We recently came across an interesting article that discusses the challenges of locating the right information to help select a primary care physician.  Some interesting points:

• Determine if your insurance is compatible with the doctor’s practice.
• What is the doctor’s hospital affiliation? Is the doctor affiliated with a reputable, nearby hospital?
• How convenient is the doctor’s office to your home?

In the coming weeks, DocAsap will be launching with primary care, allowing you to find this information, and more, with ease.

An interesting NYT poll indicates that America’s growing frustration with the rising cost of care is driving them to support government-based solutions rather than those from private insurers.  Many prominent voices in healthcare seem to agree that the existing pay-per-procedure insurance model does not promote efficiency, providing proverbial wind to the Obama administration’s reformist sails until the Congressional Budget Office released costly estimates on the universal health plan.

HealthBeat argues that the government can provide universal access to care in way that does not jeopardize the country’s financial health or raise overall health care costs.  If the Obama administration can get doctors and insurance companies at the same table to emphasize efficiency-based rather than volume-based compensation, maybe the cost of care in the U.S. can decrease over time.  Still, major efficiencies will take time to materialize, necessitating tax increases to pay for the plan.

The NYT poll shows that Americans’ willingness to shoulder higher taxes is largely partisan, with Democrats supporting them and Republicans more mixed.  If tax increases are indeed necessary to bankroll universal health access in the short-term, we are likely in store for a long battle in Washington on this issue.  Stay tuned.

One interesting HCIT-related clause in the $787 billion stimulus bill states that the Feds will work toward the “Promotion of the interoperability of clinical data repositories or registries.” While the still-evolving HL7 and other patient data standards are getting the most push from interoperability advocates, there is not currently a universally agreed-upon standard for storing and sending patient data in the U.S. much less internationally.  In W. Ed Hammond’s Health Affairs article on data interoperability, he highlighed the main obstacles of data standardization so far, such as doctor’s idiosyncratic ways of storing patient information, the still-evolving nature of HL7, and the difficulty in getting EMRs to support one data format.   The stimulus bill currently has those issues in mind by letting the CCHIT and HITSP work together under the auspices of the ONC to pick a data standard, and only reimbursing CCHIT-certified EMR purchases.

This data standardization push is welcome, as the current reality is that doctors and patients have a very hard time keeping track of past clinical data unless the patient has stayed in the same hospital network his or her entire life.  Currently, the biggest repository of patient data resides with the payers (i.e., insurance companies and Medicare and Medicaid), as they typically can aggregate data from hospital and doctor visits, pharmacy benefit managers, and wellness/disease management programs across various providers over time.  However, for patients who are part of regional insurance companies who move to a new region, or simply those who switch insurance providers, many will most likely will lose their clinical data forever, as there is no easy way for a patient to record and transfer data their health data to a new provider.   While the EMR and data interoperability initiatives imbedded in the stimulus bill eventually seek to help doctors provide better care by having access to past clinical data and help patients hold on to their personal health record, these benefits will be years in the making.  Still, the stimulus bill gets high marks from us in its extensive protections of data privacy, as those sharing patient data for marketing or non-sanctioned purposes can be severely penalized.