Half of Your Health Insurance Premium is Wasted; How to Get It Back

In 2016 in the people of the United States spent $550 billion on health insurance.  Of that, we collectively received $290 billion back in benefits.  That means that for every dollar your family spent on health insurance, they only got back about 53 cents on the dollar.  That means that on average your health insurance company either kept or wasted about 47% of the money you paid them.

So what do health insurance companies really do?  On a macro scale, they accept claims and pay benefits.  It seems pretty simple: request and response.  Netflix has the same kind of system.  You request a movie and if they have it, they play it for you immediately.  Netflix buys the product of movie makers; insurance companies buy the product of healthcare providers.  Sure there are a couple of differences.  Your insurance company doesn’t have a handy dandy little list of things that they cover on your policy, and even if they did, they work on ICD codes, currently in version 10.  So that means the in our Netflix example, you would have to have a three inch thick book to translate the name of your movie into this arcane code that Netflix would then understand.  There are several other problems such as the fact that your insurance company doesn’t provide every movie to every consumer, but we’ll get to that in a minute.  The entire point is, that exactly like Netflix, your insurance company simply handles data.

 How do we make health insurance more like Netflix, then?  First, we provide a web (or smart device) interface for our movie watchers, er, doctors, to look up procedures, see if they are covered and for how much.  Then, if they are, we deliver the payment in real time, directly after the procedure is performed.  We’ve eliminated the back and forth, the calling, the verifying, the adjudication, the monkey motion that is the difference between the 47% they waste and the 3% on average, they claim as profit yearly. 

If Netflix can manage your data for about $10 per month, your insurance company should be able to manage your data for about $10 per month.

We here at Sentia Health aren’t like your bloggers and pundits, they speak and write far better than we can, but we actually solve the problems we identify.  Having identified this problem a couple of decades ago and marveling at the arrogance of the insurance companies for mandating who does what work and how much it all costs, we solved the problem.

Sentia Health provides an Electronic Medical Records Management System (EMR) free of charge to doctors.  There are no hooks or catches, it’s really free.  We make our money by managing the health insurance data for our patients.  We charge, as mentioned above, $10 per month for the privilege of managing the patient’s data, plus the true cost of the health insurance risk, clearly about 53% of traditional insurance.  If the patient doesn’t have our health insurance, the doctors can still use our system, they just have to jump through the hoops of medical coders, adjudication, billing, ad nauseum, as outlined above. 

There will be additional savings too.  First the average practitioner in private practice spends about $30,000 per year on some kind of EMR.  The average practitioner also spends about $42,000 per year on compliance an efficacy reporting.  All our reporting is done in real time and automatically.  They won’t have to hire some accounting firm to count the beans, just click button, get report. The billing department will shrink, if not go away.  The doctors will know what is covered and for how much, and since we publish all this information to the internet and make it available to the patient, he or she has the ability to know the cost of a procedure before it’s performed. 

Instead of having one huge insurance company, we are currently in negotiations with Capstone Associated to allow practices to provide their own insurance via a captive insurance agency.  This would allow the practice to set its own pricing and completely obviate the need for these wasteful, greedy bankers and their insurance companies.  Ideally, with reference pricing, maybe 125-150% of what Medicare will pay, we can even curb the rising cost of the care itself, causing practices and hospitals to streamline their own processes like we have for big insurance.

Just as important, are some the other facets of Sentia’s EMR:

• Integrated health and wellness – We provide patients with a portal that scientifically analyzes the annual (semiannual, quarterly) checkup and prescribes patient education on how to live healthier, better, and longer.
• Integrated Email – We give the patient the ability to contact the doctor via SECURE email.
• Self-scheduling – log in and see when your favorite practitioner is available and schedule a time to meet.
• Questionnaires – Practices have the ability to design, assign and read questionnaires online.  This means you as the patient don’t sit in the waiting room with sick people filling out reams of paperwork.
• Reporting – Individual and Population Health Analysis: the individual gets a printable report of his or her health as it was recorded on the date of the health assessment.  Population Health reporting gives the practice the ability to see how they are doing.
• Compliance – as this product matures, we will be able to differentiate between people who live a healthier lifestyle and those do not by comparing the individual’s metrics against themselves over time.  Those who make demonstrably better decisions will pay lower premiums than those who do not, based on personal metrics. No longer will you be asked to pay for the risk of a “Bunny” who sits on the sofa and eats bon bons and watches soap operas all day and weighs 600 pounds.
• Telemedicine – Coming soon, you will be able to meet with your doctor via web conference.

We have demonstrated a way to cut about half from the cost of health insurance.  This is accomplished by streamlining processes and cutting out waste.  We believe this is the only way to accomplish this lofty goal without completely revamping the way care is delivered in this country and we hope you share our vision.

Lack of Leadership is What is Wrong with Healthcare

I got up early this morning to attend to some things and noticed the regular email I get from EMR & HIPAA.  Today's installment is "Top 3 Tips for Taking on Digital Health" a guest blog post by Brittany Quemby, Marketing Strategist of Stericycle Communication Solutions as part of the Communication Solutions Series. Follow & engage with them on Twitter: @StericycleComms

Brittany's three tips are these:

1. What does the patient expect?
2. What does the patient want?
3. Where does the patient go?

She states in her article that the patient will gravitate toward "consumer experience when it comes to interacting with their healthcare provider."  I take that to mean that they will do business with a practitioner who has the ability to receive and send them email, offers online scheduling, creates a paperless experience, and reading between the lines, grants them immediate online access to medical records.

This is another classic case of too many cooks in the kitchen.  Every one of the articles and blogs that I read and have read point out some thing or another that the medical industry should be doing but isn't.  They don't offer any solutions.  That is why this blog is different.  Here at Sentia, we don't point out a problem without pointing out and developing the solution.

I know my regular readers are going to know this mantra by heart, but it is true and not being heard: We have that solution that this industry is looking for and can't seem to find, but the noise generated by people like Ms. Quemby, a Marketing Strategist, is drowning out the one real message that will revolutionize and automate this industry.

Sentia's Electronic Health/Medical Records System (EMR/EHR) incorporates the consumer experience called for above, plus automates the entirety of the insurance industry with these consumer features:

• Immediate online access to medical records from anywhere in the world with an internet connection
• Secure email between patients and practitioners
• Integrated, automatic prescription of patient education tailored individually and based on clinical findings
• A practitioner configured Questionnaire generator so the doctor can design and build online questionnaires instead of having you sit in a waiting room (with sick and possibly contagious people) filling out reams of forms

While this sounds like what Ms. Quemby and the rest of the world is making noise about, we went farther and automated the health insurance industry.  We have associated procedures in our EMR/EHR with policies, and policies with patients, so the as the practitioner documents the encounter, payments for procedures performed can be transferred to the practice in real time.  We provide the entire service free to the practitioners and for a $10 monthly subscription fee (plus the true cost of the coverage) to the patient.

Let's contrast the subscription fee with the status quo today.  The Affordable Care Act (ACA) limits the amount of the insurance premium for Exchange policies the insurance company can keep for administration to 20% of the total premium.  That means that if your insurance premium is an average $500 per month, you pay the insurance company $100 for the privilege of managing your health insurance data.  If you have private insurance the percentage is not regulated and probably over 30%, meaning you are paying them $150 per month for something we'll do for $10, and do it better.  $150 is your electricity bill.  $10 is one trip to Starbucks for two. 

Further, as practitioners find Sentia's EMR/EHR they will realize that they won't have to spend that $32,000 per year average that they've been spending on a third party EMR.  Hospital administrators will realize they don't have to spend (literally) hundreds of millions of dollars on their Cerner or Epic installation. With Sentia's built in reporting capability the average doctor won't have to spend over $40,000 each per year  on compliance and efficacy reporting.  This new way of insuring people will further reduce costs by eliminating the medical coder, medical adjudication, and the entire billing department.

Those benefits alone should cut the cost of healthcare by 40-45% without affecting payments to practitioners at all.  Even better, due to reduced cost, this paradigm will become the standard, facilitating the move to a central repository of structured health data.  It will be available to the patient and practitioners anywhere at any time for research and analysis and allow us to calculate a true measure of population health and manage the overall health of that population one patient at a time to further reduce costs.

 As we found out with the failure of the ACA, automation of these mundane tasks, and therefore taking the business out of health insurance, and replacing it with a low cost subscription fee, while giving the patient the consumer experience they crave is the only way to  control costs in healthcare.

As we begin to control these costs we can tackle wasteful administration, big pharmaceutical companies, amazingly expensive medical equipment and everything else that the patient has pay for that isn't healthcare.  As for the title of this article, We believe we are the leaders necessary to solve this problem, the Henry Fords of our time, designing and building a new, better way to get the job done.

Call your senator.  Call your congressman.  Call your president.  Call your personal physician and show him or her this article.  Together, we can do what all the government and greedy insurance companies have been unable to do: cut the cost of quality healthcare.

Latest Healthcare Trainwreck: IBM Watson Partners with FDA on Blockchain Driven Health Sharing

In the latest installment of "that's now how it works, that not how any of this works" by Anne Zeiger on EMR & HIPAA  The FDA picked a privately held company to partner with.  First, The FDA can't 'partner' with anyone, they are a government agency.  they can hire IBM to solve a problem, but they should not.  Second, IBM's Watson is a Natural Language Processor.  It doesn't have anything to do with health or databases.  Further, you can do the about 95% of what Watson does with any speech recognition software and a Google/Bing search.  Third, Blockchain is nothing new.  Blockchain is just a database.  That means that it is a central repository kind of like we have been advocating for over a decade.  

So what we have here is IBM using its brand recognition to even further muddy the waters of healthcare interoperability.  As stated above, Watson has nothing to do with healthcare, at least until we start needing natural language processing.  We might want it, but I doubt we will ever need it and it will be completely useless until we have that central repository database we here at Sentia Health have been advocating for years.  We have been advocating it for years, because we went ahead and built it years ago.  

Blockchain is the power behind bitcoin.  Any time you make a bitcoin transaction, the transaction details are added to the database.  We have had several articles about this over the years that you can look up and read.  The 'added' portion is important because it is like a ledger system.  All our databases use this 'added' notion because it gives us the ability to see all the transactions, in case something gets sideways, you can manually correct it.  We stated that the financial industry model (a clearinghouse) wouldn't work  because we need to see all the history for any given patient.  While the central repository is similar to the Blockchain concept, it isn't the same.  Blockchain was designed and built to manage financial transactions.  Person 1 pays Person 2 X amount of bitcoins.  In medicine, a patient could present with a headache in the left dorsal region.  They could present with his of her heart on the wrong side.  He or she could present any of several hundred thousand ways, with any of several hundred thousand concepts applying to several hundred thousand situations or body structures.

The abundantly clear single point of failure is that all the practitioners in all the world are going to have to hire software developers to scrape data out of an existing Electronic Health Records Management System (EHR), hook up to the Blockchain's web service and transfer said data in the correct format (ICD codes won't work because that only documents procedures performed, not documenting patient encounters).  There is a database for this called SNOMED_CT.   Here are two problems with using SNOMED_CT: first, the Blockchain people don't know about it, probably, and second, the existing EHRs don't use it anyway, so have no ability to translate what is in their EHR database into SNOMED_CT codes. 

Clearly, the FDA has no idea what they are doing.  Clearly IBM has no idea what they are doing, unless this is a publicity stunt.  If it is a publicity stunt, shame on them for creating noise that obscures real work done on real solutions.  Clearly, Blockchain isn't capable of handling this kind of data, currently.  ...and maybe ever.

Speaking of real solutions, those of you who follow along know that we here at Sentia Health never point out demonstrable idiocy without offering an alternative, better solution.  Here it is: our insurance company vends its own EHR based, of course, on SNOMED_CT.  Use of that EHR is free for medical practitioners.  we have designed and built a way to pay practitioners and practices in real time for procedures performed.  Our insurance costs $10/month plus the actual calculated cost of the care spread out over the insured population.  This is going to equate to about 20% less than ACA Exchange policies, and anywhere from 30% to 50% over private policies.  We will save even more as adoption increases and doctors start using our free system (with integrated reporting) instead of paying $30,000 average per year on buying an EHR and another $42,000 per year on efficacy and compliance reporting.  Even better, the practice won't have to have a medical coder or a billing department as payments happen in real time.

This new kind of insurance will be wildly popular because it doesn't cut payments to practitioners and is easier and cheaper for patients.  As they flock to our EHR, we build that central repository that the FDA is bumbling around looking for.  This isn't a pipe dream or vaporware.  We are planning releases in India, Central America and the Caribbean this year.  Yes, we will have to build some web services so the die hard, old school users can integrate their (literally) several hundred million dollar hospital EMR installation with our free system (that doesn't make much sense does it?) but that won't take more than a couple of weeks (again literally,  Our sister company Sentia Systems generates most of the software) to build.

So yes, the FDA is fumbling around showing us they don't really understand the problem, IBM is spinning, posing and posturing.  In the meantime, we have the real solution.  Maybe you should call the FDA (or your senator/congressman/president) and have him or her read this.  If you are going to partner with someone, partner with someone who can really solve has already solved the problem.

The Medical Interoperability Miracle You Are Waiting On Will Never Happen

My new LinkedIn friend, Anne Zieger Posted a new article this morning on her site EMR and HIPAA entitled "Are We Waiting For An Interoperability Miracle?"  It is well written and insightful, but for all that misses the entire point.  Anne alludes to the fact that thousands of companies, tens or hundreds of thousands of people, or more, are working on this problem and simply can't come up with a workable solution.  They can't solve the problem because the problem they are solving isn't the problem they think they are solving.

Smart guys, programmers, doctors, marketing people, et al., are simply barking up the wrong tree and eventually will get to the end game that Anne pointed out

"The cold reality is that eventually, the data sharing system we have — such as it is — will fall apart of its own weight, as organizations simply stop paying for their part of it. So while we might not need a miracle as such, being granted one wouldn’t hurt. If this effort fails us, who knows when we’ll have the time and money to try again."

Precisely.

Here is where they are getting it wrong: It isn't about interoperability.  It is about a central data store that everyone reads from and writes to.  You can have all the interoperability in the world, but if nobody knows who you home healthcare provider is, who the custodian of your medical records is, you, or your emergency room doctor or anyone else outside that system, will not be able to find and access your medical records. 

The problem is a little like looking for your keys.  You had them at one time.  You know they have to be somewhere, because you got where ever you are, but good luck tracking them down.  The analogy breaks down when you realize that we are probably going to be looking for a web service, with no graphical user interface, so not only is the entire internet the room your keys are in, but the room is sealed, has no lights, and you have to hire someone (a programmer) to design and construct you a power source, a switch and a bulb to even be able to look for them.

As stated above, the only solution to sharing medical data is to have a central repository.  There are two viable alternatives to who designs, builds and maintains this repository: The government and health insurance companies.  We all know (and had proven to us with Obamacare) that the government can't understand, or even manage people who do understand, the technology.  How late was healthcare.gov and how many times did it crash in the first few weeks?  That leaves insurance companies.  Even if a health insurance company was savvy enough to actually build a working Electronic Medical Records (EMR) system, you still have the fragmentation of not knowing which insurance company to ask for your records.  ...and it is a security nightmare.

Which brings up the point that apparently nobody can build an EMR, much less those hotbeds of technology, insurance.  Pardon my sarcasm.  There are two viable enterprise EMRs in the land, Cerner and Epic.  Cerner is built on an amalgamation of software technologies, like nearly any big company will do in order to get productivity out of programmers they've hired and have no idea what they do.  No one person has an over view of the architecture used for their offerings and it just keeps growing.  Epic's offering is written in an archaic programming language called MUMPS designed in the 60s.  MUMPS was pretty slick then, but that was 50 years ago.  Both of these packages require weeks or months of training, are difficult to use, slow and cause great gnashing of teeth at hospitals all over the country.

If you follow along with our blog, you know that we have only once identified a problem and not offered some kind of solution.   We, at Sentia Health, have designed and developed a solution that not only gives us the central repository we discussed above, but automates the entire insurance process.  That means that the doctor in Switzerland who is attempting to fix the leg you broke on your skiing trip, has instant access to your medical records.  Even better, the cost of your health insurance will go down by about 1/3 because we don't have any big buildings, no people adjudicating claims, give the doctors the EMR, free, and pay in real time based on the procedures they perform and document.  That means they don't have to pay for an EMR, a medical coder, or a billing department.  The savings is in the automation.  that means saving to the consumer.  The consumer him- or herself gets the 20%+ the insurance company wastes (as mandated by the ACA, and why the think they can't make money) replaced with a simple $10/month subscription fee.  If your insurance is $450/month, like mine is that means you immediately save $80 (.2*450 -10). your doctor doesn't have to raise prices for years because he gets to keep the $32,000 per year he currently spends on EMR, the $40,000 he spends on compliance reporting and eliminates the coding and billing departments completely.  Ad the $80 to your part of the $72,000 in savings and you get about 1/3 of the cost of healthcare just going away.  The wasteful part.  The business part.  The part that all the Harvard MBAs waste or put in their own pockets at your current insurance company.  That means that everyone will be doing things this way because it is both better and cheaper and it will organically give you your central data repository.  Go look at SentiaHealth.com and tell us what you think.  follow us on Facebook, LinkedIn and Twitter.  Call the neighbors and wake the kids: real change is coming. 

If you really want interoperability, this is the way to have it.  We are testing this design all over the world today.  We have beta testing going on in India, the Caribbean and soon in South America.  Hang on America, we are coming.  We will fix this.

The Automation Revolution is Coming, Are You Ready?

I was checking my LinkedIn yesterday and found an article by Vivek Wadhwa titled These 6 new technology rules will govern our future, where he discusses the natural destination given the direction our technology and society is heading.

I have been evangelizing for years the eventual arrival of the Star Trek universe as imagined by Gene Roddenberry where we weren't in competition for scarce resources, eliminating the need for war and conflict and where machines do most of the work, freeing us up to think and innovate and to be smart, instead of sweeping floors and typing into spreadsheets.  Mr. Wadhwa said it better than I could and codified a few particulars that will make us 'free to think and innovate.' he says (with my commentary):

1. Anything that can be digitized will be.
   We are digitizing our social lives ourselves.  Doctors have reduced our very genome to a set of data.  With a little help from an algorithm, we can already predict the likelihood of some diseases from this genome.
2. Your job has a significant chance of being eliminated.As a developer, the main thought in my day is to make my own job easier.  I write tools that help me write software.  Some of these tools write software for me.  Today, I can generate about 80% of any application I am tasked to write, with the bulk of the remaining 20% being aesthetics, or making the user interface visually pleasing and easy to use.  If I can automate what I do, I can automate what you do.  Like in this example, the only thing that can't be automated is creativity and judgment.  There will always be marketing people.  there will always be musicians and artists.  There will always be entrepreneurs.   
3. Life will be so affordable that survival won't necessitate having a JOB.Mr. Wadhwa's example was cell phone minutes.  They want from incredibly expensive to virtually free in a couple of decades.  This is the 'freeing us from sweeping floors' that I have been talking about for years.  My company, Sentia Health, has automated the entire insurance process and distilled it down to data management.  We eliminated the need for a medical coder, billing department, third party Electronic Medical Records (EMR) (we provide the EMR free of charge to practitioners) and the whole health insurance infrastructure, plus patient and population reporting for a $10 per month subscription fee plus the real cost of the actualized financial risk of providing health insurance.  All of that automation should cut about 45% out of the cost of healthcare.  EMR and compliance reporting alone cost the average doctor over $70,000 per year.  With the most important (paid) part of the equation, the practitioner, living for less as well, we can reduce costs even further.  This is the 'think and innovate' part that follows the 'freeing us from typing into spreadsheets.'  It is only a matter of time before we (or someone else) automate(s) every other industry on the globe. 
4. Your fate will be in your own hands as never before.With all this automation, you will have the time to pursue your dreams, just like in Gene Roddenberry's vision.  You can solve interesting problems, if that is your bent.  you cant paint, you can dance, you can do whatever your little heart desires.  We advocate going forth and being fruitful to solve problems.  Your particular problem might be the perfect cupcake, or the fastest paradiddle, or the grand unified field theory, who knows?
5. Abundance will become a far bigger problem than poverty.
   We are already seeing this.  With the proliferation of the dollar menu, et al., we see a rise in obesity, cardiovascular problems associated with obesity, and diabetes.  Efficiency goes up, costs go down, we can all have more, and sometimes too much.  So much for the industrial revolution, robotics, and existing automation putting us all out of work and causing us to starve.  As we have been saying, the impact is just the opposite.  Things get so much cheaper that the net is we can afford more.
6. Distinction between man and machine will become increasingly unclear.With the exception of the extreme right, we can already enhance our minds and bodies with helpful hardware.  We already have pacemakers.  How long is it before your fitbit is internal instead of around your wrist?  How much longer after that will I have to wait to have a connection to my phone and therefore the internet, hardwired into my head, and a retinal implant (that I need anyway, to combat extreme myopia) to get results back from that connection that I can read without any external device?  You can draw your own conclusions about prosthetics going forward but I have read reports about mind controlled prosthetic arms in development.

So with Mr. Wadhwa's points 1-4 you can see where I was attempting to go with my Star Trek universe example: We won't need to work, we will be freed from the drudgery of sweeping floors and entering data into spreadsheets to go forth and solve interesting problems.  I just wish I had said it as eloquently as he has.  I am going to add a number 7, however:

7. Education will become increasingly important.Precisely as in the Star Trek universe, we have to know not only what problems to solve, but how to solve them.  I'm going to go out on a limb here and advocate a liberal education as it teaches you how to think and to consider opinions outside your own.  While seemingly contradictory, I am also going to advocate a STEM (Science, Technology, Engineering and Mathematics) education.  Once you've identified a problem, you still have to have the skills to envision and enact a solution.  As evidence I present both the current and future administration's lack of ability to solve the problems in healthcare that we have.  Literally none of them have both the vision and the technical skills to see the big picture and to put a solution in place to solve the problem they've identified, that is, healthcare that is too expensive.   

So there is my vision of a Gene Roddenberry future: a life of doing things we want to do with no strife caused by competition for scarce resources.  I would caution you all to look closely at number seven because you don't want to be a 'red shirt' (The Original Series (TOS), in The Next Generation (TNG) the command crew wears red and generally gets picked off early in the episode).  You want to be educated and solve problems, be an officer, not a part of the people who can't identify and solve interesting problems.  Without everyone being well educated, I suspect we will devolve back into the feudal system where the educated produce educated children and the uneducated produce more and worse educated children.  That will result in (and may already have resulted in) divine right of Kings.  By that, I mean the haves make all the decisions and everyone else just obeys.  Looking at the last election, I am unwilling to take that analogy further, lest we end up in 1776, 1789 or maybe 2016.

We can already fully automate financial institutions.  A health insurance company is nothing more than a bank that only lets you spend the cash you've saved on healthcare.  That means we can automate banks.  We can automate the trading floor, but we should not.  If your company builds a product, you are nothing more than a financial company that manufactures something.  Ford, Toyota, and others, already automate the manufacturing of their product and we can automate the financial services.  That pretty much automates everything, if not now then eventually.

So yes, there are the predictions, along with the potential pitfalls.  I suspect that a lot of us will sit on the sofa all day, eat bon-bons and watch 'Real Housewives of Proxima Centauri b.'  Those people will have to go get a job because the automated system will see the damage they are doing to themselves and the eventual resources they will consume to combat the outcomes of these choices and hike up their insurance costs until they have to get a job.  Problem solved.  For the rest of us who decide not to be red shirts, we can expect a long and fulfilling life of doing interesting things that make us happy and of helping our fellow human being do the same.

Healthcare IT Purchasers, You are being duped!

AI (Artificial Intelligence) is not here an may never be.  If your software salesperson, and that is all they are, starts spouting 'AI,' quietly show her out of the building, she is trying to sell you a bill of goods she doesn't understand.  On EMRandHIPAA this morning, Anne Zieger posted "Are Healthcare Data Streams Rich Enough To Support AI?"  This is a little akin to asking if we should have a salary cap for Quidditch teams. 

The thing that Anne is calling AI is actually statistics.  If you want advanced statistics calculated, you call an actuary.  Those are some smart individuals, but they aren't capable of making Lt. Cmdr. Data, or the HAL-9000 a reality.  In fact, this is not a valid application of statistics, even.  Like the fictional study of psychohistory, Asmiov's premise was that 'you can't apply it to the individual meaningfully. '  The same applies with statistics, so the assertion that any amount of health data from an individual will give a system the ability to predict (chronic) illness is spurious.  Acute illness is a different thing.  The more nails you hammer the more likely you are to hit your thumb.  Unless you hammer nails for a living.  ...or you have a nail gun.  I think I just proved that you can't apply statistics to the individual.  So yes, before you yell at me, if you smoke, quit.  Smoking is a scourge on society and causes lung cancer and lots of other problems in populations.  That doesn't mean you are going to get lung cancer if you smoke.

"What about IBM's Watson?" you ask.  IBM won't call it AI even, because it isn't.  It is a 'question and answer engine.'  You could do something very similar at home with Microsoft's Speech Recognition SDK that called out to Bing to get you a list of answers.  Is that really remarkable?  Maybe it is pretty cool, but there are lots of search engines and lots of speech recognition software our there.  Sure, that's not all Watson does, but we didn't spend hundreds of man years and millions of dollars to get similar functionality either.

"I hear about Machine Learning!  That has to be AI!" you cry.  Well, not so much.  Here at Sentia Health, we created a little algorithm that told a doctor what his or her top 25 diagnoses were for the past six weeks.  This is just a database query, but the machine 'learned' what the doctors were doing at any given time.  This allowed the influenza diagnosis to rise to the top of the list during flu season so the doctors could document all flu patients the same, allowing one click documentation in the Electronic Medical Records system (EMR).  It appears that the machine learns, and if you only take the top answer, you will get a different one at different times.  We've been doing that for decades and Larry Ellison gave the masses that ability in 1979.  So no, again, nothing new here.  Nothing to see.  These are not the 'droids we are looking for.  Move along. 

So the software salesmen and saleswomen of the world are trying to sell us a bill of goods.  They have co-opted terms they don't understand for the purpose of parting you, dear reader, from your money.  This is not fairly harmless marketing like calling blue 'cerulean', red 'scarlet' or yellow 'sunshine.'  This is misleading you into thinking your IT provider has done something amazing, something akin to GPS, something you can't get anywhere else,  something they haven't done.

Always remember: Beware of Greeks bearing gifts, don't take any wooden nickels, buy low and sell high, and above all follow the money.  In this case, the money will lead you back to a salesperson who does not have your best interests at heart. 

Eliminate the Cost of Medical Reporting: $40,000+ Per Physician Per Year

This morning on EMR and HIPAA I found an article entitled "Quality Reporting: A Drain on Practice Resources, New Study Shows" by Steven Marco the President of HIPAAOne.  His article cites a study that appears in the March issue of Health Affairs titled "US Physician Practices Spend More Than $15.4 Billion Annually To Report Quality Measures." 

The study finds a staggering amount of resources, 785 hours per physician and $15.4 billion per year,  are being squandered on reporting:

"Practices reported spending on average 15.1 hours per week per physician on quality measures. Of that 15.1 hours per week, physicians account for 2.6 hours with the rest of the administrative work divided between nurses and medical assistants. About 12 of those 15.1 hours are spent logging data into medical records solely for quality reporting purposes. Additionally, despite a wealth of software tools on the market today, about 80 percent of practices spend more time managing quality measures than they did three years ago and half call it a 'significant burden.'"

This duplicate manual entry, shipping of spreadsheets over email, copying of files around a network, and general wasted effort (my grandfather would have said monkey motion) is not only wasting these resources, but is insecure.  Anything sent over email is sent in clear text, there is no encryption.  Even worse, Any manual system, whether it is typing in duplicate information into the reporting engine, or importing it in from a text file or spreadsheet, is going to have errors.  People just aren't designed to expend the level of attention it takes to do these repetitive tasks.

Mr. Marco, of course, makes the point that the answer is "greater reporting automation in the healthcare industry." 

Well, of course it is.  If you've been reading my posts, you know that only once have we pointed out a problem without providing a solution.  Mr. Marco apparently doesn't have the capability to actually solve the problem.  Without sounding too much like an advertisement, and I've been accused of that before, Sentia Health's EMR/EHR offering includes a reporting engine.  Once again, we've already solved the problems that others are just now noticing.  Mr. Marco states that "practices spend an average of $40,069 per physician" on reporting.  Add that to the $32,000+ per year the average physician spends on EMR/EHR and you are talking about some real money, and you see why the cost of healthcare is skyrocketing.  We won't even bring up the point that our EMR/EHR has a built in reporting engine and is free for the physician to use.  Well, I guess I just did.  Here let me stroke you a check for $72,000 every year to say "I'm sorry."

Our mantra at Sentia Health always has been and always will be to simplify, streamline, combine and automate systems.  To that end, we have developed a system that not only completely eliminates the traditional insurance company, but addresses the problems presented by HealthAffairs.org and Mr. Marco.  It's true that we have only deployed three reports so far, but these reports are done, for once and for all.  If you need a particular report, you click the button and it appears on your screen in under two seconds.  You can then save it as a Word, Excel or PDF document.  You can print it out.  It is available anywhere you have an internet connection.

Pardon me, I think I sprained my shoulder patting myself on the back, but I'm sure you, dear reader, see why.  If you see the Doom-and-Gloom naysayers shouting about problems without presenting real, ready-for-market solutions, pooh-pooh them and point them to us.  We'll show them how things can, should, will be and ARE being done.