarking or measuring individual physician performance.
Anceta hired the Washington, D.C., office of law firm Foley & Lardner to guide it through all HIPAA compliance issues and has compiled a portfolio of policy statements, legal memos and contracts for medical groups to ensure HIPAA privacy compliance.
"There will be no contact between us and the patients, or between the pharmaceutical companies and the patients, without the medical groups' approval and without the medical groups approaching the patients for their approval," Brown says.
Vision of versatile database
Since 1990, Richard Ward, M.D., an MBA and former chief of medical informatics at the Henry Ford Health System in Detroit, has contributed to AMGA research projects involving individual medical groups, tracking hip and knee replacements, diabetes, asthma and other conditions.
"We always thought it would be useful, rather than developing a new infrastructure each time, to . . . develop a database that could be used for many projects," Ward says. "Anceta was really an effort to follow up on that original vision."
Ward's company, Reward Health Services in Windsor, Ontario, is in charge of defining the Anceta data model, which handles information from different medical groups and analyzes aggregate data.
The Institute of Medicine recommends that healthcare move toward computer-based clinical records so data can be used to look at care patterns and assess quality.
Repositories for analysis of practice patterns and accountability are a step in the right direction, says Janet Corrigan, director of the IOM board on healthcare services.
"Every day that goes by that providers do not have access to complete clinical data is another day that medical errors could have been avoided," she says.