President Obama’s healthcare initiatives are, once again, upfront in the 24-hour news cycles this week — albeit for reasons he probably would prefer not experience in the one-week run-up to his second SOTU address. Before all of the current negative sentiment surrounding health reform became the norm, there was a halcyon period for the new president, and it was about a year ago when he took office. Barack Obama’s election as the 44th U.S. President arrived fresh with bold promises of a completely revamped healthcare delivery system that would revolutionize access for the vast majority of U.S. citizens like no other piece of legislation since the Medicare entitlement over 40 years ago.

The talent pool from which the new president was to draw resources to revolutionize healthcare delivery included, at its centerpiece, the drive for innovation in the age of the electronic medical record. The ability for patients-as-consumers not only to have control over their healthcare information, but also have immediate access to it holds great promise for positively influencing efficiency in health information dissemination. Lower costs and less waste are to be the results of this innovation. Obama’s penchant for tech only adds to his administration’s zeal in making this happen.

Search giant Google made headlines when it entered the hallowed space of patient information and medical record retrieval. Of course, this caught the attention of the Obama administration, as it has already implemented Google as one of four key players in a demonstration project involving Medicare beneficiaries’ health information and records retrieval. Another up-and-coming HIT company targeted by the Obama administration as part of this CMS demo project is MediConnect. This company has emerged as one of the few major players in the new and thriving electronic medical records industry after growing nearly 800 percent in the past four years and is now serving some of America’s largest health payers and life insurance carriers.

I recently had a chance to interview its CEO, Amy Rees Anderson, and gauge her thoughts on the brave new world of this patient-as-consumer driven technology and what it means in the overall plan for healthcare reform. Part II of this interview will be posted on Doctor Pundit next week.

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DP: You are the CEO of a company fresh off an acquisition and explosive growth over the past 4 years. Where do you see the impact of the electronic health record (EHR) and the patient’s utilization of it in driving healthcare delivery efficiency over the next decade?

Ms. Anderson: I believe it is critical for patients to get involved in overseeing their own health care. If you really think about it, as consumers we often spend more time researching what car to drive then we do on our healthcare decisions.

In order to get consumers involved, it will take two main components 1) help them gain access to their medical records and 2) help them understand what is in those records so it becomes more meaningful to the consumer.

As we can accomplish these two things, which we believe MediConnect now offers with the combination of our record retrieval services and now the acquisition of PassportMD, the online Personal Health Record system, we can help consumers to get involved in knowing and understanding their own healthcare. As the adoption of these types of services grow, consumers will ultimately be what forces the facilitation of transferring medical information between their own medical care providers. The patient is really the only person who can build their entire health record by keeping every record from every care provider in one central repository which they can either directly access or grant access to certain portions to the people they feel need that information in order to best guide their healthcare.

DP: Do you see a similar pattern in benefiting the overall reform of healthcare?

Ms. Anderson: Right now, the term “healthcare reform” is a complex one. What I do see is that the best way we as a country can reform healthcare and provide the very best possible care for the lowest cost is to go to a system where all medical data is kept electronically.

The largest amount of money spent on medical mistakes are typically related to either the lack of health information on a patient at the time of treatment (such as emergency care where the allergy to medications wasn’t known, or repeat tests being performed because of the lack of information from a prior healthcare provider) or mistaken information that was misunderstood or unclear (such as handwritten prescriptions that are misread and filled with the wrong drug). These problems occur because the data was not available quickly and in a digital format.

If we could put the emphasis on reforming the IT elements of healthcare to incent providers to keep new records in a digital system and provide incentives for the digitization of past healthcare data that had previously been kept on paper, then we could take the system from where it is to where it needs to be.

The problem is that the incentive really has to be there to help the providers change. A one-time financial payment for installing an electronic records system in their office is simply not enough incentive to bring about change. In addition to fighting the increased costs of medical malpractice insurance and decreasing reimbursements from Medicare, we need to remember that doctors are also running a business. When they are already fighting lower revenue and increased costs, there is no meaningful financial ROI for them to then implement an electronic system that will take time to learn. For many it will take more time per patient in the exam room, which ultimately means fewer patients can be treated per day which again equals less revenue for them.

I believe we need to look at reform that includes giving doctors a financial incentive on a per-patient-treated basis in which that treatment was documented in an electronic medical records system. That way it is a continuous revenue stream for the doctor that makes it worth their while to go through the pain of switching away from their handwritten or dictated charts that they are comfortable with. The dollars spent incenting this type of switch would be more than paid for by the reduction of medical mistakes that take place today because of the lack of records data when needed.

DP: Google and Microsoft are undoubtedly power players in the speed of EHR adoption, overall. As patients get used to the idea of controlling and being responsible for their own data—payers also are getting interested. What will MediConnect bring to the table in the quest to keep information maximized and healthcare costs to a minimum?

Ms. Anderson: We are integrated with both Google and Microsoft for the transfer of electronic health information, so we agree that they are very important players in this space. We believe that one of the factors that scares patients from storing information on the health insurance provided PHR systems is the fear that they are giving their health plan even more access to their private information, which in turn they fear will result in a higher cost of insurance or rejection of covering their care.

In order for patients to feel comfortable having the health plan involved in their PHR they need to feel that they control access, not their health plan. We believe that MediConnect provides the most innovative solution for both parties. The health plan wants to have a way to communicate with their members, keep them informed of the preventative measures they should be pursuing, and share with them other relevant information that would benefit their members wellness. The patient wants to control who sees what information at what time and to know that their PHR data is theirs to take anywhere they wish, even as they switch from one plan to another without fear of losing their data.

By inserting MediConnect as a neutral hub for the medical data between the patient and insurer, we give both parties exactly what they want. We give the patient total control over their information to decide who can access their data. The records are theirs to keep for their lifetime, regardless of who their insurer is. We give the health plan a way to push content from the plan to the targeted members who will benefit from that data, without MediConnect having to disclose which of the members specifically received that data. For example, if a plan wants us to push diabetes data to any patient with diabetes indicated in their PHR data, then MediConnect can ensure that data is delivered to the members with the condition that the plan cannot see who those specific members may be. Both parties get the end result they desire without either party giving up control or privacy.

DP: Your acquisition of a healthcare information company handpicked by President Obama as one of 4 participants in a Medicare demonstration project obviously speaks to your company’s goals for the immediate future with respect to healthcare informatics. What do you hope to achieve as a provider of EHR for Medicare beneficiaries?

Ms. Anderson: The exciting thing about the Medicare pilot is that it allows us to go in and download directly into a patient’s PHR system all of their Medicare claims information, such as the providers who have treated them, the dates of service they had treatment done, the actual procedures performed and the diagnosis that went along with those procedures. This information is a great automatic way for a Medicare patient to begin populating their PHR without having to personally type it all in. It also helps remind them of all the care they have had done and alerts them to what things they should pursue further in regards to gathering medical records. The pilot is free to these Medicare patients, both for the PHR system itself as well as the import of their Medicare claims data. We hope to see this pilot expanded further by Medicare and we also hope to see private insurers offer this same service of pulling the claims data in the PHR at no charge. It’s a great way to kick start getting these consumers involved in their own healthcare.

DP: How are patients-as-healthcare consumers receiving all of this news?

Ms. Anderson: I think patients are still trying to understand how to build their own PHR and what it means to them. Health records can be intimidating to consumers as they try to read through them and understand what the doctors meant in their notes. In order to really engage the consumers, it’s important to help them get their information retrieved and to help them extract and understand the important elements of their records. If we can show consumers that we can help them do this and they don’t have to do all the work themselves, we will gain much more adoption for this concept of consumer-driven healthcare. Ultimately, everyone understands the need for it and the benefits of it, but they are not sure how to get there on their own.

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