Thursday, June 22, 2000

Jill Vardy
Financial Post

Dave Chan, National Post Dr. Chris Skinner, vice-president of product development of Mainsource Software Corp., says an authorized doctor will have Internet access to data now found in a patient's paper file, including X-ray and EKG images.

OTTAWA - There are lots of professions whose administrative business has been completely changed by technology. Medicine isn't one of them. "Health care is the most information-intensive and yet least automated of any sector, bar none," said Graham Mackintosh, an independent technology consultant.

But Mainsource Software Corp. of Ottawa is bracing itself for a boom this year, as doctors offices and hospitals finally embrace online management of patient health records.

That boom will be helped by new laws in the United States that demand health care companies create a framework for secure transmissions and auditing of health care data. The Health Insurance Portability and Accountability Act will phase in new rules for managing health information collected by people who supply medical care. The act, to be implemented in stages during the next four years, also imposes on the health care sector a framework for secure transmission and auditing of health care data.

Mainsource has a technology that will make secure transmission of patient records easy over the Internet, said Dr. Chris Skinner, a neurologist and vice-president of product development at Mainsource.

Mainsource allows different branches of the same health care organization to share patient reports without jeopardizing the patient's confidentiality. That's the nub of the HIPAA law, and the goal of every major health care organization.

But it's not the reality today, even among combined health units such as the various campuses of the Ottawa Hospital, Dr. Skinner said. "As a practising neurologist, when I'm on call for the Ottawa Hospital I can be called to emergency at the Civic campus and see a patient discharged from the General campus the day before. And the current technology doesn't allow me easy access to the records for that patient."

Instead, he's forced to phone someone in the health records department at the General, ask them to find the patient's file and fax it to the Civic.

The Mainsource system is different. Each lab report, doctor's note, X-ray or EKG is identified in the patient's file and tagged with a special identifier. The tag, known in the business as a "metadata tag," will tell the viewer what kind of information is kept in the file -- but it won't show that information to anyone who doesn't have an authorizing password.

The collection of tags in the patient's file can follow the patient around via the Internet, through a Web-based portal created for the health organization. "What the caregiver sees on the screen is the series of icons or tags that the caregiver can click on. The tag then goes to the source of the information and gets the information file and brings it back electronically to the caregiver," Dr. Skinner explained.

The tags can link to any sort of information -- text files, scanned EKG images, audio files of doctor's notes, X-ray images -- and give an authorized doctor a Web image of everything that would be found in the patient's paper file. "That's the real value of our approach. We develop a central collection and that collection follows you around. So if I go to another hospital the caregiver can see what's been done in terms of tests and examinations and, with my permission, get at my data," Dr. Skinner added.

Mainsource is negotiating with several U.S. health technology companies to embed its solution into existing technology.

Mr. Mackintosh, who has reviewed the Mainsource business model and given the company advice, said it stands to pick up significant business as the HIPAA legislation is put in force. "Mainsource has products and technology that allows it to go to companies in the U.S. and Canada and say, 'You need to deal with the transfer and consolidation of clinical information of all kinds. Our technology can make a huge difference in enabling you to do that,'" Mr. Mackintosh said.

For example, under the new law a health care provider must be able to provide an audit of exactly who viewed a patient's file and when, and where it has been transferred. "That's where we see a golden opportunity for us to use the metadata tagging system so we can tag the object and track all transactions done on that tag," Dr. Skinner said.

While it's just beginning its foray into the United States, Mainsource has already attracted some big customers in Canada. The Canadian Department of National Defence, for example, uses an older version of Mainsource software to manage the patient records of all military personnel. "We get a duplicate copy of patient records from across the country and scan them into the Mainsource system, and use it to provide information to our policy folks so they can quickly access a record," said Lieutenant-Colonel Jim Kirkland of DND. "These folks [at Mainsource] have brought some health care experience in to providing this technology, which is a good strategy."