Quantitative and Qualitative Review of the Implementation of a Healthcare Information Network

摘要

The Integrated Medical Systems (IMS) Medical Automated Communications (MEDACOM) Project was initiated between PacifiCare of Texas (PCTX) and the-many associated sites and locations of the delivery and financing of medical care in the city of San Antonio. The network allowed the paperless transfer of information between multiple locations such as hospitals, doctors' offices, and the like. It was also designed to link the locations where care was monitored and assessed, such as health services, and also where eligibility and claims are evaluated. Multiple separate organizations were electronically connected, including PacifiCare. They all are unrelated business entities and are bound together only by contractual agreements to provide services. None wished to allow direct communication to their systems by other corporations. Also, all of the companies have different proprietary software. PacifiCare hoped to link all the corporations electronically through the services of an intermediary corporation. PacifiCare selected the vendor IMS MEDACOM for the initiation of this health data network. The projected benefits from the initiation of this electronic network were all related to the increased speed of transfer and availability of data at the 'user' level. These benefits included: (1) Secure transaction switching and networking from point A to point B, (2) Clinical communication such as referrals and lab data, (3) Payer communication such as claims status information. PacifiCare hoped that by electronically connecting the various healthcare entities, the patients would receive improved care through faster (electronic) referrals, ease of access to patient specific information, and decreased administrative costs. The scope of this healthcare project evaluation is limited to: (1) the appraisal of the financial benefits that accrued to PacifiCare as one of the network sponsors.