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Health Care in Search of Connections

Health care providers and the patients they serve have an ever-growing appetite for health care IT. So it's no wonder that vendors are anxious to jump into the breach with systems that can help satisfy this need and, in the process, fix what most people agree is a dysfunctional system.

The Department of Health and Human Services (HHS) announced plans to issue a request for proposals to begin building out what the department hopes will be a national health information network connecting health service providers, government health systems and eventually consumers of health care.

The goal is for every health care organization and provider to adopt electronic health records that are interoperable with one another, "so information can be accessed and appropriately shared" within five years, HHS Secretary Mike Leavitt has said in numerous stump speeches across the country.

HHS is also pushing states to create regional health information organizations (RHIOs) and encouraging health care providers to adopt more transparent pricing structures to help reduce cost and improve value to health care consumers.

And speaking of consumers, 65 percent of U.S. residents are interested in accessing their own personal health information electronically, according to a study by the Markle Foundation released in November. And while 80 percent have privacy concerns about this, 90 percent also said they believe they can use the Internet to gain more control over their health care.

Another study, this one sponsored by Cisco Systems , shows how far health care has to go. According to this survey, 62 percent of Americans said their doctors don't offer Internet-based tools for communicating or sharing information. Forty-five percent said they would like to be able to e-mail their doctors, but only 11 percent said their doctors are available via e-mail.

Although 34 percent said they would like to be able to access lab results via a secure Web site, only 7 percent said they had that option.

This is the kind of thing that may have prompted Leavitt to note, in remarks he made to the Detroit Economic Club in late January, that the U.S. doesn't "actually have a health care system" in place. This lack of systematization "is a critical part of the cost problem."

Leavitt's answer to the problem is competition, which he says will provide the momentum needed to create a truly interconnected system. And just as in the 1992 election cycle, candidates to the White House are beginning to flesh out other ideas to make health care more affordable to individuals and less costly to society.

But the vendors aren't waiting for policymakers to make up their minds. Instead they're taking their cue from public demand.

Cisco Systems is one such vendor looking to improve health care access to patients.

The company is trying to extend the reach of the network through secure wireless communications so that elderly and chronically ill patients can receive care without having to leave their homes, significantly reducing costs.

"We want to solve real, immediate problems, and we can improve care delivery now in ways that don't require changes in how health care is paid for," said Jeff Rideout, vice president of health care, chief medical director and the Internet business solutions group at Cisco,

Rideout's group is focused on creating what he called a "medical-grade network" to support interoperability and communications.

"If the infrastructure and networks aren't designed to support those transactions, you'll have trouble doing what you want to do," he told internetnews.com.

Another initiative involves the use of IP-based telephony to support video call centers staffed by medical professionals that patients can use to get information and some forms of treatment remotely.

Rideout and others have noted that we can take a significant bite out of health care costs by reducing patient travel and time spent in hospitals, clinics and doctors' offices.

Accenture, which led one of the consortiums demonstrating network interoperability, is looking at another element of the network, and that is the data flowing across it.

According to Garret Wu, a partner with Accenture's federal government group, health care providers such as hospitals and private practices all have different ways of encoding information. So even if the data moves smoothly across a network, it may not be understandable by a physician consulting the health record of a patient he or she doesn't know.

Wu said Accenture is developing semantic normalizing applications to standardize terminology "so that physicians can read the health records. If the terminology is consistent, it gives them that extra confidence in the information that they're reading."

Microsoft , which has also made it clear that it intends to be a major player in the health care market, would like to use its huge footprint in the consumer world to connect the network to end users -- in this case, both clinicians and patients.

Chris Sullivan, who is the U.S. director of provider industry health care and life sciences at Microsoft, said that the company is focused on delivering a unified front end that consumers can use to view their health records and practitioners can use to toggle between clinical applications.

He said that Microsoft has already put close to $7 billion in research and development into its connected health framework initiative.