Electronic Health Records


Will patient subscription services for EHRs pay dividends?

By Kyle Murphy, PhD

- When it comes to implementing health information technology (IT), small practices lag behind their counterparts because of a lack of both financial and human capital. “To them when they look at an electronic medical record, for example, they see it as a cost center in the ballpark of five to six to seven hundred dollars a month,” explains Steven Ferguson, Patient Management Officer for Hello Health, “That’s quite a bit out of pocket for them, especially when there are over 140,000 physicians in the US struggling to make ends meet.”

Whereas large practices and institutions have staff and resources dedicated to health information systems (HIS), small practices must find more creative solutions to their health IT problems, which in many cases means going without:

The problem is cost — even though it’s not that high, it’s high enough — and then the other aspect is the amount of help that small practices really need in getting where they need to be with the technology. They can’t take efficiency hits to their workload, which is the way new technology has been introduced.

Until recently, the innovation in health IT focused primarily on making solutions rich in features and performance, not on making those solutions affordable to the user. “The Cerners, the Epics, and eClinicalWorks — those companies are going after the larger groups,” argues Ferguson.

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Shifting gears, shifting costs

When talking about affordable electronic health record (EHR) systems, one of the first companies mentioned is Practice Fusion, the “free” electronic medical record that uses advertisements to offset costs usually incurred by physicians and practices. The affordability of the product can’t be knocked, but many are wary of their health records appearing alongside ads — à la Gmail always pushing you to buy Spam whenever you’re trying to get rid of it.

But what else can be done if practices can’t afford the cost of an EHR system? Hello Health has taken a radical approach to answering this question, which may be new to healthcare but has been part of the app economy over the past few years: “Patients sign up for $36 a year (or $3 a month) to have access to self-scheduling, a personal health record, the ability to see lab results, request prescription renewals, and those sorts of thing.”

According to Hello Health, it’s a business model that should appeal to providers. “There’s absolutely no cost to the practice. In return, we work with the care providers to get their patients to sign up to our suite of tools they can use to communicate with the practice,” observes Ferguson. Now you’re wondering, how does the company get paid? The answer is that oractices and Hello Health share revenue generated by patient subscriptions.

So it resonates with providers, but will it with patients?

Jack of all trades, master of none?

The web-based EHR provider is taking the risk that including physicians, staff, and patients in the use of a system will pay off. And it’s a risky approach that distinguishes it from similar products, namely Practice Fusion:

It’s a deeper offering when you think about the actual overall sphere of communications of a practice. When you look at Hello Health, we have the doctors and their staff using it, but then we have all our patients using it as well. The stakes are higher for us to be successful because everyone’s using it. Now the doctors’ actual customers, our customers’ customers, are using our technology.

What Hello Health describes is a supposed “win-win” for the software provider and medical practitioner as the former has created a vested interest in the latter. “As more patients sign up, the provider starts to make more money for themselves,” continues Ferguson, “We have a very close relationship with these practices because of the way the business model is structured and the participation of the patient in this.” In a bizarre turn of events, the provider has become the salesman and the salesman a provider.

The challenge becomes putting together a product that appeals both to physicians and patients alike. An increased, diverse user base could easily lead to unwanted complexity. However, with only one set of users paying a price to use the service, it would seem like an unbalanced relationship. According to Ferguson, the trick is finding that delicate balance:

Right from day one we’ve had usability of the platform front and center. We’ve gone to great lengths to make this a very intuitive user experience, especially for the patients, keeping in mind that the medical practitioners are in there on a regular basis and become very adept at navigating through out system. Patients, on the other hand, only go in there a couple times a month, and so when they go in they have to know exactly where they need to go.

Will it work?

So will patients opt in to the subscription model? On the one hand, it seems like their own information is being sold back to them, albeit in a more polished form; on the other, the familiarity of a small practice and convenience of communicating with a provider distinguish this kind of EHR from hospital systems that can afford to offer similar features at little to no extra cost.

It’s a bit of a moral quagmire: Support small businesses by buying into their practices or keep doing business with the big boys. If the business model and Hello Health prove themselves effective, it would mean that communication between provider and patient is worth the small monthly/yearly cost. For all the talk about using health IT to restore the personal relationship between caregiver and care receiver, will the patients themselves put their money where their mouths are?

Related Articles:

• EHRs and the worsening diabetes epidemic
• Physicians moving towards mobile devices
• Why should small practices choose cloud-based EHR?
• MiHIN establishes HIE in Michigan
• Study shows dictation with EHR means worse care

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