American Healthcare, part 2

This post will combine a rant about United States healthcare with a bit about information management. With all the ways that computers make life easier, you'd think that people would be able to do the following online:

- Sign up with a physician, whether primary care or specialized
- Make an appointment

As of right now I want to make an appointment, but I can't. I have to wait until regular business hours. Business hours are passe, they're dead and gone. Schedules are almost always stored on a computer, and they probably have been for the past ten years. All you need is a hook to a secure web interface and you can have your schedule actually tell a patient (or a customer of any kind) just what times are free. When a schedule fills up for a doctor over a predetermined period, patients (or, in the case of a mechanic or something, customers) are switched to another doctor, and the process continues. This way you don't need to call each and every damn doctor to see if they're accepting new patients (at times, this information is listed on an insurance site, but not always).

Physicians might have to charge less if they had systems handling their patients rather than people. There must be databases consisting of thousands of symptoms that can establish a number of possibilities for a patient (Health Net being one of them), and all the patient has to do is fill out a form.

Also, how about arriving 15-30 minutes early to fill out those standard release and information forms? Why not have THEM online rather than dozens of square feet devoted to hardcopies of such information? Rather than have a receptionist, have a systems maintenance technician that can ensure this data is kept secure and safe on a regular basis.

The same goes for insurance. All my insurance information is handled online. These systems could be interfaced to ensure that people had coverage before an appointment is scheduled.

This would also enable people to have a much easier time of dealing with the administrative issues that happen so often at the doctor.

I suppose this is one of those "I'd do this myself and make a fortune if I had time" ideas, but hey, at least I can rant about it. :)

Here is a response from my dad on the subject:

It was a major breakthrough when the healthcare financial management (HCFA) gained acceptance of the HCFA standard insurance reporting form on paper (the HCFA 1500.)  Large hospitals now generally have relationships with the large healthcare payers (Medicare, Blue Cross, Aetna, US Health, and a few others) so that they can send claims using electronic data transfer, and now over an internet connection.  Doctor's offices can do this as well, if they want to, and large practices usually do.  The step to allowing individual patients to file e-forms is a very big one.  It was not made a part of HIPAA (healthcare insurance portability and accountability act; it was enacted in 1996 with compliance dates set through 2003, but most dates have slipped due to the immutability of healthcare data systems and business processes) because when the act was being drafted Internet was not used to the extent it is now.  HIPAA does have a lot of privacy rules, and the emphasis in healthcare information systems is now concentrating on eliminating medical error, compliance with an ever-expanding number of laws, implementing new technologies (especially in the area of imaging) and data security (which includes patient privacy.)  Making things simpler for patients is not even on their radar.

Comments

[Jeremiah]

Brandon:

Coming from a background in medical IT, you're dad hits it right on the head: HIPAA makes it very difficult and expensive for medical providers to innovate. For a bazillion legal reasons, the paper trail is of utmost importance in a hospital setting.

[kitsu]

You should be able to also browse the site from mobile WAP, because if you're in an emergency and all you have is a cell-phone, this would come in handy.