More from the conference. Steeve Kay is the founder of QTC, a disability company which provides outsourced evaluations. Given the problems in figuring out who’s disabled and who’s not, you can see why they care about getting these records electronic. Meanwhile, a private equity firm just bought his company, so he’s obviously convinced someone else that it’s a good business! Yet another little niche in the health care world where plenty (plenty!) of money is flowing around.

Steeve says that medical treatment is provider centric, medical disability is payer centric — and there are lots of payers. It’s about $350 bn total on the health care side (public and private) for medical care for disability, plus another $200 bn for cash payments to the disabled. There’s about 10,000 claim centers in the US who are involved in allocating money, and that includes about 250,000 people working as claims administrators (of various types) with some 10 m claims a year. (I may have that number wrong—Mapping this system is damn confusing!)

These all need evidence to process and judge a disability claim. Most of that needs to come from a medical record, and the legal custodian of the medical record for disability is the payer, while in the medical world it’s a provider. And the disability payer needs to do a bit more to make that complete.

And of course not much has been thought about how these different parties access medical records in an electronic world. His 2 key questions are can we standardize billing codes for disability? And is evaluating disability a practice of medicine.

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