We have reached the 10-year anniversary of Health Savings Accounts (HSAs), a health insurance option signed into law by President George W. Bush. Although consumer initiatives such as Medical Savings Accounts (MSAs) had been in effect well before this law, industry watchers consider 2004 the unofficial beginning of consumerism in U.S. healthcare.
Although four million Americans are currently enrolled in the HSA program, the "ownership society" as envisioned by President Bush in regard to healthcare has not materialized in any meaningful way. But this was only the beginning of many initiatives that significantly enhanced consumerism in healthcare.
We have seen a number of tools in the healthcare consumer space that promote cost transparency, introduce competitive shopping experiences (for insurance and medical services), attain cost reduction, and perform wellness and disease management. While there is no question that the consumer has more healthcare information available today than at any other time in history, the information gap between healthcare consumers and healthcare constituents remains wide.
The Affordable Care Act of 2011 was the next catalyst to fuel the growth of consumer tools. The National Institute of Standards and Technology (NIST) certification of electronic medical record systems (EMRs) led to a revolution in consumer tools with regard to accessing patient health information. As standards are established for health data exchange, Personal Health Records (PHRs) will play a crucial role in care coordination. As healthcare delivery shifts from fee-for-service to pay-for-performance, providers must find ways to frequently communicate with their patients.
Tech-savvy healthcare consumers (i.e., patients) today would prefer to receive their results electronically, and be able to ask follow-up questions of providers. Sharing records with specialists and consults will be easier and more effective if the patient has complete medical records in his/her control and can send it to whomever they want in a safe and secure manner.
Some of the healthcare consumer's needs in this emerging healthcare model include:
- Care coordination (sharing records electronically with specialists and other caregivers);
- Ongoing support of chronic conditions;
- Prevention & Wellness;
- Electronic health and finance information access and management;
- Manage and optimize healthcare related expenses;
- Ability to receive feedback from providers, employers, friends, family & health coaches;
- Share & communicate health conditions with friends and family;
- Challenge and reward healthy behavior.
To meet these needs, a successful consumer-centric healthcare information and communication tool should provide the following components:
- Personal Health Record (PHR);
- Patient-provider communication tool (Secure Messaging);
- Wellness and Preventive Health Tracking;
- Insurance and Finance Management;
- Health Social Networking.
In coming years, consumers will rely on PHRs just as they rely on their online banking, stockbroker portal or other frequently visited sites. With the Affordable Care Act, the vast majority of providers in the country are implementing EMRs where patient records can be easily transferred from one system to another. Before long, patients will automatically receive their medical records in their choice of PHRs.
Historically, all health information came from providers. With the advancement of internet-connected home medical devices such as weight scales, oximeters, blood sugar monitors, and blood pressure devices, a vast amount of health data can now be gathered automatically. Entirely new classes of devices that track individual activity information and exercise regimen are increasingly adopted by consumers. Wearable technology can collect a whole new set of information regarding your health and wellness activities. The next generation PHRs will be able to integrate these patient-generated data with provider data to make PHRs highly effective intervention tools and contribute to improved healthcare.
As the fee-for-service model recedes and provider rewards are maximized for keeping patients healthy, engaging patients becomes a priority for most providers. Accountable Care Organizations (ACOs) and other providers managing financial risk will be in the forefront of this transition. Patient education and counseling are important part of effective care delivery, and continuity of care management is critical for cost and risk control.
In addition to the features listed above, as healthcare becomes more and more consumer-centric, the need for many other services will also become critical. Providers have to make it easier for patients to gain access to physicians and services by allowing them to request services and appointments online. Providers should allow patients to submit information before their appointment whereby reducing waiting room paperwork. Also, facilitating online review of patient bills and bill pay features will help gain patient acceptance, loyalty and trust.
Adaption of technology combined with the tearing down of traditional information walls will increase healthcare quality and the level of personalized services. These changes will be consumer-driven. Personal health information technologies will continue to adapt to the hands-on demands of today's tech-savvy consumers.