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Information Week

Web Initiatives Satisfy All Customers

By Karen D. Schwartz
September 11, 2000
URL: http://www.informa tionweek.com/803/healthcar2.htm

ohn Halamka is a man who needs very little sleep--a useful skill he developed during his years as a medical resident. These days, Halamka wears three hats and gets very little shut-eye. As CIO of CareGroup Healthcare System, a mammoth health-care organization in Boston with 1 million patients, 3,000 doctors, and 12,000 employees, Halamka spends the bulk of his day overseeing the organization's ambitious technology infrastructure.

Halamka typically gets to work by 5 a.m. and spends a few hours writing Web programs for the company's ever-growing arena of Web-related programs and services. He spends the next nine hours performing typical CIO duties. But many days, when others might think about going home, Halamka dons his white medical coat and pulls a shift in Harvard Medical Center's emergency room, sometimes staying until as late as midnight. Then he gets up the next day and does it all over again. That's a lot of responsibility for one man, but Halamka is up to it. "I work a normal day--from 5 to 9," he jokes.

Halamka's work clearly energizes him. CareGroup, which consists of six hospitals and 70 physician practices, is one of the most technologically progressive, Web-enabled health-care organizations in the country. The Web, Halamka says, is the key to customer satisfaction, profitability, and long-term feasibility.

To Halamka, customer satisfaction is the linchpin on which everything else rests. And CareGroup, like other health-care organizations and facilities today, has three distinct sets of customers, all with separate needs.

The largest group of customers by far is the patients. To keep them satisfied, the organization recently developed PatientSite, a Web site that allows patients to schedule their own appointments, renew their own medications, request managed-care referrals, securely message their doctors, view and annotate their medical records, and review and pay bills. CareGroup's IT department developed the online messaging environment internally. If patients consent, the system can push URLs to each patient's home page and send them secure Web messages that remind them to schedule appointments or suggest appropriate specialists. The system also uses regular E-mail to remind patients to visit PatientSite and take advantage of new information or capabilities. "It's a market differentiator for us," Halamka says. "Big health-care systems are so big and impersonal, and this is a way to make it more personal."

Halamka also expects PatientSite to precipitate significant cost savings. Because much of the communication is done online, call-center volume--as well as the number of people needed to support the call center--should decrease.

Another program designed to keep patients happy and differentiate CareGroup from other health-care organizations is an initiative that provides chemotherapy patients with access to the Internet through notebook computers mounted on bedside carts. For the pilot test, the organization is using IBM 570 notebook computers outfitted with Cisco Systems' AirNet wireless routers and PCMCIA or PCI cards.

Insurance companies make up another group of CareGroup customers. To communicate more effectively with them, the health-care organization has joined with others in the area to form the New England Health EDI Network. Through this group, every health-care provider and payer in Massachusetts has agreed to perform all transactional exchanges at no charge to each other. To fund the project, the larger member organizations contribute about $50,000 each year, "but then your cost per transaction becomes pennies, because there's no limit or cost per transaction," Halamka says. And because the system is run through Windows NT servers at each site, there has been a minimal staff and infrastructure investment.

To satisfy the third set of customers--the physicians themselves--CareGroup has put in place a number of initiatives. In addition to giving physicians access to its growing array of Web resources, Halamka is considering a stronger move into the handheld arena, possibly outfitting physicians with Palm VII wireless handheld computers. For starters, the company has outfitted its emergency- room doctors with Palm V handhelds that have OmniSky wireless modems. Through these devices, physicians can track each patient's chief complaint and lab and radiological information by accessing an internally written Web application that retrieves real-time data from the company's clinical systems.

That handheld technology will lead health care into the future. "As the form factor of the personal digital assistant improves, it will become the universal interface for all of our business processes," Halamka says. "We won't have to be chained to a desktop or network."