Web Services Online office administration

by David Orenstein freelance writer

Here’s an overdue confession: Software will never fully deliver the mythical “paperless office” or totally automate office chores, such as reimbursement requests. Thousands of techies are hanging their heads in shame, but don’t overreact with cynicism. Software is about to make a major leap in how helpful it can be.

Those techies are moving with surprising unanimity to build a new generation of Internet software. This technology, called “Web services,” will equip your computers to autonomously take care of simple transactions by linking with the computers of insurers, patients, pharmacies, and suppliers. Although a passive assistant today, technology is about to take an active role in the office. When computers talk directly to each other, your staff won’t need to send as many faxes, make as many calls, or send and read as much mail.

Here’s the basic premise of Web services: Thanks to the Internet, anyone’s computer can talk to anyone else’s computer. If the healthcare industry can agree on a common way to describe data, such as patient IDs, billing codes, prescription drugs, and procedures, then two computers can communicate meaningfully with each other about those topics (much of this work already has been done). Once they can talk to each other, why not program them to take care of the mundane side of the business?

Here’s how it could work:

A woman moves to a community for her new job and logs on to her company’s internal Web site to choose a physician covered by her insurer. Once she chooses you, her (highly secure) medical records Web service automatically contacts your New Patients Web Service and sends you her medical history. There will be no need for her to complete a long medical history form on her first visit or for office staff to key it in.

At that first visit, she seeks treatment for a cough. You examine her and prescribe medicine. Later, you enter notes from her visit and what you prescribed into your practice software. From there, the software’s Web services send the prescription to her pharmacy, the reimbursement request to her insurer, and an update to her medical records Web service. The Web services on all ends are fully able to handle the transactions—even if they have never “met” each other. No intensive, expensive programming is needed to link parties.

Microsoft has two videos on its Web site (www.microsoft.com/net/use/businesstrip.asp episodes 2 and 3) with another scenario, but this is hardly something that Bill Gates plans to force the industry to do. The heaviest hitters in computing—including IBM, Sun Microsystems, and Hewlett-Packard—have been talking up Web services for years. An inventor of the Web, Tim Berners-Lee, wrote an article in Scientific American last year about a closely related topic in which he also laid out a “seeing your doctor” scenario. This technology is not real yet, but there is a tremendous amount of support for its development.

It sounds good, but obstacles remain. One, of particular note to health care, is security. People don’t want their medical history traveling all over the Internet unless they are certain it is secure and they can trust insurers, physicians, pharmacies, and others to keep it private. All the parties in the system (think HIPAA) must protect patients. A similar effort must involve finding ways to ensure that each Web service really represents who it claims to represent. A hacker could otherwise write a Web service that, say, makes phony reimbursement claims or writes phony prescriptions.

Another obstacle is that a tremendous amount of programming will be needed. Your software does not do the kinds of things I described above and it won’t for years. Even if your software had this capability, it would be worthless until the software at Cigna and Eckerd does, too. Besides, can anyone make money with a “medical records Web service”?

There is a lot to do before this is a reality. But, there is also a lot to do around the office. Someday, software may do more of it for you.

David Orenstein is a technology and business writer in Silicon Valley. To learn more about a technology topic in Computing Care, e-mail him at davealli@attbi.com.