Utahns aim to deliver on the promise of electronic medical records
Health • For a decade, electronic medical records have been long on potential and short on results. Promises of smarter, lower-cost health care have collided with privacy concerns, high up-front costs and a lack of standards that would allow providers to share information about patients.
An all-female group of e-health innovators in Utah is newly bent on solving these problems. They're ambitious, well-funded and realistic, acknowledging success hinges on the willingness of patients, doctors and insurers to shed their paperbound ways.
"I like to joke that it's the classic woman's job, lots of responsibility and no real power," said Jan Root, president and CEO of the Utah Health Information Network (UHIN), a nonprofit that helps doctors digitize their records and share them on a statewide computer pipeline.
Earlier this month, the Obama administration named Utah a pioneering community in the nation's drive to computerize patient records. With the title came a $15.8 million grant, which together with other stimulus funding, will fuel several ongoing e-health experiments.
"Utah really is a leader. There are other states with similar tools, but few that have all of the pieces aligned," said Christie North, who oversees the Utah operations of HealthInsight, a nonprofit using technology to analyze which treatments in Nevada and Utah work best. "Where we're experimenting, other states haven't started."
• One of two health exchanges in the nation. Exchanges are online marketplaces for people to shop for insurance.
• The nation's sixth all-payer database, which collects all insurance claims made statewide. Utah's repository is the first to pair claims with hospital discharge data, making it possible to analyze "episodes of care," or patient outcomes beginning with their diagnosis through their treatment and any follow-up.
• One of 15 state Health Information Networks to receive federal funding to build a data superhighway to safely transport patient data between doctors and hospitals statewide.
• Some of the nation's largest experiments in changing how doctors are paid, rewarding better care and outcomes for pregnant women, children and diabetics.
Alone, these tools offer a piecemeal approach to health reform. But the grand vision is that together, these efforts will bring greater transparency and accountability to Utah's health care system.
The all-payer database will expose how much patients are paying for health insurance, tests and surgeries. Armed with this information, consumers can then comparison shop for medical care and health coverage on Utah's insurance exchange.
Researchers could also tap claims data, pairing that with information from state's data superhighway to determine which models of care deliver the most bang for the buck. And doctors using the cHIE or Clinical Health Information Exchange will avoid duplicate labs and X-rays, and be alerted to patient's allergies and possible adverse drug reactions.
Other states, too, are cashing in on billions invested toward the president's goal of having all doctors electronic by 2015. Private industry also is eyeing the gold rush, including Amy Rees Anderson, CEO of a fast-growing medical record digitization company, Utah-based MediConnect Global.
It's a competition welcomed by Utah's political leaders, who, in the wake of federal health reform, are jockeying to show Washington how it's done.
"We've got to run faster. We've got to jump higher," House Speaker Dave Clark, R-Santa Clara, said last week at a legislative briefing on Utah's progress. "The ground and landscape has changed somewhat. The sense of urgency needs to be more pronounced."
Electronic records and patient privacy
Patients entrust their doctors with the most private details: their sexual habits, a teenage dalliance with marijuana or steroids, bouts with depression or genetic predisposition toward certain diseases. Doctors' vow to keep patient information confidential is being challenged by the digitization of patient records. You might be surprised how much information is already shared.
Who has access to your medical records?
By law, you must first agree to grant someone access to your records. But often consent is implied or required.
Insurance companies can require you to release your records before they will issue a policy or pay a claim.
If you've ever applied for life insurance or shopped for health coverage on the open market, information you provided about pre-existing conditions and habits, such as smoking or drinking, likely found its way to the Medical Information Bureau (MIB), a central database shared by more than 600 insurance companies who use it to set premiums or deny coverage.
Insurance companies also have access to prescription drug databases like IntelliScript and MedPoint, which store information on drugs you take.
Source • Privacy Rights Clearinghouse
How to protect your records
You have a right to request your medical records under federal law. That includes information shared by third parties, such as medical and prescription drug databases. At the doctor's office, you can revoke consent to release information, but you may have to pay for the visit yourself.
Think twice before participating in free or low-cost health screenings at pharmacies, health fairs and shopping malls, which can pass direct marketers information about your cholesterol levels, blood pressure and weight.
Carefully read the privacy policies on medical websites, use a pseudonym in chat rooms and remember that companies can change their policies and sell your information to the highest bidder should they go bankrupt.
If you decide to change physicians or health care organizations, it is a good idea to obtain copies of your medical records.
Source • Privacy Rights Clearinghouse in San Diego, Calif.