Thursday, June 22,
2000Press enter for your health history
Privacy issue addressed: U.S. law
is expected to spur demand for Mainsource software
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.
| Dave Chan, National
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
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
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.
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.
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
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