Health Care Faces Y2k-Scale Challenges

FRAMINGHAM (07/24/2000) - Sometime this year, the federal government is expected to unveil its long-awaited regulations regarding the electronic transmission of health information. And the stakes are high.

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which has yet to be implemented, officials of health care organizations could face fines and possible jail time if they don't adequately safeguard the privacy and security of patient information that is transmitted electronically.

As a result, health care organizations are upgrading their technologies to prepare for the initiative. Ann Sullivan, CIO at Maimonides Medical Center in Brooklyn, N.Y., recently spoke with Computerworld's Julekha Dash about how Maimonides is preparing for HIPAA as well as other technology issues facing health care.

CW: How do you think HIPAA will affect health care?

Sullivan: I'm supportive of the need to protect patient confidentiality and coming up with national standards. I think that the [proposed] regulations went much further than that.

Now my billing vendor is going to have to be able to upgrade their software to enable it to be confidential.

The networks have to be upgraded to do it. The clearinghouse needs to be updated to do it, and the receiving person has to be able to do it. . . . It's as complex as Y2k.

CW: How do you feel about the health care industry's push toward electronic health services?

Sullivan: The potential is so wonderful. No. 1, a patient who goes onto a consumer-oriented Web page such as WebMD can book an appointment at a particular hospital. Physicians can get their [Continuing Medical Education] credits. . . . They can do drug ordering now on PalmPilots.

From a business-to-business perspective, we're electronically transmitting all of our purchase orders with our premier contracts and getting discounts as a result of sending them electronically.

CW: What kind of technology?

Sullivan: We're a partner with WebMD, which we [started] a year ago. They were bringing together [other online health vendors] to enable doctors to help communications with managed care companies.

CW: Some people are skeptical of online health vendors because they think some of these companies won't be around in a few years.

Sullivan: Well, you know, some of the known companies might not be around in a year or two. . . . I hate to tell you how many went out of business when we were working with them. That's before the e-world, so I don't want to blame the e-world.

CW: Some health organizations plan to wait for their existing vendors to develop new technologies rather than take chances on new online health vendors.

Is that wise?

Sullivan: This is a very wonderful point. [A major health care vendor] is looking at migrating their customer base in New York for [a billing] product.

We talked to the [vendor] and we said, "Look, our customers want to look at a [graphical user interface] screen; they want to be able to change things."

They said they're going to redesign the product in seven years. Seven years! So that now has forced us to change our strategy. We've now decided we'll most likely change our front-end registration package and interface it to the back-end billing system.

CW: What are some of your staffing challenges? How do you keep employees?

Sullivan: You try to keep technology advanced and interesting because technology people like to be doing new state-of-the-art things. Just to keep their interest alone is a full-time job. And [we] send people to a lot of training. . . . We've actually been able to help recruit for other departments.

Some of our new residents who came in this year came to Maimonides because they heard about some of our computerized patient records.

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