This weekend, it was reported that former Senator and President-Elect Obama's pick for Secretary of Health and Human Services, Tom Daschle, has requested that Americans host Health Care Community Discussions across the Country over the holidays this December to help his Policy Team put together their final recommendations for the Obama Administration. If you are interested in hosting a Health Care Community Discussion in your home or in your neighborhood anytime from December 15th to the 31st, you should sign up at
www.change.gov. You will be provided a special "moderators kit" to conduct your meeting and to provide feedback to Tom Daschle's office.
I signed up! On the application, I said that I would invite to participate in the discussion, both employers and employees and also people with chronic medical problems and people who have few medical problems. I also said that this new administration must consider the Internet as an untapped opportunity to deliver health care to those without easy access and to those who can not afford traditional health care. I said that the Internet allows us to deliver health care effectively, safely, and less expensively. I believe that the Internet remains a largely untapped mechanism for the delivery of health care. Shouldn't I be able to go on line to see my physician and be charged $20 instead of seeing him in his office for $75?
A recent gigaOM post by Alistair Croll discusses the future of online healthcare and specifically Google’s creation of its online healthcare records feature. Croll points out that “Computerization can eliminate much of the 30 percent of medical costs that are due to inefficiency, according to Dr. Dean Ornish, founder of the nonprofit Preventive Medicine Research Institute. At GigaOM Croll mentions that advanced diagnostics will encourage prevention and reduce costly reactive treatment. I fully agree with Croll's observations. In October 2008, I demonstrated KwikMed's on line mechanism for the delivery of care (Peter Ax at Health 2.0) at the Health 2.0 conference in San Francisco. I believe that patients should have their entire medical history in an online repository available for access anytime, from anywhere with real time updates made by an integrated system of health care providers. As reported by the National Priorities Partnership, 18% of the time, physicians order medical tests which have been previously recently performed. If my personal physician could access my medical records online prior to my visit with him, he could see what tests I have taken in the past even if those tests have been ordered by a different provider. For example the x-ray of my knee taken at my local hospital in 2006 could be seamlessly accessed by the emergency room technician in Park City, Utah when I crash and hurt my knee on the ski slopes in 2008. More significantly, the allergic reaction I had to a medication in 2000 could assist my new primary care doctor in his decision to prescribe a medication for me. The first step to online records and seamless use of those records will be establishing technology standards. We must also have a dialogue about who has access to those records and how does the consumer monitor and limit access.
Recently I was in my physician's office for a routine visit. An assistant brought my medical file to the examining room while she took my blood pressure and performed some other basic health checks. I started looking at the history of my blood pressure readings and the assistant protested. "you can not look in this file without the physician present." Are you kidding me? It is MY RECORD! So goes health care. I recently came across a post/commenting on an ongoing conversation on the
National Health Dialogue blog that we will improve our health system by developing technologies to standardize medical records and patient histories and that patients want control of their health care. By creating standardized medical records and medical histories and by encouraging patient access, we will create a higher standard of health care. What's your take?
Health care is the topic du jour as it has rightfully gained its leading position in our vernacular. Let's face it, if the cost of health care delivery continues to rise at its current rate and the quality continues to slide at its current rate, in a few years we will see a catastrophe that rivals the sub-prime loan market. I like to think about health care as a bicycle wheel with many elements that combine to make it successful. Each spoke is a key element: access to care being a spoke, physician medical practices being a spoke, pharmacies being a spoke, the patient being a spoke, hospital treatment being a spoke, health innovation a spoke, sickness research a spoke...on and on. Many factors contribute to our health system to make it successful and many factors contribute to make it fail. We must now review the system from point to point and dissect how each spoke must change in order to reinvent our health system in a manner which makes it effective and efficient for the long term. We must create industry-wide standards for electronic medical record systems so that data collected in a physician's office can be uploaded to a patient's electronic medical record. Industry standards will allow for the integration of all providers and payers. We must create transparency by publishing the costs of drugs, devices, procedures and consultations and allow consumers to make informed decisions about where and how they will accept care. Consumers will quickly find that alternative delivery venues like the Internet will save significant health care dollars. By having an on line medical record available to patients at all times, patients can decide what information needs to be given to a health care provided. There will be less duplication of laboratory tests, less confusion as to a patient's medical history and an ability for health care professionals to see baseline data. An integrated system will allow us to have superior care for fewer dollars.
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