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Making JustShowMeTheDoctorNetwork.com A Reality

Posted on December 17, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Ok, that website really isn’t a project, but a website that has that functionality would be awesome. I recently had this problem. I was getting new health insurance and I wanted to know if our regular doctors would be part of the new insurance plan’s network. What a pain in the butt. Even the health insurance companies website made it difficult to know if they accepted the plan. The networks were named different than the insurance. Just plain ugly!

Turns out that Fred Trotter is doing what he can to help solve the “out of network” insurance game. Since it’s Fred Trotter you know it’s based on freeing the data. The post is well worth a read, but highlights why figuring out if your going to an in network or out of network provider is important and how the insurance companies are making it difficult to get access to this data.

Fred also points out a possible solution to a problem found in the text of the Notice of Benefit and Payment Parameters for 2016 (don’t you love how quickly the government works?). This new rule would essentially require insurance companies to provide an updated directory of providers and possibly requiring that they provide it in a machine-readable format. Seems like a small thing, but it would make a big difference.

However, this is the money quote from Fred about the government proposal above:

This would solve the problem. Anyone who wanted to could create a website that showed what plans any given provider accepted, would be able to easily do so.

But they key word here is “propose”. Insurance companies in this country benefit greatly from the confusion about in network and out of network, and so do some unethical healthcare providers. There will be lots of people who oppose this proposal.

I hope that I have made the case that this information needs to be open and machine readable. If your convinced, then you can find the comment page to support this policy here. If you disagree with us, and you still want to submit a comment, you can use this page.

Comments on this rule are due by 12/22 which doesn’t leave people much time to chime in. As someone who’s had to deal with this challenge recently, I hope that this rule is passed. I can’t wait for an entrepreneur to take this data and create a beautiful map overlay of the doctors in my network. Would make searching for a doctor in your insurance plan so much easier.

Are EMRs And Paper Records Incompatible?

Posted on July 15, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I just caught a blog post by the indefatigable Fred Trotter (a high-profile Open Source guy focused on HIT) which raised an important issue.  In his article, Trotter argues credibly that once a healthcare organization implements an EMR, its records are more or less incompatible with standard paper records.

Trotter cites the troubling case of two primary care groups which, despite the using same major EMR system, can only share data by printing out massive paper transcripts of a patient’s electronic record.

Apparently, each have a custom version of the system in place, which means that the two groups couldn’t share data directly. So when a patient from Practice A moves to Practice B, Practice A’s only option is to generate what — from a photo included in the article  — looks like thousands of pages of data.

Not only are such paper printouts awkward to store and manage, they’re painfully difficult to use. While traditional handwritten records provide a familiar, and relatively concise, source of medical data, this blizzard of paper could actually bury critical information.

After all, while the data might make sense when access via the EMR’s digital templates, doctors may not know where to find what they’re looking for when confronted with the print equivalent of a massive Excel spreadsheet.

Not only that, when Practice B scans this paper monster into its system, the problem just gets worse. When caring for the patient, B’s doctors will doubtless begin entering data into their own EMR system, piling structured data on top of incompatible scanned data. How clinicians will figure out what’s up with the patient is a mystery to me.

As commentors to Trotter’s item noted, the two practices could probably have shared a summary in Continuity of Care Document format. However, unless practices are willing to make do with a summary over the long term, they’re likely to confront paper printouts for quite some time.  Not a pretty picture, is it?

Fred Trotter Thinks CONNECT Will Unify Health Information Transfer

Posted on November 25, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ll admit beforehand that I’m a member of the Fred Trotter fan club. He’s a little bit psycho when it comes to open source licensing and the like, but that’s probably why I love him so much. When he truly believes in something he’s fully engaged in that cause.

So, of course I am completely interested in Fred Trotter’s blog post about CONNECT where he said the following:

The right conversation starts with this: we can assume that CONNECT -will- unify the health information transfer in the US. It will serve as the basis for the core NHIN and regional networks will have the option of implementing it. That means that CONNECT sets the bar for health exchange. Software must be as good as CONNECT to be considered for a local Health Information Exchange, otherwise, why not use CONNECT?

I think this is the second time that I’ve heard the name of the project CONNECT like this. I think that’s a sign that I better do some more looking into this project.