Whenever an issue lingers, especially one that impacts many people, leaders start to think, “What could I have done to have mitigated this?” This Pandemic certainly fits the bill, so you leaders, what could you have done?
As a longtime technology and healthcare executive, I remember decisions made back in the early 2000s that are certainly impacting today’s Pandemic, let us look at a big one…
I look at the decision we made as a country to not centralize a United States Health Information Exchange as a mistake, and something that could mitigate Pandemic type tragedies.
A statement like that certainly deserves a deeper discussion.
A DECISION WE MADE
Our healthcare system was built for what we need yet survives on what we want. The people that run insurance companies, healthcare providers and the people receiving the care are all at odds for information and money. This evolved as the healthcare system, built as a safety net for the emergent and chronically ill, shifted its perceived value to satisfying an insurance member’s wants. Competition between providers led to specialization and more competition for each patient. Rising costs led to competition between insurance companies and more confusing ways to get your care paid for. The patient became more demanding for specialized attention and comfort, healing became secondary. At the same time, big data became cheaper. The fierce competition would not allow all the parties involved to play nicely in the sandbox.
I remember the perspectives of the parties involved
The Provider – If I share my data with another provider, they will steal my patients and/or doctors. Personally, I remember feeling threatened by the neighboring hospital having our data back then (I was young).
The Insurance Company – If I show my data to the other insurance companies and providers, we will lose membership and pricing leverage (still true)
The Patient – If I share my data, someone will take advantage of me
This reluctance to change is exactly why we do not have big data to help us through a National health crisis and why People can use false information on our health to advance agendas. This reluctance to change is rooted from greed and fear. The solution is simple, free unidentified meaningful data.
We should be sharing masked data to ensure national public health; it could be available to everyone. Instead, we rely on the faces we see and hear on TV or a search engine to tell us. I do not believe that is what our founding fathers envisioned for the well-being of the people in the United States of America. The Federal Government should be promoting a PUBLIC HIE, not assisting with the confusion or allowing anyone else to allocate our funds for our care and certainly not taking the whole industry over.
TO NOT CENTRALIZE A UNITED STATES HIE
Make no mistake, we believe in big data, HIEs are popping up around the United States in different companies, counties, states, etc. Clearly a good idea, just not a good idea for you to have my data. Each HIE now has different structural languages that helped build it, were built for different purposes, and have different gatekeepers with different goals. We chose to not share and not centralize. They all provide information that can be masked and can be centralized and can be utilized to further public health. I know this can be done, we do it all the time between systems and providers and companies using APIs (application programming interfaces), Health Level 7, ASCII, etc.
WE MADE AS A COUNTRY
So, did we as a country really make the decision to not use our data or did industry make that decision? I believe if people had a choice to see illness like we see the weather or pay for care like we buy retail, we would say yes to big data and centralizing an HIE. We can take the next step in the battle against widespread disease and the high cost of care. Place healing first, give people a choice and free our data, we will have much better insights and it will pay for prevention. We want the holistic approach, we want to be catered to, we want to feel good and healthy; to do this, we need to share, be inclusive, transparent, trust and secure. Information is being used as a weapon, promoting false data can have grave consequences and it does not take much information to be useful. Imagine a real-time heatmap of COVID positive test results across the United States. This really takes extraordinarily little information, zip code (19430), diagnosis code (U07.1) and that is it! Once that information is transmitted real-time, securely from the provider to the HIE, software visualizes it and VOILA!
We have the capability, do we have the capacity? Would love to hear your thoughts…
#Free our data.