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March 09, 2018 11:00 PM

Editorial: The era of healthcare consumerism is here

Aurora Aguilar
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    Aurora Aguilar

    Put the patient at the center of care. It's a mantra that's voiced as often as the Triple Aim. But most providers and payers admit that, until recently, they mostly dictated what the patient wanted and needed. They controlled how much information patients received with little input from them.

    But now, the era of consumerism is upon us. Health systems are hiring consumer experts and teaming up with consumer-friendly vendors.

    We can't ignore the fact that the patient's voice is strengthening, especially when that patient has the regulatory tools to impact the experience.

    Last summer, Seema Verma experienced firsthand the lack of control patients often face once they enter the healthcare system. The CMS administrator's husband suffered a heart attack on his way home from a weekend trip, she relayed to more than 45,000 attendees of the Healthcare Information and Management Systems Society trade show in Las Vegas last week.

    Verma faced the same frustration millions of American families feel when they try to explain complex medical histories to doctors who have never before seen them or their loved ones. Speaking remotely to the family's doctors in Indiana from her office in D.C., Verma tried to get them to share medical records with Penn Medicine clinicians treating her husband. She recalled feeling helpless when she could answer few of their questions.

    Thankfully, her husband survived and after a week in the hospital, he was discharged. Before leaving, Verma asked for his medical records so that her husband's doctors in Indiana could have all of his information.

    "The doctors looked a little uncomfortable. … After some time, they handed me five sheets of paper, which was essentially just the discharge summary, and a CD-ROM," Verma said incredulously and noted that the federal government had just spent $30 billion subsidizing EHRs for the industry.

    "It's our data. It's our personal health information, and we should control it," Verma continued before announcing a federal initiative named MyHealthEData that she promised would bring the patient to the center of the healthcare system. While the plan was short on details, Verma went on to "imagine a world in which your health data follows you wherever you go and you can share it with your doctor, all at the push of a button."

    In this world, patients could track their medical history throughout their lives, at every touch point, and combine it with data from claims and even wearables. That data could "cure diseases and provide more evidence-based treatment guidelines that ultimately will drive down costs and improve health outcomes," Verma said confidently.

    Let's hope that Verma is signaling that the initiative will use the agency's power—either through carrots or sticks—to drive the industry closer to interoperability, because so far the CMS has been reluctant to push hard.

    It's interesting to note that Penn Medicine announced last month it would be one of the few providers joining Apple's move to allow health records to live on patients' phones.

    "This administration will pull every lever to create a healthcare information ecosystem that allows and encourages the healthcare market to tailor products and services to compete for patients," Verma said in her speech. And as we've seen over the past nearly 14 months, a period that has shaken the insurance landscape and scrapped mandatory alternative payment models, the CMS has not been shy about making waves.

    Verma did not say which levers would get pulled, though her announcement that meaningful use would undergo a "complete overhaul" was met with applause and sighs of relief in the audience.

    And the industry's most progressive players, at least, are ready for the sea change.

    "Nothing's been built around the patient; it's been us telling them what data they can have and when they can have it," said Marc Probst, chief information officer at Intermountain Healthcare during HIMSS. "That's all going to be turned on its head."

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