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Getting An Epic Opinion Off My Chest
We need to be far more explicit in asking a subtle but critical question
What are acceptable bases of competition in health care?
My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:
It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors
It’s NOT OK for care providers to compete on the basis of controlling or limiting access to patient health information. It’s just not right.
Today’s US healthcare system embraces market competition. For-profit and non-profit health care systems and care providers compete against one another. While we might or might not like this, all I’m asking you to do here is to recognize it.
Hospital based delivery systems work hard to keep patients within their network (walled garden) of providers. That’s understandable. But we need to probe deeper and examine how they are doing this — again, what are the bases of competition.
In many industries we accept the idea of creating proprietary, non-interoperable technology as a means of competitive differentiation. For example, the Apple iTunes system is not interoperable with MP3 players. This is an explicit and intentional part of Apple’s business strategy. I have no problem with this type of competition in digital entertainment.
Health care is different.
We are talking about people here — our children, our parents, our selves. How do you feel when you think about care providers controlling or limiting access to your health record as a business strategy?
Unfortunately, it’s not usually that black and white. In my experience, most organizations do not have an explicit strategy to control or limit access to patient information. More often the strategy is implicit, left over from the era when all records were kept on paper. It’s a default, not a conscious choice.
We need to get rid of this default mindset that anything other than patient control of health information is OK. It’s not. It’s not OK to support, enable, or tolerate competition in health care based on controlling or limiting access to patient health information.
The right strategy here will come from your heart, not your business plan.
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Getting an Epic Opinion Off My Chest http://t.co/LBSLSAZG #HealthIT #HITPol
Getting an Epic Opinion Off My Chest http://t.co/LBSLSAZG #HealthIT #HITPol
Getting an Epic Opinion Off My Chest http://t.co/LBSLSAZG #HealthIT #HITPol
Getting an Epic Opinion Off My Chest http://t.co/LBSLSAZG #HealthIT #HITPol
Getting An Epic Opinion Off My Chest http://t.co/JVnbhvxO Is the Australian #PCEHR the answer? #HISA #hcsmanz #ehealth
Getting an Epic Opinion Off My Chest http://t.co/LBSLSAZG #HealthIT #HITPol
Getting An Epic Opinion Off My Chest http://t.co/JVnbhvxO Is the Australian #PCEHR the answer? #HISA #hcsmanz #ehealth
Getting An Epic Opinion Off My Chest http://t.co/TMdwpmW3 #HIT #HealthIT
Getting An Epic Opinion Off My Chest | e-CareManagement Blog http://t.co/vRaoBjes
Great blog post by @VinceKuraitis Don't compete to offer me care based on not sharing MY data. That's not "care"! http://t.co/FqyQOLH9
Couldn’t agree more, Vince. As an individual, I think it’s appalling that providers keep information held hostage. In my community (Seattle), there’s a well regarded integrated health system that has a good patient portal. However, if you leave their system, you are hosed and have to pay to get access to paper copies. The fact is 50million people move every year and people change jobs all the time. It isn’t always possible to stay with a provider even if you wanted to.
For an industry that is focused on people’s health, it’s horrible that info is held hostage. It’s well understood that having good patient history allows for better care (and lower cost). History suggests that organizations that treat their consumers like this eventually pay a price. There’s many ways to ensure a business succeeds. Holding data prisoner isn’t the most effective way to do that.
Vince–the main offender gets mentioned in the title but nowhere else? Too subtle i fear
Dave, Thanks for your comment. We are on the same page that health information should not be held hostage.
Matthew, You might be right, but please consider this editorial the first in many more to come.
At this point I think we simply need to get people to understand that 1) there are MANY potential bases for competition in health care and 2) that controlling or restricting access to personal health information should NOT be an acceptable basis for competition.
Once people get this, then we get to 3) suggesting actions to insure that the default of holding on to information goes away, 4)suggesting actions actively to promote widespread electronic access to personal health information, and 5) calling out the Epic offenders by name.
Much of #3 is cultural. We need leadership from CEOs who will say things like “When the patient shows up and says they want a copy of their health information to take across the street or across town to a competitor, we provide that information IMMEDIATELY. No excuses.”
It’s a failure of imagination if an organization thinks a good way to compete is by holding customer (aka patient) information hostage. On #5, what better venue would there be an Matthew’s site to have the “Un-Health 2.0” list? What do you say, Matthew? A Hall of Shame that “encourages” orgs to do the right thing. It bears noting that vendors mirror their customers’ desires. No major org is forced to buy from a vendor so they can’t blame it on the vendor and keep a straight face.
The cost of controlling information can be hassles, poor care, poor coordination and it can be a life. Peggy Jo is a patient with a life threatening illness that is still unknown consequences of data held captive are lives held captive http://www.ehealthinitiative.org/blog/
I took the “Miracle on 34th Street” approach in a post I did in response to this: http://www.emrandhipaa.com/emr-and-hipaa/2011/12/15/the-bases-of-competition-in-healthcare-open-vs-closed/
Basically, it’s good business to open up that information along with it just being the right thing to do.
Getting An Epic Opinion Off My Chest http://t.co/zEEm4GEG