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Why We Are Doing This Health Care Reform All Wrong
It seems these days you can’t put on the TV without every channel discussing the health care reform in the U.S. On my flight back from Austin, the JetBlue monitor was filled with people saying yay or nay to President Obama’s plan to create a better healthcare system for all of us here in the United States. I must admit that I haven’t read all of the endless pages of information about the plan but what I do know is that we are doing this all wrong. I’d like to share why and please understand that this isn’t a political discussion, it’s a business and technical discussion.
Back in late 2007 some of you might remember that my mom was in the hospital for a couple of weeks. I wrote a post about what I saw while I sat with her in the room along with how the doctor’s handled her after she was out. It was a complete mess. Not just a mess for my mother and me but also for the doctors, the hospital, the insurance company, the pharmacists, yep, everyone involved participated in the mess (even me).
Instead of jumping from the supposedly horrible healthcare system we have in place today to one that is supposedly significantly better, why don’t we take 12-18 months and get the underlying technology fixed first?
Let’s get rid of all paper, get tablet computers in the hands of doctors, and finally create a way for patients to hold their information just like a credit report.
It’s easy to say that security and privacy will be an issue with a fully-integrated tech solution. But I am not sure that I agree it will be any worse than the way our credit is handled. In fact, I think it could be even stronger when it comes to privacy and security.
For example, let’s say you visit a specialist and the doctor wants your “record” from your primary doctor. Great, now he or she can get it in a moment using the HCS (health care system). The specialist doctor is authenticated into the system – you then log into the system and provide the specialist with time-and-provider coded access to your record.
Now you head to the pharmacy to fill a script – the same procedure is used. There would never be another paper prescription handed to a patient – imagine the savings and the reduction in fraud.
Doctors would be paid quicker, insurance forms would be completed correctly the first time, and families would have the ability to view how their parents are doing from anywhere and at any time.
Everything in the new system would be based on the patient providing the access when it’s needed, at the level it’s needed and to the parties that need it.
Let’s get startups like appointment planning service ZocDoc into the mix and other health-related startups like Skinnyr for weight tracking and Traineo for fitness tracking. Trusera and iMedix could provide a community for people to talk with others with the same issues and conditions as they have. OrganizedWisdom could provide a way to catalog all of the health care information. I am sure there are 100s of startups that could provide awesome technology for our new health-care system.
We need to get doctors back to working on fixing people not on the paperwork. Let’s get the technology to take care of the paperwork.
By fixing the technology for health care first, we can then look at creating the right plans for the country. If we move into new plans now, we will just be putting new stones on a horribly crappy foundation and we will have to do the work again in the near future. Let’s get it right the first time.
I’m sure there are a million reasons why this idea won’t work – I’d like to hear them – so leave them in the comments.
Technology is part of the issue. National health IT groups have been working on standards and protocols for years, but can’t come to agreement and finish the job of making everyone’s legacy systems communicate securely. The claims payers have big industrial databases that talk to the hospitals, but only on the claims side, not on the records side. And the marketing leading EHR software products all suck (crummy UI, hard to train, big deployments, blah blah blah) which means hospitals and doctors are loath to adopt health IT on the records side. And that’s why on the front end it isn’t automated. If the automation products were good, believe me, they would have caught hold already. But the people who developed them really don’t understand the complex nature of health care workflow, overlayed with HIPAA regulations and competing insurance providers. On the money side, the software is there, but on the provider/patient side, not yet. Check me at http://ushealthcrisis.com and you can see what I’ve been writing on this and also posting to HuffPo.
Thanks for your thoughts Francine – I will certainly check out your writings.
We can’t try to use legacy systems – the crap that worked in 1980 won’t work today.
Let’s start over. Sometimes no matter how much bacon you put in a dish trying to fix it, you may have to just scrap it all and begin with new tools and new ingredients.
Look into what Walmart has been able to do to their suppliers – do it Walmart’s way or get out.
Allen,
I’m all for technology but do you really believe that IT is a big part of healthcare reform? If you do, I’ve got a bridge for sale.
The problem is health insurance. We don’t have it.
Imagine you’re in your 40s, drive a Honda Civic, sport a perfect driving record and have never had a major auto insurance claim. Do you want to subsidize the 20 year old trust fund baby who drives a Ferrari, has 5 speeding tickets in the past 5 years and just had an accident? Of course not, but that’s essentially what takes place in the healthcare arena and with government wanting to increase demand and provide bulletproof coverage to everyone, it’s only going to get worse.
What we need is less government and more competition. Until you have that, technology won’t make a dent.
agree with you but… if we fix the tech first, then we can do a better job on the less govt and more comp. otherwise we will have to do it later and it will be even more of a mess.
im suggesting that the tech be the foundation – let’s build it good and strong and build the floors of plans above the foundation.
Peter,
You hit the nail on the head…until “insurance” becomes insurance and not a wealth transfer mechanism, we won’t see the accountability we see in any other retail space (with differing value plays and other things that will improve quality and convenience).
There’s a reason why Laser eye surgery and cosmetic surgery got cheaper and better as the rest of health care continued to bloat.
Check out HealthShoppr.com if you want to see what the retail purchase of health appointments will eventually look like…its very different than the highly variable appointment focused on billing codes that we see today.
Keep everything on a credit card sized flash drive and put the security responsibility with the owner. Like you scoial security card. If the card is lost they can request another one from the company you choose to store your info with.
Thanks GS – I thought of the card but figured it would be too much hassle to have to carry it all the time and so forth. I think it would be easier if it was centrally managed.
The problem has yet to be solved in the UK with a computer system. The NHS have been trying to implement something like you mentioned but its just such a massive task that they are faling with it.
I can’t imagine any company being able to do it the states, I think that there would first need to be some open doc formats and protocols so that there is an open system for firms to work on.
The NHS has gotten some knocking in the states but its better than the states system.
I’ve heard of the NHS but c’mon – let’s get it done. All of us need this. But instead we will get some worthless rehab of health care that won’t help a damn.
don’t forget the iphone and other mobile apps