By LYGEIA RICCIARDI
These days Americans are more politically divided than ever, disagreeing vehemently about everything from guns to the role of the press. Despite the distrust and inflammatory rhetoric, there are examples of cross-party, trans-Administration collaboration and success. Let’s celebrate them and be motivated by what happens we put differences aside and focus on shared long-term goals.
Using digital technology to empower healthcare consumers is one example of a cross-party win, a still-developing success story that has been cultivated for more than a decade by the efforts of public and private sector leaders from a wide variety of affiliations and political perspectives.
Taking Healthcare Digital is a Cross-Party Achievement
Back in his 2004 State of the Union Address, Republican George W. Bush called for most Americans to have comprehensive digital health records within 10 years. “By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care,” he said. Since then both political parties have built on the vision he laid out and added an important new twist—taking healthcare digital isn’t just about helping doctors do a better job, it’s also about empowering patients to be partners in their own health and healthcare.
In 2009 Congress allocated about $30 billion via the HITECH Act to expand and promote the adoption of health information technology, mostly through financial incentives for hospitals and doctors to migrate their medical records from manila folders to digital files. Through the resulting “meaningful use” program implemented mostly under Democrat Barack Obama, virtually every hospital and most doctors’ offices now have electronic health records systems (EHRs) which, in addition to laying the groundwork for a better traditional healthcare system, are required to have the capability to provide patients direct digital access to their own health records—effectively unleashing that data for any new kinds of uses available to and chosen by consumers.
Power to the People
Why would the average Joe or Jane want digital access to their health records anyway? For many reasons, from greater convenience (like easily getting the results of a medical test), to better health outcomes (for instance by avoiding medical errors by updating records to show which medications they are actually taking). With digital access to their own medical records, patients can also make sure the full array of people who support their health, often including multiple doctors, family members, and friends, are all on the same page, thus improving health outcomes and sometimes saving time and money in the process.
As of 2017, nearly a third of Americans had actually accessed their own health records online via a healthcare provider or insurer. Among those who did, 8 in 10 found the information easy to understand and useful.
The chart above shows what people who accessed their health information digitally did with it. While all of these activities are useful, it’s at the bottom of the chart where some of the most transformational untapped potential in empowering consumers with health data still lies.
Last year only 3% of people who accessed their health information digitally shared it with a service or app, but the conditions are right for dramatic growth in that area. While the traditional healthcare system has been converting over to digital, at the same time the public’s adoption of smartphones, apps, and wearables such as the Fitbit has been climbing. Smartphone use in the US is projected to surpass 250 million of the total population of 300 million in the next couple of years.
Enter the Tech Industry
Already 44% of smartphone and tablet owners report having a health or wellness app. About one-third own a health-related monitoring device such as a Fitbit, blood glucose monitor, or blood pressure monitor.
So far, most people haven’t linked the two… but industry innovators and investors are betting they will. Consumers supported by apps and tools can eat better, move more, remember to take medications, avoid stress, and make smarter healthcare spending decisions. All of which can benefit individual consumers and the healthcare providers and companies that want to serve them.
This year venture capital funding in digital health is projected to reach nearly a record-breaking $7 billion. And more established industry players are jumping into the fray as well, with 84% percent of the Fortune 50 Companies involved in healthcare, up from 76% in 2013.
Source: Rock Health, 2018
The Blue Button: An Inspiring Cross-Party Handoff
Last week the Trump White House hosted a forum on Blue Button 2.0 for technology developers. At the event, the Administrator of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, encouraged developers to build apps and services leveraging data about 50 million Medicare beneficiaries that has recently been made more easily available via application program interface (API) standards through Blue Button 2.0, a part of the My HealthEData Initiative unveiled by Verma and Senior Advisor Jared Kushner last spring at the HIMSS conference, which will “help to break down the barriers that prevent patients from having electronic access and true control of their own health records from the device or application of their choice. This effort will approach the issue of healthcare data from the patient’s perspective.”
At the White House event, several large industry players including Amazon, Google, IBM, and Microsoft agreed to “actively engaging among open source and open standards communities” to further the goals of greater healthcare interoperability, in addition to “empowering patients.” It also included startups and industry analysts such as investor John Doerr, who spoke of the coming “dataquake” that will transform the healthcare industry.
Large-scale change like digitizing healthcare or shifting the role of the healthcare consumer doesn’t take place overnight. By definition, it relies on the policy leadership of multiple Administrations and extended public-private partnerships. The Blue Button concept was born at a meeting at the nonpartisan Markle Foundation in 2010, and was first implemented by the US Department of Veterans Affairs (VA) to enable veterans to get their health records online. It was soon enhanced and expanded by the Obama White House and other agencies, including the Office of the National Coordinator for Health IT, which collaborated with 60 industry partners to develop API standards for data sharing and led a pledge program in which more than 500 organizations agreed to share data easily with consumers and spread the word about the benefits of doing so through a coordinated national campaign. Numerous patient and pro-patient advocates continue to lend their voices to the effort through policy advice, stories, speeches, and art.
It’s exciting to see Blue Button and the broader concept of consumer empowerment continue not just to take root, but to flourish. Regardless of party affiliation or perspective in (or outside of) the traditional healthcare industry, let’s continue to collaborate in unleashing data for the benefit for all Americans. Better health, better economics… maybe even better cross-party collaboration in Washington—now that’s good for everyone’s health!
Lygeia Ricciardi is an expert in digital health and consumer engagement with Clear Voice Consulting. She started and led the Office of Consumer eHealth in the US Department of Health and Human Services from 2011 through 2014.