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By Monica E. Oss

Last week, we looked some recent recommendations to control costs in the U.S. health care system—Would This List Bend The Cost Curve?. The recommendations ranged from eliminating fee-for-service (FFS) payments; to reducing emergency room use and reduce readmissions; to empower consumers; to standardizing performance metrics; to meaningfully addressing trauma; to allowing the government to use cost and cost-effectiveness in decisionmaking.

Jim Gargiulo

After this was published, I got an interesting response from my colleague and OPEN MINDS Senior Associate Jim Gargiulo, who wrote:

Technology vendors in health care should view the challenges of consumer empowerment, the integration of trauma-informed care, and hands-on care coordination as an opportunity to change the traditional EHR focus away from the provider community, and towards the person receiving care. The emergence of consumer engagement technologies, such as on-demand therapeutic services (via telehealth and other digital applications), have the potential to educate and empower the consumer and make them the integral part of the care decision making process. Both provider organizations and their technology vendors need an information management platform that embraces and manages these changes.

This made me think about the recent announcement about the MyHealthData initiative (see Trump Administration Announces MyHealthEData Initiative To Put Patients At The Center Of The US Healthcare System) that will make consumer health data available, conveniently, to consumers via a new Medicare Blue Button 2.0—a way for Medicare beneficiaries to access and share their personal health data in a universal digital format, and to connect their claims data to the secure applications, provider organizations, and research programs they trust. The Administration’s announcement said:

The MyHealthEData initiative will work to make clear that patients deserve to not only electronically receive a copy of their entire health record, but also be able to share their data with whomever they want, making the patient the center of the healthcare system.

My question for Jim was—what specific functionality do provider organizations and their technology vendors need to provide in this emerging consumer-centric environment? He sent me a “functionality laundry list” that included:

  1. Allow consumers to make an appointment, or direct them to an interim resource (e.g., peer support or volunteer group)
  2. Direct consumers in crisis to appropriate resources – including 911, an “on demand” therapist, or other crisis support services
  3. Provide a full suite of self-assessment and self-reporting tools, that allow consumers to track their progress over time
  4. Provide timely communication with therapist, or a diversion to another “augmented” team member or clinician
  5. Notify and provide consumers with meaningful information about their care (lab results, med changes, treatment plan changes, etc.)
  6. Provide consumers with downloadable treatment or service coordination plans
  7. Support pre-intake data entry via an online portal, or other self-service kiosk, prior to first appointment

His functional checklist came with a few interesting observations. First, these developments change the way provider organizations and their vendors view the consumer role in the care continuum. For the savvy consumer, it empowers them to better manage their own care and to seek the best options for them. As noted in the Centers for Medicare and Medicaid Services (CMS) press release about the Medicare Blue Button tool, consumers are expected to use this information to seek out provider organizations and services that meet their unique health care needs and to make better decisions about their care. This acknowledges that the data belongs to the consumer. The question is—are consumers ready to take advantage of this transition?

Second, interoperability and data aggregation become “must have” capabilities. Having data follow the consumer adds to the risk and the burden of the provider organization, charged now with managing and adjusting their current systems to meet consumer, as well as clinical needs. And while interoperability and consumer portals have always been core requirements for meaningful use certification and demonstrable proof steps abound, the adoption of easy-to-use, cost-effective connectivity and consumer engagement tools has not been widespread. The concept behind the “Blue Button” is key, because without a simple way to become interoperable, on-demand sharing will remain a concept that won’t have broad adoption.

Third, the data won’t be useful if it can’t be used. Provider organizations and technology companies that figure that out, transforming data into meaningful information that has the potential to empower consumers (and their families) as they engage as partners in their care will have a leg up. This is the market differentiator for provider organizations – those organizations that figure out ways to keep the people they serve engaged through better communication and self-reporting tools (portals), and through better integration of data from new sources (claims), will have a competitive advantage over those who stay on the traditional EHR path.

For more on the role of technology in consumer engagement, check out these resources in the OPEN MIDNS Industry Library:

  1. Tech-Enabled Care For The Complex Consumer Population – An Interview With Peggy Terhune, Ph.D. Of Monarch
  2. Consumer-Directed Health Plans Have Little Effect On Curbing Spending On 26 ‘Low-Value’ Services
  3. Cigna Acquires Technology Company Focused On Consumer Engagement
  4. Looking For A Tech Strategy? Try Consumer Engagement
  5. Building A Technology Infrastructure For Value-Based Care: Tech To Optimize The Value Of Consumer Care
  6. Tech Advantage Takes Consumer Engagement – Advice From Inglis’ Dyann Roth & Lea Frontino
  7. Consumer Satisfaction, Consumer Engagement & Shared Decisionmaking
  8. The On-Demand, Direct-To-Consumer Online Therapy Market – A Glimpse
  9. Using Technology To Improve Consumer Engagement: A Look At Successful Models For Engagement
  10. The Next Wave Of Consumer Price Shopping For Health Care

For more on this developing and important discussion on data management and access in the health care landscape, join me on October 23 at The 2018 OPEN MINDS Technology & Informatics Institute for my session, “The Challenges Of Data Management In A Digital World: An Executive Discussion On Security, Privacy, & Consumer Control.”

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