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● Industry Watch Health IT and the rise of patients as consumers

A difference paramount to coordinated care success. By Justin Barnes

T e healthcare industry is understanding that patients should no longer be perceived as passive recipients of healthcare services. Instead, the new patient-consumers are seeking quality, aff ordability and access to their data. It is health IT’s role to provide caregivers with innovative solutions as patient engagement becomes central to improved delivery. Today’s patient-consumers are also embracing technology, a message that needs to be instilled into the provider community. A Qualtrics/Vista Consumer Research survey this summer found that 81 percent asked felt that care provider use of health IT at the point of care helps physicians do a better job. T at’s a foundational baseline to work from. T at same survey found that 58 percent have shopped or plan to shop by price when considering a physician. And a Rand Corp. study published this summer found that patient segments are increasingly seeking basic healthcare needs at less expensive and accessible retail clinics, a growth from 1.5 million to nearly 6 million visits from just 2007 to 2009. Much of this is being driven by the equal rise in high- deductible employer health plans and the fact that patients are simply using many forms of technology in their daily lives. So far, HHS and ONC recognize this trending through

meaningful use, CMS Shared Savings and related means to push patient engagement forward: no less than four engagement measures in Stage 2 providing view, download and transmit capabilities (VDTs); providing clinical summaries per offi ce visit; using technology to identify and

FINANCIAL Claims payments go electronic

Only about 33 percent of payments from health plans to healthcare providers in the United States are made electronically. T at is about to change. With the adoption of standards and rules for electronic funds transfer (EFTs) and electronic remittance advices (ERAs), the industry is poised to save billions of dollars in the coming years through greater use of electronic transactions. T e Electronic Payments Association has adopted a new

healthcare payments rule as part of the NACHA Operat- ing Rules. T e rule supports the use of the ACH Network by health plans and healthcare providers for electronic

4 January 2013

provide patient-specifi c educational materials; and the use of secure online messaging. But ultimate success relies on the

healthcare information technology and EHR community to move beyond external requirements. We’ve already experienced the establishment and growth in online portals, and are now seeing the integration of personal health records into these bi-directional and patient- empowering solutions. Developers are also enhancing mobile applications, linking patients and providers to each other and to pertinent databases. Progressive EHR solutions are also advancing open

architecture to developer partners to speed innovations in engagement solutions off ered to the provider community, and are working with retail and workplace clinics to deploy EHRs to advance services in those ambulatory settings. At the same time, standards-based interoperability and

data exchange are making strides within the marketplace to connect physician practices and hospitals, because the fl ow of data is, itself, paramount to all of these advancements. A year from now, the industry will be able to look back

at a wealth of gains in patient engagement keeping pace with patient consumerism and begin to tie those eff orts to improved outcomes and sustainability.

Justin Barnes is co-chair of the national Accountable Care Community of Practice (ACCoP), chairman emeritus of the EHR Association and a vice president at Greenway Medical Technologies.

claims payments and the electronic “reassociation” of these payments with ERAs. “Any healthcare provider with a bank account will be able to receive a healthcare electronic funds transfer via ACH, just like a direct deposit,” says Janet O. Estep, NACHA president and CEO. “Providers will benefi t from faster deposits and access to funds, and cost savings from not having to deposit paper checks. Payers will also benefi t from replacing the printing and mailing of paper checks with electronic payments via ACH.” T e NACHA rule goes into eff ect on September 20, 2013. Learn more at


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