In a recent post, I discussed the opposition to the proposed HHS rule on EHR interoperability on the part of Judith Faulkner, founder and CEO of Epic, and the CEOs of some 60 health systems (see: Faulkner Opposes Proposed HHS Hospital Interoperability Rules; No One Surprised). In this note, I would like to discuss some possible reasons why the CEOs of health systems might oppose such a rule.
- Firstly and as I have long maintained (see: NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals), data portability enables healthcare consumers to "shop" hospitals. However, they may not always do so on a voluntary basis. Yearly churn in health plan membership is estimated to be about 25% so some consumers may be forced out of their current health plan due to, for example, a job change (see: Reducing Churn to Increase Value in Health Care: Solutions for Payers, Providers, and Policymakers). The bottom line here is that portability of EHR records is a key element in the improvement of consumer's healthcare experience.
- Secondly, it is asserted by hospitals that interoperability provides health insurance companies an unfair advantage over health systems in negotiating reimbursement rates between the two parties. I believe, as do many others, that the entire hospital billing system is broken and hospital bills are often indecipherable (see: Two Reasons Why Medical and Hospital Bills Are Such a Mess). The whole hospital reimbursement system needs to be scrapped, allowing us to to start over and create a rational new system. Here's an article from 2006 that discusses this mess (see: The Precarious Pricing System For Hospital Services). I am thus in favor of any change that may disrupt the current hospital billing systems.
- Finally, I was struck by the point raised by Jonathan Bush who favors interoperability as referred to in my recent note (see: Faulkner Opposes Proposed HHS Hospital Interoperability Rules; No One Surprised). He said the following: "... with new data-sharing opportunities, patients can send their medical data to new tech services that can "aggregate data and recognize patterns in a way that health systems can't..." This is one facet of predictive analytics and an exciting new development in healthcare. I don't want to stifle its development in any way. I can envision that consumers will use such "tech services" as a check of a current diagnosis, particularly a serious one.
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