Patient-centric?

April 22, 2015 -- We speak of being patient-centric and of patient engagement but still fail to give the patient control of their data. The provider institutions remain in control and responsible for stewardship of the data. Incentives for silo-ing remain in place.

Meaningful use mandates some data sharing but vendors and providers do this only begrudgingly. The value to patients of "portals" could be much better but the incentives are not there for those in our community who create them. For example, as a patient I have not seen even a single provider portal that would tell me what some service would cost. Nor has any patient portal ever asked me whom I might want to withhold any of my data from or disclose it to. We are a long way from being patient-centric.

To be fair, these shortcomings are not the fault of the system developers nor even of the health care providers. Rather, it is the financial incentives here in the USA that force them to be counterproductive. The Meaningful Use features of the Affordable Care Act will soon require providers and developers to share some small portions of their data with each other and with patients but we are a long way from giving patients control.

All this talk of being patient-centric is hot air. Only Meaningful Use Stage 3 will cause that to change. Money is the driver in every system but few channel it as perversely as we do. Big pharma, insurance companies, doctors, hospitals, labs and other ancillary service providers make money by selling products and services -- the more and the more complex the better. Our health care system does not exist primarily to serve patients, and the new legislation does only slightly more than nothing to improve that. Too bad for America!

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