Veteran health reporter Anne Zieger has uncovered another instance of data mining that could be a benefit–or not. USAA, a financial services company for military and veteran families, has started to collect health data via electronic records from life insurance applicants at the Department of Veterans Affairs and Department of Defense. They have streamlined the health records process in the application by developing with Cerner a feature called HealtheHistory that retrieves the data via the patient portal from the applicant’s EHR after consent. It cuts application time by 30 days, but the implications raise some alarms. In Ms. Zieger’s view, we should consider this carefully before huzzahing this type of data sharing:
- Is an insurer going to care much about HIPAA compliance on PHI? In her view, not likely.
- Is it a good idea to give an insurer full access to health data? There is the case of an otherwise healthy woman who tested positive for the BRCA 1 gene which indicates that the carrier has an increased risk of breast and ovarian cancer, who was turned down for insurance by USAA. To not disclose would be fraud, but the nuance is risk, not the condition.
- Will the information be shared within USAA for judgment on other financial instruments, such as mortgages–regardless of legality?
EMR and EHR Our previous look at data gathering on medical conditions run amok is here
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]If you believe we are in the midst of a slow, tidal disruption of healthcare and the ascendancy of patient-centered care–to the point of Topolesque patient ownership–then you will be upset to tears by the contrarian assertions of Dan Munro in Forbes
. He maintains that disruption isn’t what we think it is, but (and we cut to the chase here) it’s more like ‘process improvement’ and that it has to be driven by ‘K Street’ (translation: the street in Washington DC where Lobbyists Rule). Technology–patches on the flawed system. Doctors–desperately seeking to pay back their educational loans by picking the most lucrative specialties. (If they survive the internship and residency system without killing a patient or themselves; see The Misery of a Doctor’s First Days
But..there’s more. (more…)
The Wall Street Journal has likened the merger action pending among America’s largest insurers to the series ‘Game of Thrones’, said thrones occupied by Aetna, Cigna, Humana, UnitedHealthcare and Anthem. These more aptly remind this Editor of the final stages of airline deregulation, except that none are in a non-medieval bankruptcy court. Their actions reflects the payers’ urgent concerns that now is the time to reinforce a national presence, that revenues in a Obamacare environment (well, we’ll see the effect of that US Supreme Court subsidy decision due imminently) can do nothing but go down and that Medicare Advantage, commercial accounts, health system relationships (ACOs) and health IT systems are the place to be. What is missing: the fate of those independent, state and regional Blue Cross-Blue Shield (collectively, the ‘Blues’) which are not part of Anthem, many of which are ‘non-profit’ (note the quotes); the positive effect of competition on pricing and a fair consideration of the negative effects of monopoly. Ah, but there are no flung axes, regicide or poisonings to be found here. The real theme of ‘Game of Thrones’ is the effect of the powerful on the powerless (we the insured), which the WSJ writer doesn’t address…..Insurers Playing a Game of Thrones (if you hit a paywall, search on the title)