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Healthcare IT and Freeing the Power of Truly Informed Consumers

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Reducing Healthcare Costs and Inefficiency, Now!

Everyone agrees that transparency in healthcare pricing and consumer choice is critical. Everyone also agrees the healthcare industry falls far short of truly informing and empowering consumers to make healthcare choices based on competitive prices and quality of outcomes. Progress has been painfully slow.

To general surprise and not that much fanfare, Massachusetts took the bull by the horns by taking the next step into price transparency, mandating health insurers to post the costs of a variety of medical procedures for their enrollees, from the cost of office visits to surgical procedures. “This is a very big deal,” Massachusetts Undersecretary for Consumer Affairs and Business Regulation Barbara Anthony told Kaiser Health News. “Let the light shine in on healthcare prices.”

If you expect the “Massachusetts Way” to spread across the states like wildfire, think again. Plus, even in the case of Massachusetts, not every element of cost is posted per the mandate, for example, extra fees for interpreting tests. Given the rise of extra fees and an increase in the number of people who have high-deductible health plans, more consumer demand to know how much procedures cost and what to expect in total cost will rise concomitantly. What can be done?

Overcoming challenges of transparency and accountability of the healthcare marketplace

The report of the Harvard Business School First Forum on Health Care Innovation, notes:

No matter how important new firms are to innovation in healthcare, much of the activity continues to flow through established firms―providers, insurers, and suppliers―that also must engage in innovation to increase value. A key question is how the benefits of new insights can be integrated into these established organizations.

So it is clear that the sources of innovation are going to be a complex mix by necessity. In addition, it is a huge challenge to create applied practical uses in healthcare consumerism that must leverage terabytes and even petabytes of healthcare data collected in massive data sets.

We can move ahead faster in our view. For example, comparative rating systems have been publishing the costs for insurance products for years and we believe that the same or similar technology can be used to aggregate healthcare data already collected by hospitals into consumer-friendly portals that will allow consumers to shop for healthcare and make sound decisions.

Healthcare consumerism is equivalent to TripAdvisor, and aiming to grow to its scale, is being created now with disruptive goals. As such innovations take off, we see both greater chaos and greater rationality ahead, and it is to be hoped, reduced healthcare costs sooner rather than later.

Again, technology, such as the middleware integration engine which PilotFish offers, can be used behind the scenes to take all those terabytes and petabytes of disparate data from disparate sources and systems and normalize it so solution providers can utilize it and present it in user-friendly ways. Consumers clearly need better data, mechanisms for guiding their choices and understanding medical issues, and information on lifestyle choices.

On the Healthcare IT side, the premium has to be on agility at both the global and the granular level to make consumerism in healthcare really work. Healthcare IT leaders (and survivors) recognize the magnitude—and the permanence—of coming changes and current challenges and how quickly they will alter long-established assumptions and practices. What will be the next surprise like the Massachusetts mandate?

 If you are interested in trying out PilotFish’s Middleware solution to normalize your data download our Free 90-day Trial, now!

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Monika Vainius

Written by: Monika Vainius

Executive Vice President of Applied PilotFish Healthcare Integration. Monika has extensive experience with systems interoperability. She combines this experience with her professional passion for healthcare and healthcare technology to comment on current healthcare and IT news. Website

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