MONTEREY, Calif. – In an age when people can use their smartphones to find out almost anything there’s one thing they can’t do – access their complete healthcare records.
Neither can their healthcare providers.
That’s because there’s no system that provides them with complete, real-time health data on the people they treat. That leads to inefficiencies and less than ideal decision-making, a major factor that’s driving up costs while not improving outcomes.
“We keep pouring more money into the healthcare system and not getting more out of it,” Blue Shield of California President and CEO Paul Markovich told an audience at the California Economic Summit on Tuesday. “Major quality measures haven’t budged in more than a decade.”
Building a modern digital infrastructure is vital to make the healthcare system more affordable and more productive, he said, and help transform it into one where payments are based on outcomes and productivity “so we get value rather than volume.”
The data problem became more acute during the COVID-19 pandemic when the state began efforts at widespread vaccination. “There were important questions we could not answer,” Markovich said, because it was difficult for the state to gather relevant health information. What data was available could wind up out of reach for days when the state’s testing data system crashed. That was the backdrop for the state decision to tap Blue Shield to build and manage a statewide COVID-19 vaccination network that included strong data gathering and reporting functions.
The situation has not been much better in the private healthcare system. Markovich related his recent experience getting an MRI for an athletic injury and leaving the clinic “with a CD (of the imaging) in one hand and a copy of the fax sent to the physical therapist in the other.” Those relics of outdated technology are part of a system that should be replaced by a far more efficient and cost-saving digital healthcare ecosystem.
A fully digital health ecosystem would do much more than streamline that kind of data exchange, he said. With access to all of an individual’s health data, providers could have a full picture of a patient’s health and make better decisions, make them faster, and get a patient healthy sooner.
Having all that information available across the entire healthcare ecosystem offers an even bigger payoff: Supporting data-driven decisions throughout the healthcare system. With that ability, the current “pay for service” system can be transformed to one where payments are based on outcomes and productivity, enabling enormous savings from what now is a too-expensive system.
“The average American right now can’t afford the average (health insurance) premium without a subsidy,”’ he said. And with the rise in healthcare costs greatly outstripping inflation, “more and more federal and state money, instead of going into education or climate or a whole host of other social safety net issues … is being chewed up by health care.”
The good news, he noted, is that bringing health care into the digital age is possible, because the technology that’s needed “is all there,” he said. While it will take collaboration, determination and political will to make the change, “it’s time to bring healthcare into a digital world and make it much more automated than it is today,” he said.