Yesterday, I learned of a program being run by Aetna that prompted me to think differently about the medical records issue. While there is a general belief that interoperability of electronic medical records among health care providers would be of great value to society, there are obstacles to that process that keep arising. Some of these are technical, some are based on privacy concerns, and some are based on corporate decisions to protect information to maintain market share. Here, from Aetna, is an approach that might suffice to skirt many of these issues and enable consumers to send information to whatever providers they would like.
Aetna has created a personal health record -- using the claims information it receives from providers -- that is placed on a secure website and is made available to its subscribers. So, for example, it will show your test results, inoculations, allergies, surgical procedures, hospital stays, chronic illness treatment patterns, and the like. Not only can a subscriber review information about his or her medical histories, but he or she can also authorize any provider to look at it as well.
Think about this. An Aetna subscriber does not need Hospital A to share its medical records with Hospital B: The subscriber can authorize this without an intermediary. Whether the patient has shown up at an out-of-town emergency room or just wants to visit a doctor or hospital in another provider network, the feature is instantaneously available.
I know this is not a complete medical record, but it contains enough information to be helpful in many cases.
Why can't we do this in Massachusetts? It could start with Blue Cross/Blue Shield, the largest insurer in the state, acting alone. Or imagine the power if BCBS, Harvard Pilgrim, and Tufts were all to create this program as a shared venture, but with a firewall between their systems so that data stayed with the subscriber's current insurer. If the underlying platform were the same, the subscriber's data could easily be transferred if an employer or the individual subscriber changed insurers.
I think this is an elegant solution that could help cut the Gordian knot of the interoperability problem. If we can solve 80% of the problem with a quick fix like this, it might be more valuable than waiting a decade to solve 100% of the problem. Maybe those of you out there who are more expert can tell me why I am wrong.
(By the way, Aetna also uses this information to conduct an evidence-based medicine review for patients with chronic problems to help reduce underuse and overuse of medical services. For example, if a diabetic patient is not keeping up with a treatment regime, the patient's primary care doctor is notified by Aetna's medical consultants to contact the patient. Sharing of this data is authorized by the patient when he or she becomes an Aetna subscriber.)