Without Giants: Health Care Could Use A Standard-SetterWithout Giants: Health Care Could Use A Standard-Setter

Big companies can set the direction and pace for business-technology standards adoption within their own industries and beyond. To see what an industry looks like without such leaders, look to health care.

The industry needs standards for information-sharing to cut costs and improve care. The sharing of clinical data in particular remains antiquated and manual. "Health care is definitely behind the game in [IT] standards," says Linda Reino, CIO at Universal Health Services Inc., a hospital-management company.

The lack of such standards makes it difficult to share information if a patient is admitted at a hospital far from where his medical records are kept. Nomenclature and terminology aren't standardized, even at facilities within the same company: One institution might say a drug has been "suspended" if it has been withdrawn from use, while others say it has "been put on hold." Standardizing processes and automating workflows in health care could reduce the risk of errors. "Quality is paramount in our industry," Reino says.

Government regulation is helping to drive the industry toward standards in some areas, such as the messaging interface and transaction standards in the Health Insurance Portability and Accountability Act. But there's a lack of standards in many other areas.

One impediment is that the financial returns from establishing standards for clinical data-sharing are more difficult to measure than for, say, retailers, so it's tougher to make the investment case, Reino says. Also, technical sophistication in the industry varies, from tech-savvy insurance companies and medical-supply companies to small hospitals and doctors' offices.

Universal Health Services is installing similar IT systems throughout its 11 hospitals with data repositories that use standard terminology and data formats such as identical patient medication administration records. That makes it easier for the hospitals' pharmacy, laboratory, and billing IT systems to communicate. The next step is to roll these technologies and practices out to the company's more than 100 surgical and behavioral-health centers in the next three years.

Reino is confident that standards will emerge even without an industry heavyweight driving the process. She predicts the industry will see more standardization in the next five years than it has in the last 50.

Illustration by Brian Stauffer

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