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We are on the verge of healthcare modernization that will transform the healthcare experience.
Despite the dramatic and overwhelmingly positive changes in how we live digitally, there remains a persistent group of deniers bent on preventing the digital evolution of healthcare.
The deniers' refrain includes several pseudo-reasons:
• Healthcare is too complicated;
• Physicians won’t change;
• Healthcare data is too sensitive to be stored in an easily retrievable place; and
• Healthcare organizations can’t or won’t adopt adequate safeguards.
Among all our activities of daily living, healthcare remains the most stubbornly unmodern. Organizations still use faded paper forms, multiple nonstandard registrations and health histories, and complex bills that can confuse even the staff members who produce them.
Despite the lack of enthusiasm, we are on the verge of healthcare modernization that will transform the healthcare experience. Here’s just some of the evidence:
1. The rapid adoption of electronic health records (EHRs) by physicians.
2. The dramatic expansion of telehealth.
3. Online access to the best and most current healthcare research.
4. Fitbit, Apple Watch and all the marvelous new toys that allow us to track our daily (good and bad) activities.
5. The conversion of radiology to digital imaging, with the ability to share images and reports to tablets and phones.
6. Digital home monitoring of weight, blood pressure and glucose.
7. The use of avatars for remote monitoring of rehabilitation in the home.
8. The early and highly effective conversion of pharmacy prescribing,
routing, copay collection and refill reminders.
Seven things required to continue on the path toward modernization
The path to modernization for healthcare will continue to prove daunting. It will require:
1. Prices that are simplified and based on final products or services. For example, a hospital bill for “one left knee replacement” rather than six pages of inputs with no obvious connection.
2. Standard protocols for exchange of health data among physicians and between physicians and customers.
3. Personal health records in standard formats owned by the consumer.
4. Online appointment scheduling.
5. Provider directories that are current and consumer-friendly.
6. Standard patient registration and health histories, completed once and updated as needed.
7. A commitment to addressing the very real and complex security issues.
The greatest challenge: protecting patient data
Not surprisingly, the more relevant (and more difficult) question is how to move aggressively and safely to a digital healthcare world.
Almost certainly, this digital world is more likely to reside in the cloud (and not in physician offices), and more likely to use the already well-demonstrated skills of the large-scale Internet retailers who today provide and maintain huge data stores with sophisticated security features.
The world of data management has rapidly evolved to expert service providers. The healthcare industry must recognize early and commit to security management provided by others. It seems likely that even the larger healthcare providers (and insurers) will move to environments that are more sophisticated than they can readily operate and support. We will also see data (and programs) vanish from laptops-stored in and accessible from the cloud only when needed.
Early progress is evident. EHRs systems are transitioning rapidly from physician office-based servers to cloud-based systems (Athena has been an early and effective proponent of this), as it becomes clear that data interchange among providers is likely unsupportable among individually maintained and operated systems.
The thorniest issue for healthcare is the increased likelihood of a security breach involving personally identifiable healthcare data stored digitally. For decades, most collected health data was recorded by hand and collected in paper copy medical records. These medical records were then stored in color-coded folders in closets not accessible to anyone other than healthcare workers.
That was great for security, but the records were time-consuming to retrieve and not very useful once located. These files were shared only by an authorized release of the records, almost always produced through copying and personal delivery or secure fax. Records could be individually lost or stolen, but the risk of disclosure of thousands (or millions) of records was non-existent.
HIPAA and even more protective state legislation froze this storage method in place, imposing significant penalties for sharing of data without express patient consent. These regulations have largely prevented the effective sharing of behavioral health and substance abuse providers with physicians and hospitals providing other types of care.
Primary care physicians have often resorted to “brown bag” days-where patients bring all their prescriptions with them to an office visit-as the only way to know exactly what their patients are taking. Coordination of care and effective oversight of pharmacy have been sacrificed.
Don’t be a denier. Ready or not, the digital age of healthcare is here. Planning, standardization and thoughtful regulatory reform are all essential to success.
Tom Kelly is CEO of HealthSmart, the healthcare industry’s largest independent third-party administrator and a provider of innovative benefits to employers, members, providers, payers and brokers.