By Colin Read
Issue: March 2022
For the past decade the healthcare industry has been promising something that would dramatically improve quality of care. That day has arrived.
I recall a decade ago Champlain Valley Physicians Hospital’s early efforts to bring all records into a unified system. With the help of the University of Vermont Medical Center over the years CVPH made good progress. The system, and comparable systems used in individual practices, are talking to each other and are working effectively.
In this information day and age, it should not be a surprise that information technology be fully incorporated into the inner workings of any major service provider. The hurdles in the medical care industry were formidable though. For comparison purposes, the Canadian health care system has been united around shared platforms for many years. I recall hearing from relatives a decade ago that they could go online, have access to their records, view their prescriptions and see doctors’ notes and records of tests. Meanwhile, I was going to the doctor every year for my annual checkup and writing down on a card — which I inevitably couldn’t find next time — my blood pressure, heart rate and cholesterol levels.
Canada has a simpler structure. The primary difference is that it is a single payer system. All hospitals and doctors’ offices had to interact with a single platform to be sure they were approved and paid for procedures. Since the details of these approvals and final disbursements necessarily require results of exams, prognoses, test results, and other details, their information technology systems had built into them methods to share records, if for no other reason, than to coordinate care and payments.
Given the universality of that system, it was not a big leap to then let patients themselves into the loop. A common interface was created and patients were given online and secure access to view the records their health care providers were sharing.
In the United States, although there are similar levels of care, there are myriad providers in each space. The number of platforms was originally proportional to the number of insurance providers, each of which developed proprietary systems. I always marveled at the difficult job our professionals who work with these insurance companies must have. Each has different rules, rates, extents of coverage, and approved procedures and drugs.
While hospitals are now typically part of larger networks, the number of independent hospitals a decade ago was much larger. Each hospital subscribed to an information system which was purchased, or had evolved internally. One of the biggest hurdles in the consolidation of hospital level health care providers was to knit together disparate systems. Add to that another layer in which individual doctor’s offices also had their own systems, their benefits coordinators and the complexity seemed overwhelming. But they did it.
I attend a professional and well-run doctor’s office, and am able to communicate easily online through a secure platform. If I need to see a doctor directly aligned with the hospital, I sign onto another similar platform. Both systems talk with each other and provide my test results. In preparation for an annual physical exam, my physician’s assistant is able to prescribe a test that will tell him how my cholesterol has been tracking and measures another five dozen important health indicators.
All I have to do is go to the testing lab at the prescribed time and am in and out within half an hour. A couple of hours later, I see the lab results appear in my patient portal. I recall the olden days in which I had to make the appointment and bring in a big form, in triplicate, issued by my doctor. Following the test, I might not have had the test results for days.
After a visit with a specialist, I see his comments in my chart later the same day. That allows me to understand what he has diagnosed and what I need to do. If I need a prescription, that too is done on the spot, with my pharmacist often sending me a text message that my prescription is ready before I get home. Dang. I wish I had gone to the drug store right from the doctor’s office! It would have saved me a trip into town. That’s okay, though. Now, some of my prescription renewals can be delivered to me just a little bit before they expire.
In this COVID era, the ability of my health care providers to meet me through Zoom is very helpful. And, I have tried out a device advertised on television that allows me to get a relatively complete readout of my heart rate and activity and, should I ever be concerned, be able to send it to my doctor through my portal. This progress is amazing, and I am sure it took a lot of hard work to unite systems and make them easy to access. I still have to deal with a couple of different portals, but that’s okay. It is way better than no portal at all. Now, if only I can remember how to use all these technologies without having to read a user manual every time!
Dr. Colin Read is a professor of economics and finance at SUNY Plattsburgh’s School of Business & Economics. You can read his weekly blogs on the economy at www.everybodysbusiness.online