Verizon, the largest US telecom, also wants to be the repository of first resort for electronic medical records (EMRs).
EMRs are part of a national government-sanctioned push to get all doctors' offices to digitize patient records. The hope is that, as the EMR effort reaches critical mass, it will begin to drag the healthcare industry out of the dark ages to operate on par with other service industries.
When we get everyone up and running, we'll have 350,00 physicians on the system.
Ardi Kazarian, product manager for the Medical Data Exchange
To accomplish this, Verizon is turning to cloud computing. It had already launched a data storage and distribution service, designed specifically for medical records, called the Verizon Health Information Exchange. It is now building on that offering with the Verizon Medical Data Exchange, a service that hospitals and medical practices, medical office technology vendors and end users can use for HIPAA-compliant tranmission of medical records between medical providers. It's a back-end transmission service used programmatically by existing applications.
But the process is not simple: moving even a moderately sized state-run hospital can take five years or more. A hospital administrator for a Massachusetts state-run mental health facility said her hospital migrated to an EMR system from medical IT services firm Meditech. It was a great improvement over the status quo, save for a crucial hole in the system: the pharmacy is run by subcontractors, and their IT system won't work with the new medical records system.
"The one part of the system that would really help us out, can't be made to work," she said.
The administrator did not want to be identified due to her status as a state employee. Her department still has to fax prescriptions to the pharmacy to get prescriptions filled for patients admitted at the facility, she said. The pharmacy is in the same facility.
Meditech came to install the EMR system but didn't stay long enough to resolve the issues at the pharmacy, which the hospital had no control over. The pharmacy refused to pay for the migration, and the state was out of money. "The consultants took their money and they're long gone," she said.
Can cloud help?
Verizon said its Medical Data Exchange is banking on its cloud capabilities to help sort out messes like these. A Verizon spokeswoman said that, faced with a similar situation, Verizon would sell its online data storage and delivery system as an easier, incremental path to compatibility than on-premise software and data migration; comparable to switching to Gmail instead of replacing Lotus with Exchange, for instance.
The service is designed as a smart data management back end for medical records. EMR systems can plug it in as a replacement for other online transmission systems that are either not secure or hard to secure (like FTP). Verizon is expanding the types of files it takes to include radiology images (up to 5 GB per file) and scientific test results in a variety of formats. The service will then spit them back out into existing medical records and document management systems. That handles HIPAA compliance issues in one fell swoop and claims to do away with the most common and worst imaginable way to communicate medical information these days -- the fax machine.
It's not a 100% kosher cloud service -- Verizon now sells it as a flat fee, all-you-can-eat subscription instead of billing incrementally -- but it is elastic, scalable and self-service by the applications that will use it.
"What we're finding is that most share information via fax or by mail, or even the patient takes the information as a printout or on a CD to the next practice," said Robin Daigh, VP for business development at MD-IT, a medical documentation software company.
MD-IT is partnering with Verizon to deliver the Medical Data Exchange. HIPAA regulations had spooked the medical industry into ignoring online communication in favor of antiquated methods, and the reasoning wasn't always logical, she said.
"The industry has decided that any kind of email transmission is not compliant with HIPAA," she said. Health informatics in general can be a huge mess; every hospital had slightly different ways of doing patient records, which made delivering the correct information a headache.
The one part of the system that would really help us out, can't be made to work.
"One of the biggest challenges is in dealing with structured data because of a lack of standards," she said. Unstructured data, such as raw image or text files, were easier. Daigh said that standards around medical records would shake out as more hospitals saw the value of standardizing and using a cloud-based service. For now, Verizon will support basic Healthcare Information Technology Standards Panel (HITSP) guidelines, and the aim is to add more.
So far, it seems to have met with success. The Verizon Medical Data Exchange is on track to serve one-third of the doctors in the U.S. by Christmas, according to Ardi Kazarian, product manager for the Medical Data Exchange.
"When we get everyone up and running, we'll have 350,000 physicians on the system," she said. "We are right now getting everyone onboarded in our data centers."
The American Medical Association reported in 2006 that there were 921,904 physicians in the U.S. Verizon is far from the only health information exchange (HIE) out there; they're becoming common practice in states now, with Maine having one of the most advanced, and the VA and Medicare are piloting their own projects.
[Ed. note: This story was updated Friday morning with additional information about Verizon's new Medical Data Exchange and existing Health Information Exchange offerings.]
Carl Brooks is the Technology Writer at SearchCloudComputing.com. Contact him at firstname.lastname@example.org.
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