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IS departments lead Clinton's health care reform.

While the Clinton Administration has been studying ways to reform U.S. health care, a sweeping restructuring of the industry has already begun, with computers and communications the major agents of change.

At the Wishard Memorial Hospital in Indianapolis, for instance, use of a sophisticated computer network for recording treatments and ordering drugs saves an estimated $900 per patient by encouraging doctors to be more cost-conscious and by reducing mistakes and avoiding unnecessary tests.

Likewise, at the Erie County Medical Center in Buffalo, specialists use a two-way video link to treat and observe the progress of a patient at the rural Cuba Memorial Hospital 85 miles away; while at the Baylor College of Medicine in Houston, a NASA satellite soon will allow surgical consultations between doctors there and patients in countries as remote as Russia, Turkey and Saudi Arabia.

At The Travelers Insurance Co., the extensive use of computer networks and the integration of data, text and voice in its managed care system has helped to ensure that physicians and hospitals provide the right treatment and the right service at the right time and that the care is of higher quality and less expensive.

In these and other instances around the country, networked computers and advanced, wideband communications services help medical professionals deliver better health care for less money.

If the system and techniques used at Wishard Memorial, for example, were applied nationwide, the savings would exceed $30 million, according to researchers who are studying computerized care at the hospital under a federal grant.

"Up to 40% of all hospital costs are related to the generation and storage of information," says the Wishard's Dr. William M. Tierney, "so it makes sense that information technology can improve efficiency."

At Wishard, each ward has a network of three to five IBM-compatible PCs, which are linked to a detailed clinical database. Doctors using the system are encouraged to consider costs when ordering tests and treatment.

First, the system lists the costs of the tests and medication, while alerting the doctors to alternative generic drugs. It also suggests optimum testing intervals and the most cost-effective tests for a patient's medical condition. The system has cut patient bills by more than $3 million in one year, representing a savings of 12.7%, and shortened the length of a stay by 10.5%, or almost a full day.

Since hospitals account for 42% of health care spending, they are sure to be the focus of reform efforts. Some savings will come from mergers and consolidations, and some from the elimination of middle managers and the flattening of organizations. A recent study of the nation's health care will undoubtedly fuel these moves, since it found that administrative costs account for one in every four dollars spent on hospital care.

According to a recent survey of 211 health care CIOs conducted by the Center for Healthcare Information Management, a majority of hospitals will be investing in their networking infrastructure over the next two years. The new cabling, switches and other systems will be needed to handle new applications, such as imaging, and to provide facilities for internetworking LANs and linking multiple sites.

Only 15% of the CIOs surveyed are using teleradiology and remote medical imaging at the moment, but 70% more are either planning, installing or evaluating such technology. Similar levels of interest were found in telemedicine and remote consultation via interactive video links.

Changes in health care are forcing hospital administrators to rethink these networks, which typically link a single hospital with a group of doctors. What's needed today are "community" networks that can link several hospitals with physicians, pharmacies, managed care organizations and local or regional labs.

Some government bodies, such as the State of New York, are helping to launch pilot installations, and a few communications companies have entered the fray. Ameritech has set up the Wisconsin Health Information Network in Milwaukee and plans to create similar networks in 33 other cities around the country, according to the newsletter "National Report on Computers and Health," of Rockville, Md.

Elsewhere, hospitals are working with specialized vendors, such as Integrated Medical Systems (IMS) of Golden, Colo., to create community-wide information networks. IMS hopes to have 50 networks in place by year's end, up from 14 a year ago.

Another highly touted money-saver is Electronic Data Interchange, or EDI, which is expected to cut costs by replacing paper claims and other paperwork with electronic transactions. Based on its study of EDI pilots, the Timber Group, Chicago, estimates that EDI can save the health care industry about $4.7 billion annually.

Data communications consultant Morris Edwards serves as program chairman of the Network Computing Solutions Conference and Expo (NetCom), which will be held at the Radisson Centre in Miami, March 8 10, 1994.
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Title Annotation:information systems
Author:Edwards, Morris
Publication:Communications News
Article Type:Column
Date:Oct 1, 1993
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