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Banking on Care: Leveraging Financial App Innovations in Patient Care

Raise your hand if you think the convenience of your banking and finance services could be a guide to how a patient receives care.
June 27, 2024
monitior my health - eVigils - The-Patient

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Raise your hand if you think the convenience of your banking and finance services could be a guide to how a patient receives care.

Financial apps like Credit Karma, Fidelity, Chase, PayPal, Venmo, Rocket Mortgage, Mint, Acorn, Progressive, and more.

Yup – I see a lot of hands.

Financial apps help streamline financial services; they are convenient, intuitive, comprehensive, accurate, understandable, secure, and colorful and they have snapshots, news, summaries, services, support, and even inter-operate.

Financial apps focus on the consumer user.

Now think about The Patient user. How a patient or their caregiver can streamline care, engagement, information, goals, and results – all of which have more life impact than accumulating wealth.

Innovation of patient-user technology lags behind the rest of healthcare technology development. Yet accountable care and value-based care models make it imperative that workflows support the mantra “it’s all about the patient.”

My colleagues in population health contend that their success or failure in the business of delivering care is based on achieving advances in patient engagement.

And, if we channel Brené Brown and show some vulnerability, don’t each of us desire better ways to participate in our own care or as a caregiver?

It’s all about THE PATIENT

Today’s focus on The Patient is so different than the three key items a seasoned hospital CFO shared with me in the mid-1980s: days in accounts receivable, percent of occupied beds, and the cash balance.

Today’s CFO’s list is much longer and includes several topics related to the patient.

Engaging the patient is a key variable. It even has a hashtag: #patientengagement

Let’s begin with two of the more timely patient topics of the day: patient data availability and access under The Cures Act, and applying mobile technology to patient care.

Patient Data Availability and Data Access: The Cures Act

The Cures Act is pivotal legislation that aims to revolutionize patient data access and sharing. Think about how your personal financial data flows among and across institutions, and apply this to your health data.

Although its title suggests a focus on medical cures, The Cures Act most significant impact is ensuring that a patient, their caregivers, and their providers have comprehensive access to electronic health information (EHI).

The mission: eliminate Data Blocking

The primary target of Cures Act legislation is data blocking – the obstruction of patient data sharing between health entities. This law mandates that some health organizations, or “Actors,” make patient data accessible to the patient and their other health providers, thereby improving care coordination.

The law clearly titles the problem as “data blocking”. Not data enabling. Not data sharing. Not data allowing. Not data access. #datablocking

And the law aims to stop it.

Now here’s the why: because some health organizations – Actors – historically reflect a reluctance or hesitation or low priority to make “their” patient data available to another health entity that is in the act of providing [your] patient care. Some even want really high fees.

So, who owns patient data? Answers depend on where you sit at the table but the final determinant is the entity holding the patient data has ownership as well as specific responsibilities. Examples of these entities are provider groups, insurance companies, laboratories, hospitals, and more.

The good news: HIPAA guarantees the patient has full right to access their own patient data.

Did you know [your] patient data is very likely (> 95%) also stored in a ‘clearinghouse’ similar to how your financial information is stored and used by credit bureaus like Equifax or TransUnion? A health data clearinghouse, or in current parlance a health data utility, has a broad responsibility to the community they serve.

Historical Context

Data blocking issues stem from past legislation like HIPAA and the HITECH Act.

HIPAA, enacted in 1996, aimed to protect health information confidentiality and security. This was followed by the HITECH Act of 2009 which provided $27 billion in incentive payments for the adoption of electronic health records (EHRs) by providers and hospitals.

$2.4 billion of the HITECH incentives went to the states to enhance health information exchanges (HIEs). Noteworthy, today some parts of the US have no HIE coverage – like my home of the Middle Tennessee metropolitan area, major urban areas (e.g. Chicago), and many rural areas. But many other areas have HIEs in place, albeit in varying levels of sophistication.

The Cures Act’s Impact

The Cures Act aids every patient and every health care provider organization, akin to how financial and banking laws impact and protect the consumer.

The Cures Act aims to eliminate data blocking by specific Actors:

  • Health information networks
  • HIEs / health data utility
  • Certified health information technology developers
  • Healthcare providers

The Cures Act legislation is a big deal. Actually, really big. Think HIPAA-big. And not enough people are tracking it.

We read about big fines associated with HIPAA violations. Even bigger fines can be assessed to Actors for Cures Act violations.

Like HIPAA, the OIG (Office of Inspector General) has a website dedicated to initiating, documenting, and reporting Cures Act situations.

Health data utility in action today

Here are two quick, everyday examples of how eliminating data blocking improves patient care

  • Care teams are notified – like Amazon does a package – when their patient seeks emergency care or is admitted to a hospital or discharged from a post-acute facility and many other changes in patient location.
  • Care notes entered by a provider in the hospital are immediately delivered – again like an Amazon – to a patient’s care team
    Both of these examples are key factors in slowing down the escalating cost of delivering health care.

You can see, can’t you, how each helps eliminate waste of resources and time? And, if you are a dialysis or cancer or cardiovascular patient or other patient with chronic disease these are a big help to your care team.

Personal Experience

Eight years ago I had an emergency heart event 1,600 miles from home and I wish my local cardiology team had been notified. Yes, the Phoenix-based heart team requested my medical records, but their focus was, appropriately, on addressing “the big hairy thing” versus seeking out or addressing any underlying issue. Prior to and during the procedure I did advocate for myself (literally) but the attention was on the current problem.

After a horrible 16 months post-procedure, I was on the table again, locally, to complete the fix with 2.25 inches of continuous stents added to the original stent in a heart artery that is five inches in length.

That second stent procedure was a 400% increase over the original stent.

All involved believe my emergency care and recovery may have benefited if my local specialist was alerted or contacted – not just the medical record department – of my situation.

Wrapping up this part, we will report how and where The Cures Act is aiding patient care in future posts, along with [your] patient rights, what is considered a violation, and fines.

For now, let’s transition to mobile technology, but, don’t forget: patient data does help the delivery of [your] care and the patient has full access rights.

The Necessity of Mobile Apps in Healthcare

Google AI reports the vast majority of Americans have cell phones (97%) and smartphones (90%). Mobile technology is a groundbreaking area in healthcare.

According to Topflight, as of 2024, there are about 65,300 health apps on the Google Play Store and 54,000 on the Apple App Store. These apps are utilized by patients, providers, caregivers, and others involved in healthcare delivery.

Patient Use of Mobile Apps

Each health app’s purpose is to provide meaningful value, often with specific or targeted functionalities. Competition and overlap in the marketplace drive the growth and direction of these apps.

My company began delivering mobile apps to providers in 2012 and patients in 2013. Our focus is ‘actionable’ patient data and care coordination for patients with chronic conditions.

Most striking, to me, is the current day sharing of patient data across health apps (i.e. interoperability). Or, said another way, data blocking is not prevalent in the mobile app world.

Interoperability: The Key to Effective Healthcare Apps

Let’s give an example of mobile app interoperability related to patient care:
Strava + Training Peaks + Apple Health + Vanderbilt Heart

Interoperability is crucial for app efficacy, for example enabling apps like Strava, Training Peaks, and Apple Health to share data seamlessly – for the benefit of the user.

This integration empowers users to monitor and share their health metrics effortlessly, enhancing both personal monitoring and professional healthcare collaboration.

In my case: my Garmin GPS watch connects and records data from a supplemental heart rate chest strap monitor. At the end of the activity, the Garmin watch downloads data to the Garmin Connect app which auto-magically sends my relevant metrics (heart rate, time in heart zones, effort, recovery, VO2, etc.) to Strava, Training Peaks, and Apple Health. It’s similar to a treadmill stress test.

My care team at Vanderbilt Heart references my activity data to supplement other test results and measures being monitored. They have metrics from my camping and hiking as high as 14,400′ elevation. That’s really good data.

Other examples are plentiful: glucose monitoring, blood pressure, oxygen saturation, test results, etc.

Looking Ahead: The Future of Patient Care Technology

The journey of enhancing patient care with technology was formalized in 2004 with the creation of the Office of the National Coordinator for Health Information Technology (ONC) by CMS. This initiative aims to dismantle waste in healthcare delivery and improve the patient experience.

Celebrating its 20th birthday this year, the ONC is the momentum behind the 2030 CMS goal that all Medicare and Medicaid beneficiaries receive care under accountable care methods. Out with the old (fee-for-service) and in with the new!

CMS Strategic Goals for 2030

2030 is a critical year projected for the US healthcare delivery evolution. The draft of the 2024–2030 Federal Health IT Strategic Plan outlines three factors impacting this goal:

  1. The full implementation of the Cures Act
  2. Ongoing regulatory flexibility
  3. Education of providers and patients

There’s The Cures Act, once again. It’s the track that makes the delivery of accountable care possible. Ensuring patients and providers have access to necessary information – just as banks and financial services have for consumers.

Your Role in the Evolving Healthcare Landscape

Whether you’re personally invested (at some point we are all a patient), a caregiver, or professionally engaged (health care is 17.3% of the GDP), staying informed about emerging patient technologies and practices is crucial, and interesting.

Subscribe to stay updated on the latest in patient-related healthcare technology and engagement.

After all, it’s all about The Patient, right?

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Value-Based Care
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AndrewRittler - Chief Executive Officer

Author

Andrew Rittler

Andrew Rittler, Chief Executive Officer, joined MITEM Corporation in 2013 to bring the eVigils platform to market and lead product direction. Andrew has a 35-year history in healthcare technology leading consulting, sales, and service operations.

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