Patient/Provider Connectivity: Leading the Transformation of Healthcare Delivery

The uninsured, higher co-pays and consumer-directed plans are changing the dynamics of the physician economic relationship. Patients seek less costly care while others approach decisions in consumer retail mode. Fortunately these trends are spurring adoption of Internet tools that deliver accessible, affordable and convenient care. Physicians easily interact online with patients on non-urgent symptoms. Point-of-service and self-service capabilities drive collections and develop payment plans. Testimonials illuminate the convergence of clinical and financial Web tools translated to savings and better outcomes.

David Nace, MD, RelayHealth

Nace began his presentation with a review of the current challenges facing practices. He noted that healthcare cost pressures and the economic downturn have cause a need for administrative efficiencies and reimbursement management at the point of care. Healthcare reform and the HITECH stimulus also present challenges in trying to achieve meaningful use and interoperability for care collaboration.

Nace moved to the results of RelayHealth survey on point-of-service (POS) reimbursement challenges, which found that practices want better visibility into payment at the POS, patient collections are a significant challenge for physicians, and practices are willing to collect payment at the POS based on credible estimates.

Returning to the topic of administrative efficiencies, Nace noted that the total cost of medical practice interaction with insurers is $21-$31 billion per year. The total practice impact is more than $68,000 per physician each year.

Moving to the laying of the foundation for interoperability, the speaker explained that health information exchange (HIE) is moving faster that EHRs, with HIE funding beginning in 2010, typically received as up-front grants via the states, and EHR funding beginning in 2011, paid directly to provides AFTER proving meaningful use. Options for those who adopt are a “connected” EHR, going with a modular approach, or starting out with the basics and then adding advanced application, explained Nace.

Focusing on HIE, Nace stated that the evolving world of Web services (SaaS)—through Web applications, clinical data distribution, interoperability services, and network identify management—allows for the avoidance of costly, complex, locally installed softer; the avoidance of infrastructure needs (just access to the Internet); rapid deployment and adoption; no need of local or practice IT staff, and predictable costs. Further, HIE use can help reduce staff time that would be spent on handling lab and radiology results and clerical administration and filing; decrease what is spend on redundant test; decrease costs of care for chronic care patients; and reduce medication errors, according to Nace.