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HomeHealth Blog

Medical Bankruptcy: The Downstream Impact of Poor EHR Interoperability

Medical bankruptcy is a phrase that strikes fear into the hearts of many Americans. It's a grim reality that can crush not only your finances but als

Medical bankruptcy is a phrase that strikes fear into the hearts of many Americans. It’s a grim reality that can crush not only your finances but also your peace of mind. Numerous studies have revealed that medical debt is the number one driver of bankruptcy in the U.S. For decades, it’s been that way. According to the Kaiser Family Foundation, the $200 billion in collective American medical debt is the size of Greece’s economy. Oncologists now suggest patients weigh the cost-benefit of treatment outcomes to financial outcomes. And Warren Buffet has referred to the healthcare system as the “tapeworm of American economic competitiveness.”

The High Cost of Healthcare 

So, why does healthcare cost so much, and how do we make a sustainable change? The factors contributing to the high cost of healthcare are numerous and complex. One critical aspect often overlooked is the lack of EHR integration and overall system interoperability. Interoperability is the seamless exchange of electronic health information (EHI) among healthcare providers and systems. It’s the digital glue that should hold our healthcare ecosystem together. Without it, endless silos of data translate into massive inefficiencies in how care is delivered, contributing to the trillion dollars of waste in healthcare spending.

The Impact of Poor Interoperability 

Poor interoperability has far-reaching consequences, both for patients and the healthcare system as a whole. Here are some key ways in which it contributes to the high cost of healthcare and the risk of medical bankruptcy:

  • Fragmented Patient Information: Without interoperability, patient health records remain fragmented and inaccessible to different healthcare providers. Fragmentation leads to duplicate tests, delayed diagnoses, and inefficient care, which can increase costs.
  • Missed Preventive Care: The inability to share patient data across providers can result in missed opportunities for preventive care and early interventions. Lack of data sharing can lead to patients only seeking medical attention when their conditions have worsened, driving up healthcare expenses.
  • Administrative Overhead: Poor interoperability often forces healthcare organizations to invest in costly workarounds, manual data entry, and administrative tasks to reconcile incompatible systems.
  • Unnecessary Diagnostic Tests and Procedures: Healthcare providers may repeat diagnostic procedures when medical histories are inaccessible, even if the same diagnostics were recently performed elsewhere. Duplicate testing not only wastes resources but also increases patients’ financial burden.

How to Avoid Financial Ruin

Every one of us is a patient at one time or another. How do we avoid being wiped out financially when we’re most vulnerable? The answer lies in taking charge of our healthcare and doing what we can as individuals to help make our healthcare system more efficient and patient-centered.

  • Industry-Wide Commitment to Interoperability: Policymakers, healthcare organizations, and technology providers have made significant investments to improve Electronic Health Record (EHR) integration, making it more accessible and affordable. These investments aim to enhance healthcare interoperability, streamline data exchange, and improve patient care. However, challenges still exist. There’s a lack of nationwide standardization for EHR systems, inconsistent data quality and completeness, and gaps in interoperability between EHRs and different health IT systems, to name just a few. Since 2009, taxpayers have spent tens of billions on EHR integration. We need to hold industry leaders, health IT vendors, and healthcare providers accountable to ensure the vision of seamless interoperability comes to fruition.
  • Patient Empowerment: Patients should actively engage in their healthcare by gaining access to their records, advocating for healthcare providers to share their medical records, and pushing providers for electronic communication and access rather than paper, phone, and fax. Patient portals and personal health records can help individuals take control of their health data. When you take charge of owning your health records, you can ensure they are shared with all providers caring for you. You can also help reduce some of the inefficiencies in healthcare by using electronic communication, such as using the portal to send a secure message and completing patient forms online when available.
  • Advocate for Policy Change: Healthcare policy reform is essential to incentivize interoperability and data sharing. Advocating for policies that prioritize patient data access and privacy while fostering interoperability is crucial. Patients can actively engage in this advocacy by supporting initiatives that promote standardized data formats, backing the enforcement of penalties for information blocking, and encouraging healthcare organizations to adopt EHR systems that prioritize interoperability and seamless data exchange. Additionally, patients can participate in patient engagement forums and advocacy groups to share their experiences and voice their concerns, ultimately influencing policy decisions that enhance data interoperability and safeguard patient privacy.
  • Financial Planning: Patients should be proactive in financial planning for their healthcare needs, recognizing that healthcare expenses can be a significant portion of their budget. To achieve this, evaluate insurance options that best align with your healthcare needs and financial situation. Include factors such as premiums, deductibles, copayments, and out-of-pocket maximums. Additionally, explore options like health savings accounts (HSAs) or flexible spending accounts (FSAs) that can provide tax advantages for healthcare expenses. If that seems too overwhelming, consider consulting a financial advisor or counselor specializing in healthcare financial planning. These professionals can provide personalized guidance on managing healthcare costs, optimizing insurance coverage, and planning long-term healthcare expenses, such as retirement healthcare needs.
  • Take Charge of Your Preventive Care: Research or ask your doctor what preventative care you are due for. Mammograms, colonoscopies, flu shots, annual physicals, and other preventive services can help identify health issues earlier and reduce potentially high-cost care.  

In conclusion, the high cost of healthcare and the risk of medical bankruptcy are complex issues with multiple contributing factors. Addressing the challenges of poor EHR interoperability is critical to making healthcare more affordable, efficient, and patient-friendly. By investing in continued interoperability efforts, empowering patients, advocating for policy change, and practicing prudent financial planning, we can collectively work towards a healthcare system that ensures our physical and financial well-being.

Smartlink Health offers an Integration Platform-as-a-Service (iPaaS) that

has the unique ability to integrate with EHR systems via the user interface (UI). Smartlink also supports traditional integration methods like API, HL7, and database. To learn more, visit www.smartlinkhealth.com

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