HealthBlog

Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

The paper blizzard not addressed by electronic health records

The paper blizzard not addressed by electronic health records

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Everything we read suggests the day is nearing when all hospitals and doctors will use computers instead of paper to create, store, and share imageour medical records. It is something that is long overdue. But despite the progress being made to eliminate paper in hospitals and clinics, there remains an insidious blizzard of paper in the health industry that seems to be only getting worse--medical billing.

Frankly, I’d rather sit down and do my tax return than try to manage the paper trail involved with explanation of benefits and medical bills.  Lately, my wife and I have been trying to help our elderly parents deal with Medicare and secondary insurance carriers following their hospitalizations or illnesses. What a nightmare! Both my wife and I have worked in healthcare, so we know our way around medical terminology and billing codes. But pity the poor civilian who even tries to understand how much they owe and to whom after a hospitalization or major illness. Pity them even more if they are elderly, disabled or slightly demented.

The past few weeks there has been a lot of press about the federal government releasing a “rate card” that details the full price hospitals charge before insurance companies apply discounts for the most common medical services and procedures. No surprise, those prices vary widely. Prices are literally are all over the place. Much is being made of the release of the rate card and the impact it could have on price transparency in healthcare. Pundits say consumers might use this information to shop around.

imageLet me tell you, price transparency is only the tip of the iceberg and probably a minor issue compared to the most predominant source of consumer stress. In this day of electronic billing, why in the world does it take months, and yes sometimes years, for a person to know how much they owe and to whom after imagespending time in a hospital or after having a medical procedure? Not only are the explanation of benefits forms and medical bills inconsistent in how much detail they do, or don’t reveal; the information is mailed to the patient’s home over such a protracted period of time and in such volume that it truly is a paper blizzard. There is no way the average consumer can make heads or tails out of  this. Our elderly parents often just give up and pay for things that are already covered by Medicare or their insurance. Worse yes, they become so confused about what they owe that they neglect to pay bills entirely, and then have to deal with nasty letters and phone calls from collection agencies.

I firmly believe this problem is only going to get worse, and not just for elderly people on Medicare. As more and more employers shift healthcare costs to employees through complicated, high-deductible insurance plans or health savings accounts, nearly every family will increasingly face this potential paper tsunami of healthcare billing. I know for a fact that government and private industry can do a better job. My current employer, Microsoft, has worked closely with our health plan administrator, Premera Blue Cross, and community providers and partners to deliver a fairly seamless, on-line, paper-free way for employees to manage our health savings account, deductibles, and co-pays.  

Surely all government and private insurance plans and others involved in coordinating health benefits and medical billing could do a better job. The current system is costing all of us a fortune. It is absolutely a disgrace that we expect the elderly to endure this onslaught from medical billing, especially at a time when they are already feeling overwhelmed and vulnerable. Why can’t government, insurers, hospitals and clinics, labs, imaging centers, rehab facilities and everyone else involved in delivering care around the country, sort all this out and present the patient with a single, comprehensible account of what they own and to whom within a reasonable period of time ? It is intolerable in this age of “high tech” and electronic records that people are having medical bills still rolling in a year or more after medical services have been performed—intolerable not only for the patient, but for the health industry as a whole.

Bill Crounse, MD                     Senior Director, Worldwide Health                 Microsoft

 

  • Very interesting; kind of frightening article. Is that the result where we stand after so many years of IT in health care? Let me bring the European perspective into the equation.

    I am just going through a similar experience with relatives in Germany. Paperwork and bills that is hard to fill out and almost impossible to comprehend for the elderly.

    Yes, there is this whole issue of elderly care, which needs to be tackled. And I see Microsoft in this area as well with their E-Services for the Elderly? Speaking of the elderly: are there any solutions that will help them coping with the two choices: either working themselves through the paper trail or trying to cope with the new demands of electronic systems?

    A personal care manager seems to be the solution, but: who is going to pay for a role like that?

    As one can see: no easy solutions here, but probably plenty of room for a new blog…

    By the way: - to be frank - we are still far away from paperless hospitals in reality. Yes, I know a few, but this seems to be more a proof of principle rather than everyday practice. May be the USA is more advanced? Even in the public sector?

    Thomas Liedtke, MD, PhD; working for the health care IT-industry in the UK and Russia

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