Side Benefits

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The health care industry has been slow to comply with new federal requirements for the electronic exchange of medical data. So how did one cooperative find a way to comply—four years ago?

Side Benefits

Besides seemingly solving the security issues of health care networks, Halamka also found a way for hospitals to live with one of the hottest of hot-button privacy issues—the so-called "Unique Patient Identifier," or UPI.

An obscure section of the HIPAA law mandated the assignment of a unique identifying number for every patient served by a HIPAA-compliant medical entity. But several conservative members of Congress believed that a single number that tracked nearly every American's medical hitory, cradle to grave, had a distinctly Orwellian scent about it.

But Halamka saw a UPI as a key element in providing comprehensive health care for CareGroup's patients. "A UPI is a good idea because it allows us to do a virtual consolidation of medical records that may be spread all over a system," Halamka says. "So, I spent over $1 million at CareGroup to develop our own patient identifier for every CareGroup patient."

The software developed by Halamka and his programmers at CareGroup enables any doctor, clinic or hospital within the CareGroup family to locate the patient's medical file with as little information as their name. "So, if one of our patients has a heart attack at a shopping mall 25 miles from the hospital that normally serves him, our system can find his file," Halamka says.

Halamka says if a patient gets care anywhere within the CareGroup system, the system clusters all those medical records under a single UPI—even though each hospital may still use its own proprietary numbering system.

Sharing patient data can also prove a health benefit to all patients. To prove the point, Halamka used the NEHEN network to establish an early warning system within days of the news that someone had sent anthrax-tainted letters through the postal system.

"I contacted the members and said, 'Look, since we have this infrastructure in place, how about branching beyond claims and eligibility and referrals?' " Halamka recalls. "How about we use our standards and infrastructure to exchange and aggregate health surveillance data on bioterrorism?"

Every day, each hospital would transmit a ZIP code-based count of emergency room visits. This would provide a daily snapshot so that if suddenly there were a 20% spike in emergency room visits in Watertown, Mass., an alarm would go off.

It took one week to build and deploy such a "regional bioterrorism surveillance network" because of the napkin network's infrastructure, already in place and in use.

Stephen P. Pizzo has written for Forbes SAP, The New York Times, The Washington Post and Mother Jones. He is the author of Inside Job: The Looting of America's Savings and Loans (McGraw-Hill, 1989).

This article was originally published on 2002-02-04
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