Wednesday, March 24, 2010

How Can WE Fix Our Medical System?

Now that the drama and debate over the legislation is done with, I'd like to try to capitalize on your frustrations. No matter what your point of view in this debate, one thing is clear: no one is satisfied with the outcome. And despite all of the ignorance and spite shown on TV, I think most Americans are more informed and engaged on this issue than they have been in years... which makes this the ideal time for us - individual people - to start doing this the right way: from the Bottom Up.

One of the things that I regretted about the President's approach to health care reform was the way the issue of keeping and managing medical records disappeared from the debate. There are two things that seem to be most broken in our national health care systems: Communication and Liability. Communication needs to be better, both between patients and doctors, and between different doctors (as a patient moves or is referred). Liability means (to me) balancing consumer protection and safety of the patient against protecting doctors from unwarranted lawsuits. (I don't like the term "frivolous".)

I think that we can go a long way toward solving both of these problems by taking control of our own medical records. Keeping good records will mean becoming more involved in our own health; tracking our habits and diets, keeping up on our own regular check-ups, managing our own health histories - all of this will serve to provide our doctors with the information they need, and protect us and them from legal problems down the road. We have online tools for doing this now, which we can access for free and use to interact with all of our different medical professionals.

I've written before about some of the different services, and now I'd like to hear from some of you who have used them. I plan to begin working with my own doctor to figure out which service will work best for both of us, and I will be suggesting to them that they start working with their other patients, too, so that this practice will spread.

We won't clear up the whole problem overnight, but if we all begin taking responsibility for the part that IS within our power, we can begin to influence how the solution will play out. And maybe if we are taking more direct control over our health, the issue of "government takeover" will diminish on its own.

There are four concrete ways this can happen:

1. By using free online services, the cost burden of maintaining records will not be laid on doctors offices, on Health Management organizations, or (as it would eventually land anyway) on the consumer. Services like Google Health ( are going to pay for themselves in much the same way Gmail and the Google Search services pay for themselves (which is a good subject for whole other essay).

2. Since they are free online services, providers and patients will have some flexibility in which one(s) they use. (I suspect that we'll see two or three front runners become the "winners", much the way we've seen Facebook emerge as "the" social networking site.)

3. Privacy has been a huge concern in this, so market pressure will be on these services to give consumers the kind of privacy they need. I see this as an area where the government might need to weigh in, as we (the People) determine what Privacy legally means in this age of widespread information sharing.

4. Health care will improve. When you go to the doctor, they won't have to rely on your memory or their handwriting to tell what your problems are. That alone makes this worth doing.

As I said, I plan on bringing this up with my doctor. I should be having a checkup soon, so I'll report back what I learn from him. If you have any ideas or suggestions, please do comment so I can research them.

Update: In exploring the various online health records services available to me, I discovered that my Insurance provider already has a pretty detailed record of everything I've done under their coverage. They allow me to update this record with tests, procedures, etc. that I might have done outside their system; with my family history; and they interface with the MicroSoft Health Vault, so that if I prefer to manage my records outside of their system (and I know some of you will be concerned about allowing your insurance company to have ALL of that information), I can use that service.

I am a bit embarrassed to discover that this "great idea" of mine was available to me all along, but that probably means that a lot of you could benefit from logging into your insurance company's online service to see what record management services they offer.