Developing a secure healthcare information network on the Internet - Indiana University School of Medicine's Indianapolis Network for Patient Care and Research

Healthcare Financial Management, Jan, 1997 by Steven Calcote

Healthcare professionals across the country are using the Internet for a variety of activities, including the transmission of medical record data via e-mail. The transmission of confidential information, however, is a serious concern of healthcare consumers, providers, and payers alike.

At Indiana University School of Medicine, security on the Internet is no longer a concern. The Internet is, in fact, the heart of a healthcare information network currently in development for the Indianapolis area. A complex set of encryption/decryption algorithms and user identifier and private passwords currently in development should greatly reduce the risk of security breach on the network.

Some EDI experts predict that the Internet could become the dominant mechanism for delivering healthcare-related information in as few as 10 years.

A number of healthcare professionals already are using the Internet in innovative ways. A physician in West Virginia uses Internet standards to transmit medical records within his healthcare organization. A large managed care organization in Minnesota prefers the Internet to other delivery mechanisms as a way to transmit EDI information. And a number of pharmaceutical companies on the West Coast use Internet-based EDI for business-to-business communications.

An interesting use of the Internet and EDI is taking place in Indianapolis, Indiana, where a group of medical information specialists currently is designing a healthcare information network that will test the feasibility of linking care providers across organizational boundaries and measure the benefits of such a network.

The INPCR

Many EDI experts caution against using the Internet to transmit highly confidential EDI information, such as diagnostic test results and laboratory data, recommending, instead, using the Internet to transmit less confidential information, such as eligibility verification and claims submissions. Lack of security on the Internet is the reason given for such caution.

But at Indiana University School of Medicine, security on the Internet is not a concern. In fact, the Internet is the heart of the Indianapolis Network for Patient Care and Research (INPCR), a healthcare information network currently being developed.

INPCR will link a large community medical record system to three hospital emergency departments, 50 community pharmacies, 10 clinics, four HMO offices, and 12 patient care sites for the homeless in Indianapolis. The network will consist of clinical workstations linked to a central clinical data repository that will provide interorganizational access to information resources, enable data retrieval, and permit order entry as well as other services that are currently available through the Indiana University Hospital. The network will supply information and services via a medical library, computerized patient medical record system, and citywide prescription database. Data security will be ensured through a complex set of encryption/decryption algorithms and user identifier and private passwords that confirm a user's identity when he or she enters or retrieves data.

Currently, about 2,000 people (half of them physicians) at the Indiana University Hospital system engage in EDI transmissions via the Internet. Navigation software is located on computers scattered throughout the hospital system, and information such as laboratory data is transferred to and from mainframe computers in the same way data is transported on the Internet at large.

Conclusion

EDI and the Internet hold great potential for communicating vital information among healthcare organizations. Organizations that have avoided exploring the possibilities of the Internet because of security and other concerns should rethink their opposition to the Internet for data transmission.

A growing number of healthcare organizations are developing safe new ways to move data electronically and are pointing the way toward more widespread use of this technology in the healthcare industry.

Steven Calcote is director of new media strategy, ECHO Strategies Group, Inc., Boston, Massachusetts.