HHS is preparing to evaluate the results of a year-and-a-half pilot program utilized as part of the Obama initiative on health reform. Specifically, the program strives to inform CMS how Medicare beneficiaries use their personal health record (PHR). The pilot, which is about to conclude, is being implemented in Utah and Ariz.
Doctor Pundit has interviewed one of the CEOs of the vendors chosen by Obama in this effort — Amy Rees Anderson of MediConnect.
Current PHR business models represent broad and varied uses, from disease management to health promotion, with sponsors consisting of commercial vendors, heath plans, employers and healthcare providers. We know very little about why consumers, and specifically Medicare beneficiaries, elect to use PHRs and what functionality they want from a PHR.
Fair enough. Can’t wait for the results. Perhaps the Obama administration’s effort to eliminate fraud, waste, and abuse within Medicare will get a jolt of sound information from this enterprise. | LINK
A study out this week [PDF] in the NEJM highlights the uncompensated “care”[1] family physicians — correctly referred to in this NYT piece as medicine’s “embattled frontline” — must carry each and every day they continue to earn, at most, 50% of what many specialists pull in as income.
The study set out to show that the daily non-patient logistical workflow is a both a critical and burdensome task needed to be mastered in order to provide appropriate healthcare to patients — and as such, should be compensated. The study also highlighted the need for streamlined health information technology to incorporate these administrative tasks into a model that allows for the determination of compensation for primary care physicians.
A couple of weeks ago, I interviewed the CEO of the EHR/PHR tech company MediConnect, Amy Rees Anderson. What follows is the second half of that interview here on Doctor Pundit.
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DP: How important is portability of the health record for patients beginning to benefit from EHR adoption?
Ms. Anderson: The cheapest way to facilitate the portability of the records is to have the doctors adopt electronic medical records at point of care. Once this occurs the ability to retrieve and transfer records will become substantially more affordable. 
Again, I don’t think we will see this adoption for doctors really start to boom until we incent the current providers to do so. I do, however, believe that the rising generation of physicians who grew up with their handhelds and tablet PCs will come right out of school using these systems already. But it’s the physicians who have been practicing for years that we need to incent to switch over. Without electronic health records we can still retrieve and digitize the paper records like MediConnect has been doing since 1996, it just comes at a higher cost than if we dealt with all electronic records.
DP: Do you see any immediate barriers to adoption with respect to hospitals, vendor interface, or broadband availability in resource-poorer regions of the country?
Ms. Anderson: I don’t think broadband availability is the barrier to adoption today. The majority of records are stored in offices in the metropolitan areas of the country where the highest numbers of people live anyway, which has ample availability for high speed. In the smaller areas, where the Internet is slower, the doctors can keep records on a local server that can connect and upload to secure online storage in batch mode, so it won’t prohibit them from the changeover to electronic records. With regard to vendors, I think it’s important to let doctors choose whatever electronic records software works best for them in their own practice. Trying to force everyone on to one system is just not practical. That said, every system should allow for the transmitting secure health data to other systems as requested by the patient controlling that data.
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.
Talk about your ultimate curbside consult. Healthcare informatics is taking the distribution of medical information in a new direction: right to the point of care. General Electric’s approach to healthcare in the digital age has been dubbed “healthymagination”, and it is a commitment which places a best practices imprimatur on patient care at the point of that care. The initiative is a new way in which improvements in healthcare quality can be obtained with the rapid distribution of specific information which is readily usable by healthcare providers who participate in the process.
A Utah health system which has worked closely with GE will be piloting the initial rollout. It is hoped that the rapid dissemination of information will be just that — rapid. As healthcare delivery begins to close out one of its more innovative decades in its history, it only seems appropriate that a new mechanism of efficient information flow will only make reforms in healthcare easier to implement, thus decreasing waste and driving down costs. LINK
This morning’s vote on the health reform bill is as anticlimactic as it is divisive. After weeks and months of speculation, townhall harangues, and political incivility, the Baucus bill[1] and its more liberal cousin[2] will merge and go the floor. It’s a foregone conclusion that the bill will be more notable for what it does not contain than for what it does — mainly a so-called public option provision that is enough to satisfy Obama’s more politically Left base.
Fueling the the events today was the release of a report on Sunday (which the White House denounces as a political ploy at influence peddling) from the AHIP lobby detailing the rapid increase in premiums [PDF] if Baucus’s plan saw the light of day. No matter, according to Baucus — as he has the votes to pass his version. Responses are coming out of the woodwork on the heels of today’s vote. A few:
Although there are key differences the White House says Insurance completely ignores, like the utilization of healthcare exchanges to ensure future cost savings; there is generally broad bipartisan agreement on issues of the abolition of preexisting condition provisions, preventive care initiatives, and EHR implementation. The road to complete agreement on how to spend dollars to achieve these goals is a different matter altogether, however.
At this point, any objections to the electronic health record/IT are moot. It’s practically 2010, after all. Used to be that the most vocal complainers over the adoption of EHR into the average daily medical workflow were of the geezer set — those who graduated medical school before 1970. Well, call it the snail’s pace of technology (the efficient wonders EHR is supposed to create and the herculean task of waiting for it to happen); but, physician resistance isn’t the only source of healthy skepticism toward the centerpiece of Obama’s planned healthcare overhaul. | LINK
We all know that the swift development of an electronic medical records universe constitutes one of President Obama’s major benchmarks of healthcare reform in the coming decade. Corporate behemoths like Google have embraced electronic health record (EHR) technology, paving the way for a market, though nascent, that is ripe for vigorous growth. Now you can count another herculean player using its heft in entering the healthcare marketplace via EHR distribution — WalMart.
The big box discount retailer is partnering with Dell computers and an IT company to deliver its brand of EHR to physicians and healthcare organizations. You may recall that WalMart spearheaded and has successfully negotiated the resale of bargain basement generic medications for patients, invigorating the market for non-branded pharmaceuticals. It plans a similar trajectory with this venture, which will be marketed to smaller healthcare organizations and physicians in small group or solo practices. | LINK
Originating from Saint Paul, Minnesota, [doctorpundit.com] is a weblog about the policy of healthcare and where it intersects with politics and public opinion; it is edited by Michael Douglas, MD, MBA. Welcome, and please consider my take on what is Healthcare 2.0, complemented by a few of my thoughts on my personal avocations and guilty pleasures: music, prose, and writing. Follow Doctor Pundit via RSS above.
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DOCTOR PUNDIT @ ONE YEAR | An occasional DP series from 2010 highlighting healthcare policy trends over the period from 2009-2010 in a compare/contrast format.
