Cookova zprava

[Vladimir Vrabec]

Vazeni,
dostal se mi do ruky kanadsky ohlas na "Health Care & Computer Networks -
COOK Report Special Report", ktery shrnuje moznosti uplatneni pocitacovych siti
v medicinske technologii USA, tedy i uplatneni Internetu. Mozna, ze by text
puvodni zpravy s ohlasy mohly zajimat nasi cesnetovskou verejnost. Pripojuji
proto ke kanadskemu dopisu jeste zpravu z COM-PRIV (17 Sep 1993) uvadejici
podrobnosti k puvodni zprave, ktera mela byt publikovana ve 3 castech (rijen,
listopad, prosinec) a stat $250.00. Zdravi
                                                        Vladimir Vrabec

------------------------- Text of forwarded message A --------------------------

>From: x-man at mgcheo.med.uottawa.ca (Michael Pluscauskas)
Subject: Canadian health care applications for the Internet
Date: Mon, 6 Dec 1993 11:53:24

I am currently working as a consultant for Industry Canada, in Ottawa,
examining health care applications for the Internet.  I have read the Report
on Computer Networks and Health Care from Cook Network Consultants and felt
that it identified some areas that I also had thought would be good points of
focus.

These areas included.

1) The use of the Internet (and other high speed communications networks) for
Electronic Data Interchange in medical claims processing.

2) The use of the Internet for processing and transmission of Medical Records.

3) The use of the Internet for the Health Outcomes research.

The report did an excellent job of focussing on what is happening in the US; I
am interested in a Canadian focus, although I would be glad to hear from
anyone who feels they can help.  Because the report was published in September
I would be happy to hear about any new areas of work as well.

Because of the scope of the possible applications for networks in health care
I would very much like to hear from anyone in the Canadian health care field
with an interest in these areas as we are trying to get an expert committee
together to study how these technologies can be applied in Canada.

I will be posting this to a few other listserves and would be happy to forward
a summary of responses to anyone who requests it.

Thanks,

Michael.
---------------------- End of forwarded message A -----------------------------

---------------------- Text of forwarded message B ----------------------------

>From com-priv5-forw at lists.psi.com  Fri Sep 17 00:25:09 1993
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From: cook at path.net (Gordon Cook)
Date: Fri, 17 Sep 1993 00:25:09 GMT
X-Mailer: Mail User's Shell (7.1.1 5/02/90)
To: com-priv at psi.com
Subject:  Health Care & Computer Networks - COOK Report Special Report
          published today
Message-Id:  <9309170025.aa21586 at pandora.sf.ca.us>

The COOK Report on Internet -> NREN announces the publication of a Special
Report titled "COMPUTER NETWORKS AND HEALTH CARE:  A SURVEY OF FOUR GROWTH
AREAS.  IDENTIFICATION OF PLAYERS AND POLICIES THAT COULD GIVE INTERNET
SIGNIFICANT ROLE.

This 20,000 word documented study examines recent developments in:

1. Medical Electronic Data Interchange networking

2. Community Health Information Networks

3. Outcomes Analysis and

4. Computerized Patient Records.

These are areas with the near term potential (less than 5 years) to save 100
billion dollars a year via the development of standards, administrative
reform, and federal leadership in using our existing networking infrastructure
to promote electronic medical commerce.

The report documents what is currently happening in each of these areas.  The
people involved, their businesses and alliances, and early network ventures
are all described.  These are all efforts that can use data networks to make a
meaningful impact on medical costs.  They are contrasted with the high tech
medical applications (such as3-d visualization of tumors) most often promoted
by the backers of NREN and HPCC.  While these showy applications can impress
the politicians, they will leave the current structure of our health care
system unchanged and do nothing to drive down medical costs.

Work being undertaken in the above four areas *will* have an impact on costs.
The extent of this impact will depend in part on the degree to which federal
policy makers promote the US portion of the internet as an existing network
infrastructure that providers and insurers should use in their everyday
commerce.  The record so far is discouraging as private and expensive VANs are
used for medical EDI, and as the Health Care Finance Administration has not
yet been involved with HPCC or FNC or anything else to do with the internet.
Although the 1991 Institute of Medicine Report on the Computerized Patient
Record recommended specific action to involve the CPR Institute with the
development of the NREN, little has happened in this area.

This report summarizes current medical network developments and additional
developments in medical technology that will require networks in order to
succeed.   In addition to a thorough survey of the past year's worth of
published literature, it relies on data with from some network vendors, and on
network discussion from several health care oriented mail lists to identify
what has been done and contrast this with what needs to be done.  It has
developed a **nine point policy agenda for the more effective application of
the Internet to the problems of our health care system.**  The report contains
a resource section giving: the positions of some of the players on standards;
information on how to obtain some of the reports involved; vendor and federal
policy makers names, addresses (snail and electronic); and network listserv
data.  It also has a text box discussion on cost and connectivity
considerations faced by a medical organization thinking of joining the
Internet.

The *complete* report is available *NOW* for $250.00.  It will be published in
3 parts in the October, November, and December issues of the COOK Report

Some quotes:

In 1990, employee healthcare benefit outlays accounted for 62 percent of the
pre-tax profits of the nation's 100 largest corporations.  "By the end of the
century, according to projections, healthcare costs will erode almost three
quarters of US corporate pre-tax profitability. (The bite was a mere 8 percent
in 1960.) That is not a burden docilely to be borne for services whose value
is at best ambiguous."
----------------

"While Ameritech spearheaded WHIN's development and paid for much of the
network, the company also relied on Aurora's 300-physician network in
Wisconsin.  The state sorely needed a unified network: Its fifteen proprietary
networks required doctors to run as many as five computing devices on their
desktops, each linked to a separate telecommunications grid."

-------------------

On an average day in 1968, U.S. hospitals employed 435,100 managers and clerks
to assist in the care of 1,378,000 inpatients . By 1990, the average daily
number of patients had fallen to 853,000; the number of administrators and
clerks had risen to 1,221,600."

--------------

In a report issued last spring, the U.S. Department of Health and Human
Services pegged the savings inherent in electronic claims filing at $5 per
claim.  Nifty numbers, but the "real significance of the deal," Higgins said,
"is that it lays the technological groundwork for a planned private- sector,
statewide 'all-player' network" linking health care providers, payers and
patients of every ilk. Plans to leverage the Maryland Blue system into the
Maryland Health Information Network will go into effect well within the
current year, Higgins said.

----------

John McChesney, president of Integrated Medical Systems, estimates that
hospitals have ''wasted'' $ 500 million creating their own physician-hospital
networks.  ''All the constituents viewed the network as a potential tool for
gaining a sustainable competitive advantage,'' he said. ''But . . . . industry
must support the creation of an ''open'' electronic infrastructure that can
support the equipment used by all participants."  ''Banking learned the hard
way, when each bank had its own system that wouldn't talk to the others,'' Mr.
AKatz said. Proprietary computer equipment is becoming rarer. . . that trend
will help hospitals and physicians when they want to buy equipment to connect
to a network."

------

"In short, the government could have stimulated the development of electronic
medical commerce over the Internet simply by legitimizing in the form of a
requirement that their contractors accept the Internet as a valid mechanism
for data interchange. In doing so, they would have made the incremental cost
of developing services for this community much lower and stimulated the entry
of people into the marketplace."

Sean McLinden
Qouted ----
---------------------- End of forwarded message B -----------------------------