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E-Patient Update:  Keeping Data From Patients Has Consequences

Posted on September 20, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Given who I am – an analyst and editor who’s waist-deep in the health IT world – I am primed to stay on top of my health data, including physician notes, lab reports, test results and imaging studies. Not only does it help me talk to my doctors, it gives me a feeling of control which I value.

The thing is, I’m not convinced that most physicians support me in this. Time and again, I run into situations where I can’t see my own health information via a portal until a physician “approves” the data. I’ve written about this phenomenon previously, mostly to wring my hands at the foolishness of it all, but I see the need to revisit the issue.

Having given the matter more thought, I’ve come to believe that withholding such data isn’t just unfortunate, it’s harmful. Not only does it hamper patients’ efforts to manage their own care effectively, it reveals attitudes which are likely to hold back the entire process of transforming the health system.

An Example of Delayed Health Data
Take the following example, from my own care. I was treated in the emergency department for swelling and pain which I feared might be related to a blood clot in my leg. The ED staff did a battery of tests, including an MRI, which concluded that I was actually suffering from lumbar spine issues.

Given that the spinal issue was painful and disabling, I made an appointment for follow up with a spine specialist for one week after the ED visit. But despite having signed up with the hospital’s portal, I was unable to retrieve the radiologist’s report until an hour before the spine specialist visit. And without that report the specialist would not have been able to act immediately to assist me.

I don’t know why I was unable to access the records for several days after my visit, but I can’t think of a reason why it would have made sense to deprive me of information I needed urgently for continued care. My previous experience, however, suggests that I probably had to wait until a physician reviewed the records and released them for my use.

Defeating the Purpose
To my way of looking at things, holding back records defeats the purpose of having portals in the first place. Ideally, patients don’t use portals as passive record repositories; instead, they visit them regularly and review key information generated by their clinical encounters, particularly if they suffer from chronic illnesses.

It’d be a real shame if conservative attitudes about sharing unvetted tests, imaging or procedure data undercut the benefits of portals. While it’s still not entirely clear how we’re going to engage patients further in managing their health – individually or across a population – portals are emerging as one of the more effective tools we’ve got. Bottom line, patients use them, and that’s a pretty big deal.

I’m not saying that patients have never overreacted to what looked like a scary result and called their doctor a million times in a panic. (That seems to be the scenario doctors fear, from conversations I’ve had over time.) But my guess is that it’s far less common than they think.

And in their attempts to head off a minor problem, they’re discouraging patients from getting involved with their care, which is what they need patients to do as value-based care models emerge. Seems like everyone loses.

Sure, patients may struggle to understand care data and notes at first, but what we need to do is educate them on what it means. We can’t afford to keep patients ignorant just to protect turf and salve egos.

A Look at the Recurring Revenue Model for Patient Services

Posted on April 10, 2015 I Written By

The following is a guest blog post by Oleg Ganopolskiy is VP of Operations at Aria Systems.
A few years ago, a global manufacturer of medical equipment developed a new line of CAT scan and MRI machines.

Sales executives soon hit a wall, however, because of the limited number of customers who could pay for these machines, which cost hundreds of thousands of dollars.

Smaller regional hospitals wanted the machines but couldn’t afford them, so what to do?

The manufacturer began leasing the equipment to the regional hospitals on a pay-per-use basis. Pay-per-use, by the way, is one of the many iterations of recurring revenue, a payment model that’s quickly gaining adoption in the marketplace, even down to the level of the small clinic and solo practitioner.

Thus, in going from direct sales to pay-per-use, the manufacturer opened a new market and everyone benefited, including front-line providers of care.

The manufacturer shifted from selling devices to selling a service, and added smaller, regional hospitals to its market for CAT scan and MRI machines.

Regional hospitals preserved their capital and patients received care locally without the additional time and expense of traveling to distant facilities.  Everyone won.

Medical care is at the leading edge of industries embracing innovative delivery of services through the recurring revenue model.  But medical organizations must protect the privacy of both front-line providers and patients with secure, cloud-based technology.

That’s why we recently went through the rigorous HIPAA certification process for our monetization platform, so that our customers migrating to recurring revenue models can continue to protect patient privacy.

That new level of protection couples with our PCI DSS v.3 certification for protecting credit and debit card transactions. As a result, we exceed the administrative, physical, and technical safeguards required to protect patient privacy.

Security becomes increasingly critical as entrepreneurs pursue ideas to build new patient services using mobile healthcare and the Internet of Things (IoT), which links billions of devices to a vast, interconnected network, to unlock recurring revenue.

Monetizing the Internet of Things & New Healthcare Services

Market research firm Gartner predicts that by 2020, 26 bil­lion devices will connect to the IoT, providing a vast array of services worth $300 billion-plus in annual sales. For example, the automatic monitoring of biometric and other devices will soon become pervasive as companies like Apple pioneer new technologies.

Apple’s much-anticipated Apple Watch will include the ability to collect medical research data on a large scale, including data from clinical trials involving thousands of patients. This capability is expected to revolutionize how trials are conducted. Apple said its new ResearchKit for application developers, to be launched as the Apple Watch goes on sale April 24, is a game changer.

Research organizations such as Cornell University, Dana-Farber Cancer Research Institute and Stanford Medical Center are planning to target asthma, breast cancer, cardiovascular disease, diabetes and Parkinson’s disease with new programs enabled by the data-collecting devices.

In the near future, doctors and hospitals will be able to do consultations with “health kiosks” via video conference and access patient monitoring devices securely and quickly for vital signs and recent history. These new businesses will often leverage recurring revenue models to cover the costs of providing these services.

Another possible recurring revenue application: providers offering new services to patients based on their medical histories, such as physical therapy. Cloud-based case management systems could generate recurring payments for the providers during the course of treatment. For instance, a provider could recommend physical therapy through medical records, and recommend facilities where the patient could go for therapy. The provider generates revenue by managing subscriptions to the health club facilities.

With the proper security measures in place, the rush to recurring revenue is on in the healthcare sector. Wall Street rewards it, the competition is doing it and customers and patients are beginning to embrace it.

About Oleg Ganopolskiy
Oleg Ganopolskiy is VP of Operations at Aria Systems where he ensures that all systems provide the highest level of security, compliance, performance, capacity and reliability. Oleg joined Aria Systems from Nokia, where he was responsible for operational capacity, planning, analytics, and modeling across the company’s Global Services Platform. Previously, he managed technology operations at AOL, spent eight years in operations at eBay, and has held senior technical roles at Oracle Corporation and Nordic Systems, Inc.