What if one doctor could “friend” or “link in” with another for the purpose of patient exchange? Today when we hear people talk about clinical integration, they’re talking about financial integration…literally owning every stage of the treatment of a patient just so that the data created from that care can be integrated. That kind of thinking has fostered a proliferation of miniature Kaiser Permanente-like health organizations across the country–each with their own multi-hundred-million-dollar proprietary system to hold their data all in one place.
I think owning a lab is an expensive way to integrate the data from that lab into a common view of a patient—let alone “owning” a cardiologist! Furthermore, as the nexus of health care moves ever further away from the hospital ward and towards the home, owning every point of health care delivery will become increasingly difficult, if not impossible. So what’s the alternative? It’s the same one that gives us integrated credit ratings and the ability to walk up to any ATM in the world and still get money from our own account. It’s a market for clinical information exchange enabled by social networking-type technology.
When you think of it, Facebook and LinkedIn present integrated pictures of all the people you’ve touched in your life or work as soon as you log in. And over time you see how that integrated picture of your life or work life improves.
I know there’s something like this for clinical integration.
I know because, at athenahealth, we just had a physician client in Texas perform our very first “friending.” This doctor friended a major health care network in Texas and it went like this:
- Our client had a patient that needed a certain procedure, and this particular health care network was the ideal provider choice.
- To perform the procedure, the health care network needed the patient’s insurance eligibility, key medical records, and financial information.
- We’re building a pipeline from our cloud-based medical record into the big health care network’s proprietary system.
- We reached an agreement that every time athenahealth performs an injection of the exact, pre-formatted clinical and financial information that the network needs to care for a patient, it would pay us for that service. The service fee would be a few dollars, significantly less than the big network’s administrative costs to verify insurance and clinical information and get that patient scheduled. This presents a new opportunity to change the way EHR technology is paid for and should encourage wider implementation through lower costs for EHRs on the front-end.
- Now, any time that anyone we serve sends a patient to this Texas network, that patient’s chart will reflect what happens at both places.
It sounds nascent because it is. In fact, it’s the first time it’s happened anywhere.
Next year we’ll be doing more friending and more patient exchanges.
It’s health information exchange, or HIE, as a verb instead of a noun.
We think that it will result in confederated patient information—that is, the ability to consolidate a patient’s information while allowing that patient to receive treatment from a broad array of places…including (over time) his or her home.
Doctors are going to be able to friend each other. And when they do, the receiving doctor can expect to get exactly what he or she wants from the sending doctor. The charts in the athenahealth EMR from the sending doctor are going to automatically shape shift to make sure that the data the receiving doctor wants is being captured and transferred.
Finally, no matter where you go in the world, a doctor you authorized will be able to find you on athenaNet…but that’s another story.
Jonathan Bush co-founded athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. He obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School.