The seeds of a consumer-driven health care revolution, one that could turn the U.S. health care system on its head, were sown in early March. This potential disruption comes from an unlikely source: two proposed rules from the Department of Health and Human Services that could have consumers and America’s biggest tech firms joining forces.
The rules, from the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) are both focused on allowing consumers free and easy access to their health data and letting them opt to share that data with big tech or whomever else they choose.
The ONC rule would require that health care providers and electronic health record (EHR) vendors make patients’ health data easily and cheaply available to them electronically. The CMS rule aims to liberate patients’ data from another critical source: insurers.
How can all this technical mumbo jumbo revolutionize health care? Because it has the potential to open up the health care marketplace to consumer-driven competition in ways never seen before.
One reason that health care markets are so flawed and inefficient is that consumers and patients lack the knowledge to make good choices. In particular, they lack data about their own health and about the health and economic consequences of their decisions. The EHR and these new federal rules could change that fundamentally, by giving patients unprecedented access to the information they need to be wise consumers of health care.
Even with data liberation, however, there is a substantial gap between theory and practice. Many consumers are ill-equipped to make sense of the reams of detailed information that populate their EHRs and their claims repositories. They need help organizing those data and interpreting them in light of their own histories, the scientific literature and the health care resources available to them in their own communities. The solution: Consumers could rely on information companies to collect, manage and refine the data on their behalf.
Other obstacles to a consumer-driven health care revolution remain. Threats to patient privacy and security abound when third parties are authorized to access patients’ data. Nevertheless, with the publication of these rules, and likely further public and private actions to come, doors are opening to a health care system that may look dramatically different from the status quo.
