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The Real Problem with High Healthcare Costs

Posted on February 27, 2018 I Written By

The following is a guest blog by Monica Stout from MedicaSoft

The rising cost of healthcare in the U.S. is something that nearly everyone experiences on a regular basis. Looking at the trend over the last few decades, there is an eye-opening surge in cost. There’s a great article/table by Kimberly Amadeo that outlines health care costs by year from 1960 to 2015. The cost per person for health care in 1960 was $146. In 2015, the cost per person was $9,990, over 68 times higher than it was in 1960.

The trend shows no sign of slowing; 2018 costs have only gotten higher. The National Conference of State Legislatures cited a figure from a Kaiser Employer Survey stating that annual premiums reached $18,764 in 2017. Costs for people purchasing insurance on an exchange or privately increased even more.

Increasing healthcare costs impact everyone. Why have costs gotten so high? Wasn’t the Affordable Care Act supposed to make coverage more affordable? Instead, many are faced with even higher insurance premiums for themselves and their families. Sometimes that equates to having to make difficult choices in care. And should people have to decide whether or not they can afford to seek care or treatment?

Many people want to blame insurance companies or hospitals or lobbyists or politicians. In truth, it’s a complex issue. And one of the core reasons it’s so hard to dissect is that there is a real lack of data – cost and price information, and clinical information on care quality and outcomes. Nobody has all of the data in one place. Without all of the data, the real problem or problems can’t be seen. If a problem can be guessed, it can’t be fixed. As in the Wizard of Oz, the real drivers are lurking behind the curtain; worse, the data that describes the drivers is splintered and located in different places, waiting to be collected in a way that reveals the whole truth.

How can health IT help? Are there ways that we can help solve the data problem and reduce high healthcare costs? Electronic Health Records can help gather the data. Adding claims data to complete, longitudinal patient health records can also help. Connecting PHRs, EHRs, and claims data together can help bridge the data gaps and tell more of a complete story. Until we have that story, the industry will continue to operate in siloes. Costs will continue to rise. And people will have a harder time seeking out the care they need.

About Monica Stout
Monica is a HIT teleworker in Grand Rapids, Michigan by way of Washington, D.C., who has consulted at several government agencies, including the National Aeronautics Space Administration (NASA) and the U.S. Department of Veterans Affairs (VA). She’s currently the Marketing Director at MedicaSoft. Monica can be found on Twitter @MI_turnaround or @MedicaSoftLLC.

About MedicaSoft
MedicaSoft  designs, develops, delivers, and maintains EHR, PHR, and UHR software solutions and HISP services for healthcare providers and patients around the world. MedicaSoft is a proud sponsor of Healthcare Scene. For more information, visit www.medicasoft.us or connect with us on Twitter @MedicaSoftLLC, Facebook, or LinkedIn.

The Opportunity for Health Information Exchanges (HIEs) to Untangle Health Records

Posted on February 6, 2018 I Written By

The following is a guest blog by Monica Stout from MedicaSoft

As the government’s Meaningful Use incentive program accelerated the adoption of Electronic Health Records, it also increased the use of patient portals and PHRs to meet MU patient engagement measures. You see this today when you’re offered a portal login at your doctor appointments. Other encouraging trends developed around the same time:

  1. Studies proved that engaged patients tend to exhibit more positive health outcomes at lower costs.
  2. Interest increased among patient populations to be involved in their health and wellness, including a desire to see (and even contribute to) their electronic medical records.
  3. Technology innovations flourished to support health (wearables, health devices, applications, etc.).

Despite these trends and the relative success of MU-driven deployments, the patient portal and personal health record landscape leaves much to be desired for their primary users and audience – patients. Many of these tools were created simply to satisfy MU requirements and while they do this, they don’t completely tie together patients’ complex health histories, include data from multiple providers, or travel with the patient from visit to visit. Instead, patients have many different portals – a different one from every different provider. Who wants 10 different portals? Nobody has time for that!

Patients need help assembling a single view of their health records. HIEs are unique in that they work with many different health systems, hospitals, and providers in their regions. HIEs represent an opportunity to be a true integrator of health information between providers and their patients. This can be a regional solution now, and with efforts like the Patient Centered Data Home (PCDH), there is greater opportunity for HIEs to share data across state and regional lines, further expanding their reach and extending real benefits to patients who want their data in one place.

HIEs can leverage their unique position into a meaningful benefit for patient by first creating a single patient record or universal health record (UHR). This UHR or platform works seamlessly with PHRs. By making PHRs available to providers in their exchange, they can then share health data among every provider they link up with and the connections grow from there when you add in PCDH connections in other regions and states. Once there is a platform in place that is truly interoperable, sharing data between providers, patients can start using PHRs that have useful, relevant health data from all of their providers. HIEs can then start building in other capabilities like analytics, population health, care quality metrics, and more.

A patient’s medical journey involves multiple providers and different physical locations as their lives and health evolve. Their health information – in a single, universal health record – should evolve with them. HIEs can play a significant role in making that happen.

About Monica Stout
Monica is a HIT teleworker in Grand Rapids, Michigan by way of Washington, D.C., who has consulted at several government agencies, including the National Aeronautics Space Administration (NASA) and the U.S. Department of Veterans Affairs (VA). She’s currently the Marketing Director at MedicaSoft. Monica can be found on Twitter @MI_turnaround or @MedicaSoftLLC.

About MedicaSoft
MedicaSoft  designs, develops, delivers, and maintains EHR, PHR, and UHR software solutions and HISP services for healthcare providers and patients around the world. MedicaSoft is a proud sponsor of Healthcare Scene. For more information, visit www.medicasoft.us or connect with us on Twitter @MedicaSoftLLC, Facebook, or LinkedIn.

HIT for HIEs

Posted on October 17, 2017 I Written By

The following is a guest blog by Mike O’Neill, CEO at MedicaSoft. This is the third blog in a three-part sponsored blog post series focused on new HIT for integration. Each month, a different MedicaSoft expert will share insights on new and innovative technology and its applications in healthcare.

Health Information Exchanges (HIEs) have been in the news lately, and for good reason. With major hurricanes devastating Texas, Florida, the British Virgin Islands, and Puerto Rico, accessibility of patient health information rapidly became a major concern. Electronic Health Record adoption has led to most patient data being in electronic form, but it hasn’t necessarily made that data available when and where care is delivered. HIEs can help make that data available; during the recent storms two HIEs were able to spring to action to help clinicians provide care for patients. The ability of the Houston and San Antonio-area HIEs (Greater Houston Healthconnect (GHHC) and Healthcare Access San Antonio (HASA) to exchange information allowed patient records to be accessed remotely – which was absolutely critical during this natural disaster.

If you were on the fence about “the cloud,” this is the perfect case study in its effectiveness. More than ever, HIEs are called upon to assist by making health records available during critical care encounters. HIEs need modern technology to best serve their communities in these instances, going beyond basic connectivity and interoperability to deliver tangible value using the wealth of data they collect –

  1. Organize the data into meaningful health records. HIEs often have access to years of raw data. They may need help organizing it into a clinical data repository, matching patients, and providing a health record that is clinically useful. This is one way we assist HIEs in using the data they’ve collected.
  2. Provide valuable alerts & notifications. These are useful, especially in a crisis, to locate patients, but they can also give patients notice on events they need to follow-up on. This is another layer we build onto HIEs’ data foundation.

Health records that are useful go a long way – beyond individual hospitals, and regions and state lines. To be useful, health records must go where the patients go, wherever that may be.

An emerging approach to meet this need is the Strategic Health Information Exchange Collaborative (SHIEC’s) Patient-Centered Data Home (PCDH) concept among HIEs. PCDH helps providers access real-time health information across regional and state lines, wherever the patient is seeking care. Regardless of where the clinical data originates, it becomes part of the patient’s longitudinal patient record – the PCDH – giving patients control of their data.

About Mike O’Neill
Mike is the CEO at MedicaSoft. He came to MedicaSoft from the U.S. Department of Veterans Affairs (VA) where he was a Senior Advisor and member of the founding team of the VA Center for Innovation. Mike serves as the Chairman of the Board of Directors of the Open Source Electronic Health Record Alliance (OSEHRA). Prior to VA, Mike was involved in the commercialization of new products and technology in startups and large companies. He is a die-hard Virginia Tech Hokie.  

About MedicaSoft
MedicaSoft designs, develops, delivers, and maintains EHR, PHR, and UHR software solutions and HISP services for healthcare providers and patients around the world. For more information, visit www.medicasoft.us or connect with us on Twitter @MedicaSoftLLC, Facebook, or LinkedIn.