Paging Medical Information: Examining Access Issues

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Patients and doctors demand access to digital health data, but privacy and protection issues remain at the fore. Comparing the costs of different doctors and medical procedures can be a time-consuming affair for consumers. A new project launched in recent months by the administration of Florida Governor Jeb Bush is using the internet to simplify the process by providing a one-stop site where consumers can compare the costs of visits to the doctor's office by ZIP code and find other cost savings.

The government-sponsored project seems to have inspired other healthcare organizations to place cost-comparison information on the internet—the latest versions of so-called medical information audits. Other cost-comparison tools are emerging that are national in scope, too.

"With the push for electronic medical records and increased federal regulations, medical information auditing is a hot subject," says Peter Ransome, EVP of Active Data Services, a business process outsourcing firm. The latest trend enables consumers to audit, or review, their own health information or cost information comparing different doctors. This is a new twist on the decade-long move to audit medical records, in-house, at doctors' offices, and it is taking the sophistication of medical records to a new, unexpected level. 

Emerging Initiatives 
Late last fall, Florida's Agency for Health Care Administration (AHCA) launched the new consumer internet site Florida Compare Care. Florida government officials see the interactive site as an initial step in making the healthcare system there more transparent. 

The Florida Compare Care site is emerging as part of an initiative mandated by House Bill 1629, signed by Governor Bush to create a consumer-friendly site on the internet where performance measures of Florida hospitals and outpatient surgery centers can be found. The site is set to provide information on the number of patients at each hospital, the charges for various medical services, the average length of stay for a patient, re-admission rates for each hospital, mortality rates, and complication rates. "The more transparent our system is, the more likely we will see even better performance," says AHCA secretary Alan Levine.

The site is integrated into another site, www.floridahealthstat.com, which also provides information for patients on particular medical conditions and procedures. Most importantly, the site is providing details on why the costs and other data differ from hospital to hospital. The hope is that by making the information publicly available, hospitals will create new benchmarks to improve performance. State officials hope that making such information available will help save additional lives.

There are some 32,000 healthcare facilities in Florida and 37 HMOs. The AHCA administers a $15 billion Medicaid program for the state. The AHCA's online initiative seems to be inspiring other healthcare providers to make information about their costs and services available online. 

Earlier this year, Florida-based CIGNA Dental launched an online Dental Treatment Cost Estimator, which it billed as a "first of its kind" project on the internet. The site enables CIGNA Dental members to estimate and plan for their dental-care costs before they receive services and is being touted as "the next generation" of online information tools. 

Actionable Information
"Consumers have a growing need for actionable information to help them make decisions about their healthcare, including their dental care," says Karen Rohan, president of CIGNA Dental. "Having this cost information prior to receiving services can help consumers get the most value from their dental coverage and help them to maintain good oral health."

According to the National Association of Dental Plans, an industry association, there are 159 million Americans covered by some form of dental insurance. Of those patients, 19% pay entirely for their own dental benefits and 48% share the cost of their dental premium or fees with their employer. With the new online tool, CIGNA Dental members can select the procedure or treatment they are considering and estimate what their out-of-pocket cost would be—before making an appointment. Treatment cost estimates are based on plan information and are adjusted for geographic location.

There are some 117 million Americans who regularly use the internet to find some kind of healthcare information at established sites like WebMD that provide general information on afflictions, symptoms, and cures for an array of maladies.

A national site similar to the one launched by Florida last fall was officially launched in late spring. The site, Healthia, which is funded by Bessemer Venture Partners, targets consumers and small and medium-sized businesses shopping for healthcare coverage and services, according to Shankar Srinivasan, a member of the founding team.

"Healthia was founded in 2005 to catalyze the consumer-driven healthcare movement. At healthia.com, people can compare health savings accounts, health-insurance plans, carriers, and doctors side by side and will soon be able to price and compare hospitals and even individual procedures," according to Srinivasan.

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