Posted by Healthcare organizations have historically lagged their corporate brethren in adopting cutting-edge technologies. The slow evolution of healthcare information systems, initiated in the mid-1960s, was catalyzed by the collaboration between Massachusetts Institute of Technology (MIT) and Massachusetts General Hospital under the leadership of Dr. Octo Barnett. This partnership led to the development of the MUMPS operating system designed by Neil Pappalardo, laying the foundation for healthcare computing technology and giving rise to widely used hospital information system platforms like MEDITECH which Neil founded, and EPIC Systems.
The 1970s: A Shift to Automation and Cost Containment
While the initial applications were clinical, the focus in the 1970s rapidly shifted to automating manual medical billing processes. Escalating healthcare spending in the 1980’s prompted the US Government to focus on cost containment. Dr. Jerome Grossman, CEO at Tufts New England Medical Center (Tufts-NEMC) and a MEDITECH Founder, assembled a team to respond to this challenge. The team, led by Peter Van Etten and Robert Raco, conceptualized a “Strategic Management System” to leverage medical data for the first time to facilitate knowledge-based decision making.
The Transition System and the DRG Methodology:
With the release of the Diagnostic Related Grouping (DRG) methodology by the US Health & Human Services in 1983, a shift occurred in reimbursement models. Medicare’s move from a retrospective fee-for-service to a prospective system compelled hospitals to manage operations more like corporations. In response, Tufts-NEMC made the “Strategic Management System” commercially available in 1986 as “Transition Systems.” This marked a crucial step in reshaping the delivery of medicine, delivering management systems that empowered both financial analysis and clinical decision making.
Transition Systems and the Role of Data:
The success of Transition, like any business intelligence system, depended on robust operational data collection. MEDITECH, the leading community hospital system platform, played a pivotal role providing the necessary departmental data to feed Transition. Edward Marney, being involved in development of Transition, joined MEDITECH in 1986 to bring Transition’s system to hospital CEO’s who were confronted with massive organizational change. This prospective reimbursement model required a significant redesign of healthcare delivery, and powerful information systems were an integral part of the solution.
The 1980s to the 1990s: Swift Changes in Healthcare Landscape:
The late 1980s into the 1990s witnessed continued rapid changes in the healthcare landscape. Independent hospitals started consolidating to navigate these challenges, leading to the formation of large state-wide health networks. The Transition system played a crucial role in managing this time of transition, delivering the first viable hospital business intelligence system in the United States.
The Rise of Outpatient Services and TouchPoint:
Not under the same DRG based reimbursement constraints, Outpatient services rapidly expanded in the form of day surgery centers and multi-specialty physician groups. Thus, the government’s cost containment focus turned beyond hospitals to outpatient services. The Resource-Based Relative Value System (RBRVS), developed at Harvard University in 1988, aimed to reshape retrospective medical reimbursement outside the hospital environment. Recognizing the impact these changes may have, Edward Marney founded Health Strategies Inc in 1991 and subsequently TouchPoint Software Corporation in 1994 to address the upcoming outpatient services management needs. The RBRVS system was implemented as Mr Marney predicted in the mid-1990s, leading to more physician consolidation and the era of Managed Care. TouchPoint’s InfoPOINT PLUS Analytical Worksheet coupled with the InfoCENTRAL Data Warehousing system became a de-facto outpatient healthcare business intelligence management system, providing actionable information to these evolving healthcare organizations.
WebMD Acquisition and Continued Impact:
Recognizing the strategic value of TouchPoint’s product offering WebMD Corporation acquired TouchPoint Software Corporation in 2001. The InfoPOINT PLUS system has subsequently been renamed Practice Analytics, continuing the leading business intelligence system legacy as a critical component of Greenway Health’s product line.
Stratified Healthcare Business Intelligence Applications:
Today, healthcare business intelligence applications have evolved into four classifications: Descriptive Analytics, Diagnostic Analytics, Predictive Analytics, and Prescriptive Analytics. While Transition and TouchPoint delivered Descriptive and certain Diagnostic Analytic capabilities, a new breed of Predictive and Prescriptive healthcare business intelligence systems are emerging. These advanced systems, combined with vast clinical data powered by artificial intelligence, are poised to bring forth groundbreaking applications that transcend and enhance the next chapter of healthcare delivery.
The healthcare information system journey, from inception to the current era of stratified business intelligence applications has been marked by innovation, collaboration, and adaptation. The original MUMPS based systems paved the way for transformative systems like Transition and TouchPoint, which has in turn laid the groundwork for sophisticated predictive and prescriptive analytic systems emerging today. As healthcare continues to advance, these intelligent systems are set to play an even more critical role in shaping the future of healthcare delivery, improving efficiency, and enhancing patient outcomes.