Spotlight: Highlights from talks with IT strategistsSpotlight: Highlights from talks with IT strategists

Mark J. Smith is vice president of information technology at Athena Diagnostics, which provides advanced neurological diagnostic assays of patients to their physicians. He spoke with us about the strategic integration projects he's currently heading, as well as the need he sees for better data interchange in the near future. Smith is a bit of a Renaissance man, holding bachelor's degrees in computer science and history/political science, as well as a master's in business administration.

Q: Tell us about the integration projects you're currently heading.

A: Sure. We're a clinical laboratory. We perform [more than] 100 neurological-based tests. And with those tests, our product is a patient result report. I know in some of our future deliveries of this result report that we are going to need to access many data sources.

There are four projects. These are projects which are by no means simple. But, when I sat down with my programmers, they believed they were doable with the Ensemble product in a three- to four-month timeframe. Ensemble provides a fusion of rapid integration and rapid development that is proving key to meeting that objective.

[For example,] one of the projects is what we call e-notification or a sample status notification, which will make it possible to inform customers of when they can expect to see the results of their tests. Although many of our tests take only a few days to complete, others are quite complex and can take as long as six weeks. For these tests with a longer turnaround time, the wait for results can be very stressful. Therefore, it's important that doctors and patients know when they can expect their results or if there are delays in processing. Good communication can help to reduce their anxiety.

[Ensemble uses] basically the same object scripting language as InterSystems' Cache database. Since all my developers have been using Cache for the past three years, it was very easy for them to understand how the language is structured, what it's designed to deliver, and how to optimize the programming in a timely manner.

[With e-notification, we're creating] integration between our Cache-based Misys laboratory system, Microsoft Exchange, secure email, and HTML. Our biggest challenge thus far is integrating an HTML message with Exchange. Ensemble made it much easier to do. The HTML message will be delivered via email. It will have the status of a particular patient and will be delivered securely.

Q: What direction do you think enterprise integration platforms should take in the future?

A: In the world of EDI, I'd like to see this technology support smoother integration into X12. Being a healthcare provider that is guided by HIPAA [Health Insurance Portability and Accountability Act of 1996], I know that there's much more to come with EDI. At this point, we outsource [our EDI] to a clearinghouse. However, it may eventually make more sense to internalize EDI. As we have more demands from our customers and from our insurance company payers, such a transition would enable us to react much more quickly in a much more cost-effective way to those demands.

Q: Are you concerned about interenterprise integration and better industry standards regarding data interchange?

A: Yes, the more standards the better. And I believe another piece to the integration puzzle, from a healthcare provider's view, is the need for adapters for encryption packages. The HIPAA security launches are effective as of April 2005. And part of the e-notification project that I described earlier is that there will be PHI — protected healthcare information — that will be embedded in this communication over the Internet. Any communication over the Internet must be encrypted and very secure.

Q: It seems like HIPAA is a double-edged sword, because on the one hand it provides a mandate to share more data, but on the other hand, don't you face liability as well if any of that data is leaked?

A: This is true, but from an IT perspective, HIPAA is probably one of the best things that's happened to the healthcare industry. Prior to joining Athena Diagnostics, I worked in consumer electronics manufacturing. In the manufacturing arena, we were doing certain things in computing that healthcare is just now starting to adopt. And I see HIPAA as a driving or enabling force that's starting to push healthcare, with messaging that, in effect, says, "Hey, come on, guys. You need to get up to speed here very quickly and use the automation that's available because you can and will reduce costs by using information technology."

Q: But where are the standards lacking? I mean, X12 has been around for how many decades and...?

A: What I find lacking in standards is that everyone has one. X12 has improved over the years, but it has a way to go. This is where an integration package can help bridge the gap in standards deficiencies. What I found somewhat surprising is that even today there is no X12 standard for patient result reports. The HIPAA X12 standards are currently financial — focused primarily on electronic claims. This was the first step in HIPAA X12. I would say the next part should be to get the patient result information electronic and standardized as well.