Governor Ernie Fletcher is advancing an E-Health plan. From the Herald Leader and Associated Press:
“FRANKFORT - Doctors would have immediate access to patients' medical histories, allowing them to cut medication errors by catching potentially harmful drug-to-drug combinations. Recommended information on how to treat a particular patient would pop up in seconds -- all electronically, over a statewide network.
Similar to how banking customers can view their statements and access accounts without ever going to a bank, doctors would have immediate access to patients' medical histories, said Dr. James Holsinger, secretary of the Cabinet for Health and Family Services. Patients' permission would be required.”
Now as anyone who has read this blog knows, I’m not a real big fan of the Governor. But on this issue he and I are in general agreement. However the Governor’s plan, as described in this article, does not go far enough and I do have one major reservation about the whole idea.
Dr. Holsinger's comparison to the banking industry does not comfort me. Obviously, the good doctor is not familiar with the concept of identity theft. But let's assume there is adaquate security around the system.
First, I don't see any mention of the patient having access to their personal medical information. If you are going to keep and publish information about me online, particularly something as personal as health information, I want to be able to see it.
Second, if the Governor and the Legislature really want to make a difference in the way medical care is delivered in the Commonwealth, then the “E-Health" initiative must be expanded to include health insurance providers.
Having just spent the last year trying to resolve the billing statements from University of Kentucky Health Care with the payments made by Humana and Bluegrass Health (a Fletcher administration mandated switch in providers), I believe that it’s a miracle that any insurance claim ever gets paid.
And I’m also certain, that when it comes to insurance company payments, the average person doesn’t have a clue who paid what, when it was paid, where it was paid, how it was paid or why it was paid.
Given there are a finite number of reasons to file a health insurance claim, from an annual physical to a catastrophic illness, why is it necessary for every medical provider and every health insurance company to have a different billing system?
If you are designing databases that will have a patient’s medical history, how difficult is it to add fields to that database to reflect the insurance provider, cost and payment for treatment and require the health insurance companies to use the system?
Too Big Brother?
Maybe, but if you are already putting my medical history online, I really don’t care if the insurance company information is included, particularly if it gives me some idea about who's paying what medical expense.