As all American’s begin the process of assembling financial records to file their personal income taxes, it has come to mind, how easy the process has become to pay our personal taxes. Today the information flows in and flow out via your computer. You can now synchronize you credit cards and checking account in the cloud and prepare your financial statements and then file your taxes online.
Yet, currently 50% of all medical offices still have paper medical records. Of those, approximately 50% that have meaningful use software, an even smaller fraction have active patient portals. We are either still in a paper driven industry, or an industry that has electronic health records (EHR) that in theory communicate via an HL-7 protocol , but nearly never do. The consumer is losing out and so is the healthcare payer, the government, corporation and consumers.
To make matters worse, we are still overwhelmed by paper forms every time we see a new physician, not to mention every year or so when it’s time to update our information.
There is talk of interoperability and there are some very large players that have said they will work to make their systems talk to each other. We think this is either all talk so that the U.S. Government does not jump in to it, but maybe even more likely to block out the truly innovative companies that are in the space now but just off the radar screen.
What if we reverse the model?
What if the patient owns the medical record, the doctor connects to it, and the information is always accurate and available?
At present, there are effectively two ways for information to be transferred from one provider to another. One of the systems is “directed exchange,” which is when a doctor sends relevant health information to another doctor via a 256 bit encryption, using the previously mentioned HL-7 communication protocol. The core problem is the “fields” do not match, making it very time consuming. Every system has it; but it’s rarely used. The second is more an “emergency mode” or “query-based” search. This, in theory and practice, allows, for example, an emergency room physician to access all the patients’ records across a captive information system.
There is a new-third possible way. That is a fully consumer centric model where the patient controls the medical record, or at least the master medical record. One where the basic information is stored, including the patient history, as he remembers it; but also as documented by other physicians’ notes, and even their prescription drug history. Can we imagine the value alone of what a doctor could do with even the 5 year history of all our medications? Imagine the impact on a Medicare patient possibly on as many as 6, or 10 medications, at one time?
This system would empower the patient, and maybe even more importantly, engage the patient. We can do that now with a new generation of EHRs built for interconnectivity. We can do that by having the patient portal be that “controller.” Baby-Boomers already use the best technology, and their offspring’s consumer technology and interconnectivity, like no other generation ever.
We can see in the next few years the ability for consumers to manage their healthcare information, as easily as they file their taxes. Empowered consumers will be able to have their information available anywhere in case of emergency. They will be able to fill in missing information, to see the medical billing, the explanation of benefits from their insurance company, eliminate fraud and abuse, and we believe will lead to better health.
With years of investments in EHR in the U.S. the satisfaction level from doctors is horrible; I hear it every day. Consumers have not seen much of a benefit either. In many cases there are both paper and electronic versions, of the same record. The consumer is going to make the difference, and we are at the threshold of transformation; one driven by consumers, not government, or even the healthcare industry.
-Noel J. Guillama, President