Staying on Track

June 24, 2011
Holt Anderson Healthcare organizations face an increasingly difficult administrative challenge in keeping track of the dozens of standards,
Holt Anderson
Healthcare organizations face an increasingly difficult administrative challenge in keeping track of the dozens of standards, technology, and regulatory initiatives that affect their operations. A healthcare technology consortium in North Carolina has come up with a way for providers, insurers, industry organizations and even government officials to stay on top of these initiatives, and make it easier to see how these disparate standards and regulations interact.

The North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA), a nonprofit consortium based in Research Triangle Park, N.C., has developed an electronic timeline that organizes healthcare standards and regulations, along with associated milestones, into a visual “map” (created within Redmond, Wash.-based Microsoft Project) that makes it easier to see how long a particular initiative may take to deploy, and how changes or delays can affect the overall implementation schedule.

NCHICA has teamed up with the Workgroup for Electronic Data Interchange (WEDI), Reston, Va., to further develop the timeline into a publicly accessible tool that healthcare organizations can use to structure their own deployment plans. The two organizations are currently seeking additional sponsors for the project.

“We want to discover all of the dependencies and all of the pieces that make for a successful implementation,” says Holt Anderson, executive director of NCHICA. “If we are going to change the way we do things in healthcare, we have to achieve success with these projects. By having a tool to help planners keep track of these IT initiatives, organizations can uncover any unintended consequences, oversights or omissions in the deployment process before we end up with a wreck in the tunnel.”

According to Anderson, NCHICA formed its Timeline Task Force in 2005 after he received a call from the office of Senator Elizabeth Dole asking the group to support a bill that would have mandated the use of the new ICD-10 disease classification codes in 2008. However, these new codes could not be utilized until the new 5010 transaction standard was implemented, which wouldn't occur until after 2009.

Anderson and the NCHICA team decided they needed some way to map out the various initiatives that impacted their members, which would not only list important milestones, but also visually present how these projects affected each other.

“Think of it like a construction project,” Anderson says. “There is a sequence to it. You don't want the steel on the site before you clear the trees and grade the ground, just like you need 5010 in place before you can use ICD-10 codes.”

When WEDI learned about the tool at a recent board meeting, the organization recognized how useful it could be for its own members. “Our member companies come in all different sizes and with different levels of resources, and one challenge for us has always been knowing how they will need to allocate financial or human resources to address these issues,” says Jim Schuping, CEO and executive vice president of WEDI. “We're constantly pushing them to get this planning done in advance, but they are struggling with the practical, day-to-day business challenges of reallocating resources constantly to meet impending regulatory deadlines.”

According to Anderson, the group would like to receive input from all sectors to make the timeline as complete as possible. With WEDI involved, there will be additional input from a much larger, nationwide pool of subject matter experts.

Currently, NCHICA is working on the 5010 portion of the timeline, which was scheduled to be available in time for the WEDI conference in November. The ICD-10 portion of the timeline is also being built. Future additions could include standards for personal health records (PHRs) and electronic health records (EHRs), and WEDI's work on standardizing electronic attachments.

The timeline will be available for download on both the NCHICA and WEDI Web sites later this year. For now, the database will be available as a Microsoft Project file, but data can be exported into other types of spreadsheets and databases.

Stanley Nachimson
When the timeline is available online, healthcare providers, policymakers, insurers and other organizations will be able to download the tool, and use it to manage their own projects within the context of these broader initiatives.

“Once the tool is built and available, it will provide any individual entity a picture of the health information technology projects that are going on, and all that they entail,” says Stanley Nachimson of Nachimson Advisors, LLC, Baltimore, who is consulting with WEDI on the timeline project.

It will also help policy makers and industry organizations understand how new legislation or schedule changes can affect the overall deployment plan.

“This will be useful to federal authorities, who can begin to understand that they can't just promulgate a rule and stick it out there,” Anderson says. “There is a whole environment that it has to work within.

“It will hold the various sectors accountable,” he adds. “If something starts slipping because a review hasn't happened, for example, it shows up on the timeline.”

Anderson also emphasizes that the timeline will remain a work-in-progress. “We don't want people to think, ‘Here it is. That's all I need to know.’ We want people to think about what kind of input they can provide,” he says. “We're always finding someone who has a piece of the implementation we hadn't thought about.”

Brian Albright is a contributing writer based in Columbus, Ohio.