You Know Healthcare IT is Lagging When…

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Posted By: Roberta Mullin May 6, 2014

Chandresh ShahA Rhetorical Question

By Chandresh Shah
Twitter: @chandresh27

Is Healthcare IT Lagging? That’s a rhetorical question. If you disagree, consider this:

  1. Doctor’s office has no automated way of knowing what is the patient’s deductible when the insurance card is scanned.
  2. Doctor does not now if a pre-authorization is required for a procedure.
  3. Specialist does not know if a referral is required based on the patient’s insurance.No automated way of knowing patient responsibility including copay, co-insurance, deductible – and adding everything up.
  4. In very limited instances can my doctor see my past medications prescribed from other doctors – even if, not more than 6 months.
  5. Specialist cannot see notes from primary care provider that referred me, and vice-versa, even if I have agreed to permissions.
  6. Doctors cannot see my test results if someone else ordered them – again, even with my consent.
  7. When I go to visit a doctor, no one knows what will I be responsible for paying for the visit and all tests/procedures she may do, until I get a complicated EOB (Explanation of Benefits) that explains nothing.

Now consider this:

  1. I can be in any part of the country – I run out of cash, I can go to any ATM and get cash, even if I bank at a small unknown bank in a rural area.
  2. I have an 18 year old kid that has a credit card tied to mine. I am able to put ‘rules and controls’. He goes to a store to buy something, and before he walks out to the parking lot where I’m waiting, I get a text messaging informing me about the transaction.
  3. I can go to my financial institution’s app on my phone to see anything I want and actually do transactions.
  4. I can now even snap an image of a check you gave me and deposit it into my account without going to the branch. (Do they still have branches?)
  5. If I’m out of town – 1000 miles away and use a credit card that was not used for buying the plane tickets, I will get a call from the institution asking if I did the transaction.

So you know where this is going.

Don’t tell me about security and regulatory environment. The financial industry has stringent regulatory, and security controls as well as extremely tight privacy requirements that put HIPAA to shame.

It is a myth that HIPPA makes it difficult to fully digitize medical records. Banking/finance/credit cards have strict privacy controls and are still able to digitize their records and transactions.

Why?

Because of Geed. Two major stake holders – Insurance companies and Pharma industry have a tight grip on you and me. They have intentionally kept everything complicated and opaque.

This article was originally published on Chandresh Shah’s blog and is republished here with permission.