It's time for our first ever Clarifying Health reader poll. We have some pretty strong opinions and we aren't afraid to write about them, but I realize that a lot of readers don't necessarily agree with everything we have to say. That's why we're going to try running polls periodically to let everyone have a voice.
I want to start by asking what you think about electronic medical records. To summarize the issue, it's commonly agreed that one of the most promising areas in which we can improve the price and effectiveness of care that doctors and hospitals provide patients would be to store all medical records on computers rather than in paper files. This would reduce errors (like sloppy handwriting or misplaced records) and it would potentially improve collaboration between doctors because it's much easier to share electronic data than endless sheets of paper.
On the other hand, many people aren't comfortable with the idea of their medical records being stored on computers, particularly if those computers can be accessed remotely. There are enough stories about hackers and identity theft that many people are happy with their personal information being stored using a good old-fashioned filing cabinet.
So what do you think? Are you afraid of hackers? Do you think that the risk is worth the reward?
If you're reading this in an email or feed reader, you may need to click through to the full post to participate in the poll
As always, let us know your thoughts in the comments.
In case you aren't up on your tech lingo, cloud computing is a term that refers to internet services like Gmail where the data is all stored on someone else's servers. The advantages of cloud computing are that you don't have to worry about maintaining servers, installing updates, or managing your data. The downside is that people worry about the security of letting someone else hold on to all your sensitive information.
Obviously, since security is a major issue with medical records, people are afraid of storing medical information "in the cloud". Here at Zane Benefits, we're strong believers in cloud computing. After all, our software products use that same model. So why is it that I think you should all happily hand your data over to our Google (or Salesforce) overlords?
Sure, putting your data in the hands of a third party is scary, but you need to consider who is more likely to protect that data from both thieves, and from honest human error. If you leave your information on a server that your doctor's office maintains, not only does it make it difficult for other doctors help you efficiently, but it requires your current doctor to actually know something about running a data center.
If you store your data with a major tech company like Salesforce, you can feel pretty comfortable that it's being protected with offsite backups, physical security, and professional sys admins making sure everything is working.
My brother came up with a great analogy to drive this point home. When banks first started showing up, it probably seemed like a weird idea to give all your money to someone else. What if they weren't trustworthy? What if they lost your money? Now, it's obvious that banks are a much more reliable way to store your money than keeping it in a shoebox or hiding it under your mattress. Cloud computing works the same way. Think of companies like Google and Salesforce (and Zane Benefits) as banks for your information. We store and protect your data, make it easily accessible, and pass it back to you whenever you need it.
Medical I.T. is one of the main phrases tossed around when politicians talk about innovation and cost savings. There's no question that improving the way doctors and hospitals store and share information could have a huge impact, but I wonder if the private sector won't be the driving force behind this change.
I'm going to compare the possibilities of a government led initiative with those of a private solution. Specifically, I'm going to look at Google Health because I'm an unashamed Google fanboy. There are hundreds of companies offering really promising medical I.T. services and products, but I'm going to use Google to represent all of those companies.
How the government gets things done:
There would be no point in me acting like I know how the reform bill will work, but mixing common sense with a dash of speculation can lead us to some pretty solid assumptions.
First of all, the government generally gets things done through taxes. They incentivize people and organizations to act in certain ways by either taxing undesirable behavior or offering tax breaks for the desired behaviors.
Mandates are another big one. It's likely that by a certain date (let's say the beginning of 2015) all medical providers will be required to meet some kind of loosely defined standard.
How Google gets things done:
Google is famous for having virtually no traditional marketing or distribution methods. They also aren't generally swayed by how other people think things should be done. With search, email, and online advertising, Google basically came up with a great product and assumed that users would adopt it.
What does this mean for Google Health? It basically means that Google probably has a pretty good idea of how things should work (in their opinion at least). They will adapt as they learn from experience, but they wouldn't be releasing a product unless they were confident in how it will work.
The main difference:
I believe that the main reason a company like Google will have more success than the federal government in bringing about lasting change is that companies are able to work from the ground up and the government has to work from the top down.
While the government is worrying about money and mandates, Google can worry about a real solution.
The reform plan will throw a lot of money at certain problems and set some very vague guidelines. The problem is, it's not the governments job to really suggest specifically how the problem should be solved. They just hand money out and hope that by the date they set, everyone has figured it out on their own.
Google, on the other hand, is able to start with the solution and worry about the money later. If a user signs up for Google health, they don't see guidelines or suggestions. They see a thought out application that tells them how to manage their health records. They then take that to their doctor who has to start supporting Google's system.
This model didn't work 20 years ago because a company like Google had no distribution without the internet. Today, a good idea can spread across the entire country in a matter of hours. We don't necessarily need a massive national initiative to bring about rapid and lasting change.
I don't believe that real health reform can be achieved without government intervention, but medical I.T. is one area where the government is seriously out gunned by any number of individual companies.
As you can imagine, these two stories are combining to form "All your medical information will be stolen" stories. Putting aside the fact that the hackers may be lying about stealing the medical records, I thought I'd talk about the relationship between these two events and what I, as a programmer in the healthcare industry, think about it.
First of all, when implemented properly, electronic information is generally more secure that paper files. It's harder to "hack" into a well designed system to steal records than it is to break into a hospital and steal all the files. Also, electronic data can be encrypted so that even if a hacker does get their hands on the information, they won't be able to read it.
When you hear stories about credit card or social security numbers being stolen from a server, it's almost always the case that either the system they were being stored on was at fault (which can easily be prevented) or it was an inside job (which can also happen with physical records). What I'm saying is, assuming we implement this system correctly, there's nothing to worry about.
But I am worrying all the same. I know a few doctors and it sounds like the technology hospitals use for administrative work is poorly designed and outdated. If Obama expects these hospitals to be entirely digital in the next 5 years, chances are good that they will try to patch their existing systems rather than building from the ground up. This could lead to a real mess. Adding new functionality to old, broken systems doesn't normally work very well.
In the mid-90s, the IRS began upgrading their antiquated IT infrastructure which was designed in the 60s. The result was one of the most embarrassing technology failures in the history of computers. Like many computer science students, I studied this as an example of what not to do. The moral of the story was that at some point, a system becomes so broken that you are better off rebuilding it from scratch rather than trying to fix each and every problem individually.
I could see this happening if we're not careful. Apparently each hospital will be eligible for up to $11 million in reimbursements in return for being an early adopter of electronic medical records. If this money is used properly, the country will be in a much better place in 5 years. If the money is squandered on patching problems rather than rebuilding, it wouldn't surprise me if we see a few more cases of identity theft via stolen medical records.
Clarifying Health is a blog about health insurance, health benefits, and everything else related to how Americans pay for medical expenses.
If you have any tips or suggestions for this blog, send an email to blog@ZaneBenefits.com and let us know. We always appreciate feedback
We also run a company called Zane Benefits where we're doing everything we can to help America out of the current healthcare mess.
If you want to learn more about how Zane Benefits helps companies with their benefits, or you're interested in working with us, visit the Zane Benefits website.
