Tuesday, August 10, 2010

Not So Strange Bedfellows

An article in the Wall Street Journal recently reported on the increasing cohabitation of health insurers and electronic medical record companies. In moves that would surprise most of us about as much as hearing that Coke and Diet Coke are actually made by the same company, several large inscos have joined forces with EHR vendors to “help” docs with the transition to digitization.

OK, I admit that last sentence sounds as if I’m skeptical of the reasons behind these collaborations. And, well…I am…but, maybe not as much as I would have thought. After also reading about Surescripts partnering with Microsoft to offer web-based access to prescription histories for consumers and about the health units of both GE and Intel getting together to form a new company focused upon “telehealth and independent living,” it occurred to me that in this mountainous mishmash we call our healthcare system here in the U.S., perhaps a little more collaboration might be a good thing.

Seriously, I think the majority of companies currently having even a foot within the healthcare sandbox would get Fs on their report cards to date in the “learning to work and play with others” category. Between proprietary this and antiquated that, it’s downright impossible to move along down the digital roadway until more players (and payers) learn that we all gain when we work together. Remember that little thing we all portend to care about: patients? Aren’t they better served when your tool plays well with mine? (Keep your minds out of the gutter.)

In her WSJ piece, author Avery Johnson (out of the gutter, I said) quotes the illustrious patient privacy rights advocate, Dr. Deborah Peel, who has concerns about conflicts of interest which may put personal health data at risk. I see her point, but I also feel there is just way too much to gain and far too much we could do with all this data, medically, if we could access it more effectively. The inscos already have oodles of patient data; I’d love to be able to actually see what they see to see if I see what they see the same as they see it. See?

Aetna and IBM say their system will pool patient records, lab, and claims data to help docs “measure their care against national quality standards” and that the insurer won’t have access to the data, just the docs will. Wellpoint plans on helping rural hospitals build out IT, but won’t tie their billing into the EHR the hospital chooses.

Humana and athenahealth are getting even more skin into my game (“my” meaning the collective physician world) by helping to cover 85% (Stark?) of the costs of implementation and then actually paying up to 20% more if users show they can hurdle certain performance standards. (This is, I’ve heard, above and beyond any HITECH funds, but don’t quote me on that.)

Deborah, I agree that we really need to keep a very close eye on folks who have access to our patient data. But, if they are going to share what data they gather back with me so that I can watch them watching me, I think that way beats out the current system where they have it all and I’ve no clue about what data they’re using to make payer decisions.

Like it or not, until we have a monogamous, single payer relationship (coughs, harrumphs heard all around,) these are the Bobs and Carols and Teds and Alices with whom we are snuggled. We’re polygamous; we might as well admit it and figure out how to make this ménage a multitude work. Unless you want to start talking seriously about that single payer idea…

From the trenches…


“When I played in the sandbox, the cat kept covering me up.” - Rodney Dangerfield

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