What Are Your Blood Test Results Telling You?

What Are Your Blood Test Results Telling You?

Understanding blood tests and what those elements and numbers on your results mean.

 

 

Have you ever felt confused when reviewing your blood test results? You’re not alone. Even medical professionals needed time and training to fully understand what the results really mean.

For starters, there are different types of blood tests. But regardless of the panel or type of test, the results inevitably come back with technical terms and numerical results in various formats.

What do these symbols and numbers mean? What do these results say about your overall health? Are negative results a good or bad thing?

Why Do We Need Blood Tests?

Blood tests are diagnostic tools. They help healthcare providers and medical professionals diagnose your health or illness, by analyzing the chemical content of and markers in your blood.

 

Why blood tests

 

Physicians don’t always order blood tests. Often, the physical exam your doctor or caregiver conducts by checking your breathing, heart rate, blood pressure, eyes, ears and throat are enough to determine your current health.

But there are times when a blood test isn’t just warranted. It may be critically necessary, especially if you have a serious infection or disease.

The primary reasons blood tests are conducted include the following:

  • Precision. Blood tests can provide a more precise measurement of your body’s health in addition to a standard physical examination.
    • For example, measuring glucose levels in patients who have diabetes allows their caregiver to monitor and administer medications. They can also recommend additional lifestyle changes when they see fluctuations in sugar levels.
  • Organ health. Blood tests allows you and your physician to accurately assess how well key organs like your liver and kidneys are operating.
    • For example, people diagnosed with hepatitis can lead normal lives through the periodic monitoring of their liver function through blood tests.
  • Infections. Blood-borne infections, such as meningitis (inflammation of the brain and spine linings), osteomyelitis (bone infection), sepsis (the body’s extreme response to an infection), and parasitic diseases, are confirmed by a blood test.
    • Blood tests can also provide a confirmation or measurement of other diseases through blood-borne markers and residue of those diseases, like CD4 cells in patients diagnosed with HIV.
  • Chronic illness. Chronic diseases like diabetes, kidney failure and coronary artery disease can be diagnosed, monitored and managed through the use of blood or urine tests.
    • Doctors often evaluate your kidney functions by first using a urine strip to measure its protein levels: the higher the protein level, the more likely something abnormal is going on, which would then require further blood testing.
  • Pre-treatment. Prior to surgery and some medications, a blood tests may be needed to ensure that the patient’s body and organs are strong enough for the treatment.
    • For instance, patients taking Roaccutane (vitamin A derivative) for their acne typically have to undergo lipid and liver tests. They may also have to take a pregnancy test, to avoid any potential fetal deformities caused by vitamin A.
  • Drug dosage and effectiveness. In some instance, like osteomyelitis and cancers, a specific level of medications in the blood has to achieved to eradicate the infection or the cancerous cells.
    • This can also apply to sepsis and other infections that occur in difficult-to-examine areas of the body, such joints and the central nervous system.

 

Types of Blood Tests

When you or your physician orders a blood test, there are an array of tests from which to choose. The following lab procedures are the most common types of blood tests conducted today:

  1. Complete Blood Count (CBC). This gives information about the cells in your blood, such as the cell count for each blood cell type and the concentrations of hemoglobin (the protein molecule in your blood cells that carry and transport oxygen).
  2. Basic Metabolic Panel (BMP). This blood chemistry test measures the levels of certain chemicals in your blood. It confirms how well your organs are working and can help detect abnormalities. Blood chemistry tests may also be called chemistry panels.
  3. Comprehensive Metabolic Panel (CMP). The CMP is a more expanded blood chemistry test than the BMP.
  4. Blood enzyme test. When cells are damaged, enzymes are released into your blood stream. Blood enzyme tests help to detect the presence of certain diseases. For example, the enzyme troponin is often released into the blood stream after a heart attack. Physicians will often run a blood enzyme test that looks for the presence of troponin, to determine whether a patient has ahad a heart attack.
  5. Blood tests to assess heart disease risk. Since the amount of lipids or fats have a direct impact on your heart functions, this type of blood tests may be necessary to measure and monitor in high-risk patients.

 

More About the CBC Test

The CBC test is the most commonly requested lab test and is often included in any routine checkup. It can detect blood diseases and disorders, such as anemia (lack of healthy red blood cells or hemoglobin), infections, clotting problems, blood cancers, and immune disorders.

This test measures many parts of your blood.

  • Red blood cells. Red blood cells contain hemoglobin that carries oxygen from your lungs to the rest of your body. Abnormal red blood cell levels may be a sign of anemia, dehydration, bleeding, or other disorders.
    • The normal range for men is 4.5 million to 5.9 million cells per microliter (cells/mcL); for women it’s 4.1 million to 5.1 million cells/mcL.
  • White blood cells. White blood cells are an important part of your immune system, which is your body’s first line of defense for fighting infections and diseases. Abnormal white blood cell levels may be a sign of infection, blood cancer or an immune system disorder.
    • The normal range is 4,500 to 10,000 cells per microliter (cells/mcL).
  • Platelets. Blood platelets are blood cell fragments that help your blood clot. They stick together like glue to seal cuts or breaks on blood vessel walls, thereby allowing your body to stop minor bleeding. Abnormal platelet levels may be a sign of a bleeding disorder (insufficient clotting) or a thrombotic disorder (too much clotting).
    • The normal range is 150,000 to 450,000 platelets per microliter (mcL).
  • Hemoglobin. The hemoglobin is an iron-rich protein in your red blood cells that carries oxygen around your body. Abnormal hemoglobin levels may be a sign of anemia or other blood disorders.
    • The normal range for men is 14 to 17.5 grams per deciliter (gm/dL)
    • For women, the normal range is 12.3 to 15.3 gm/dL.
  • HBA1C. If you have diabetes, excess glucose in your blood can attach to hemoglobin and raise the level of hemoglobin A1C (HBA1C). Your red blood cells have a life span of 120 days, and HBA1C reflects the exposure of hemoglobin to glucose in your red blood cells, hence why this test can provide you with a 3-month (120 day) retrospective view of your glucose levels. No fasting is required for this test.
    • The normal range for HBA1C is less than 5.7%.
    • You are considered pre-diabetic if your HBA1C level is between 5.7% and 6.4%.
    • A level of 6.5% or higher means diabetes.
  • Hematocrit. Hematocrit is a measurement of how much space red blood cells take up in your blood. Think of it as the amount of tea between the bubbles in your Boba tea.
    • A high hematocrit level might mean you’re dehydrated. A low hematocrit level might mean you have anemia.
    • The normal range for men is between 41.5% and 50.4%.
    • For women the range is between 36.9% and 44.6%.
  • Mean corpuscular volume (MCV). The MCV is a measure of the average size of your red blood cells. Abnormal MCV levels may be a sign of anemia or thalassemia (abnormal red blood cell shapes).
    • A normal-range MCV score is 80 to 96.

 

 

Blood testing  

More About the BMP

A blood chemistry test is actually a group of tests that measures different chemicals in the blood.

These tests usually are done on the fluid part of blood (the clear part known as plasma). The tests can give doctors information about your muscles (including your heart), bones, and organs, such as the kidneys and liver.

It includes blood glucose, calcium, and electrolyte tests, as well as blood tests that measure the kidney functions. Some of these tests require you to fast before the test (usually 12 hours), and others don’t. Your doctor will tell you how to prepare for the tests you are taking.

 

Blood Glucose

The normal range is between 64 and 100 milligrams per deciliter (mg/dL) or 3.55 to 5.55 millimoles per liter (mmol/L).

Glucose is a type of sugar that your body uses for energy. Depending on how well your cells consume glucose, abnormal levels may be a sign of diabetes.

For some blood glucose tests, you have to fast before your blood is drawn (12 hours prior).

 

Calcium

The calcium concentration is normally between 8.5 and 10.2 milligrams per deciliter (mg/dL).

Calcium is an important mineral in the body. Abnormal calcium levels in the blood may be a sign of kidney problems, bone disease, thyroid disease, cancer, malnutrition, or other disorders.

 

Electrolytes

Called electrolytes because they actually have an electrical charge, these are minerals that help maintain fluid levels and acid-base balance in the body. Common electrolytes examined during a blood test include:

  • Sodium. Normal blood sodium level is 135 – 145 milliequivalents per liter (mEq/L)
  • Potassium. Normal blood potassium level is 3.5 – 5.0 (mEq/L)
  • Bicarbonate. Normal serum range for bicarbonate is 22-30 millimoles per liter (mmol/L)
  • Chloride. Normal serum range for chloride is 98 – 108 mmol/L

Abnormal electrolyte levels may be a sign of dehydration, kidney disease, liver disease, heart failure, high blood pressure, or other disorders.

 

Kidney Functions

Blood tests for kidney functions measure levels of…

  • Blood urea nitrogen (BUN). Normal BUN level is 7-20 mg/dL
  • Creatinine. Normal creatinine clearance is 88-128 millileter per minute (mL/min) for women and 97-137 mL/min for men

Both of these compounds are waste products that your kidneys are supposed filter out of the body. Abnormal BUN and creatinine levels may be signs of a kidney disease or disorder.

 

More About the CMP

The comprehensive metabolic panel measures all the factors mentioned in the above BMP. In addition, the CMP includes two protein tests – for albumin and total protein – as well as other liver function tests:

  • Albumin. The normal range for albumin is 3.4 to 5.4 grams per deciliter (g/dL). Albumin is produced by your liver, and it helps keep fluid in your bloodstream, so it doesn’t leak into other tissues.
  • Total protein.  The normal range is 6 to 8 g/dL. It is used for liver and kidney functionality, and levels can spike during infections or malignancies.
  • ALP (alkaline phosphatase). The normal range is 44 to 147 international unit per deciliter (IU/L). The ALP examines your nutrition and liver functions. Abnormal values might may sign liver, gallbladder, or bone disease.
  • ALT (alanine aminotransferase). The normal range is 20-60 IU/L. The ALT examines your liver functions and is increased if the liver is damaged.
  • AST (aspartate aminotransferase). The normal range is 10 to 35 IU/L. Th AST looks at kidney and liver functions. It is also used to measure the effect of alcohol on the liver.
  • Bilirubin. The normal range is 0.1 to 1.2 mg/dL (1.71 to 20.5 µmol/L). Bilirubin helps diagnose health conditions like jaundice, anemia, and liver disease.

 

Blood Tests to Assess Heart Disease Risk

A lipoprotein panel is a blood test that can help show whether you’re at risk for coronary heart disease (CHD). This test looks at substances in your blood that carry cholesterol, which, if abnormal, can cause cardiovascular disorders.

A lipoprotein panel gives information about your cholesterol and fat levels:

  • Total cholesterol. This measure both your LDL and HDL combined and should be maintained under 200 mg/dL to lower the risk of cardiovascular diseases.
  • LDL “bad” cholesterol. This is the main source of cholesterol buildup and blockages in the arteries and should be maintained under 100 mg/dL.
  • HDL “good” cholesterol. This type of cholesterol helps decrease blockages in the arteries and should be maintained higher in the 40-59 mg/dL range.
  • Triglycerides. Is the other bad type of fat in your blood and should be maintained under 150 mg/dL.

Most people will need to fast for 9 to 12 hours before a lipoprotein panel.

Cholesterol Test results  

More About Blood Enzyme Tests

Enzymes are chemicals that help control chemical reactions in your body. There are many blood enzyme tests. Here, we’ll focus on enzyme tests used to check for heart attack:

  1. Troponin. Troponin is considered abnormal of it exceeds the concentration of 0.4 (ng/ml). It is a muscle protein that helps your muscles contract. When muscle or heart cells are injured, troponin leaks out of cardiac tissue, and its levels in your blood rise. For example, blood levels of troponin rise when you have a heart attack. For this reason, doctors often order troponin tests when patients have chest pain or other heart attack signs and symptoms.
  2. Creatinine Kinase (CK). The normal range for CK is 22 to 198 U/L. A blood product called CK-MB is released when the heart muscle is damaged. High levels of CK-MB in the blood can mean that you’ve had a heart attack.

 

How Long Does it Take to Get Your Blood Test Results?

The short answer is that “it depends. Sometimes, results are available instantly, within minutes of performing the test (e.g. finger prick tests for glucose, or a urine test strip). Other tests can take days or weeks to obtain blood test results (e.g. STI tests, electrolytes).

Whether normal or abnormal, physicians and medical professionals are obligated to contact you when your results are ready. Your doctor should be available to answer your inquiries over the phone or schedule you for a follow up in case of an abnormality.

Sometimes, results are available instantly, within minutes of performing the test.. Other tests can take days or weeks.

 

Blood results timing  

The time between the blood sample being taken and your doctor receiving the results can vary based on the category:

  • Complete blood count (CBC). This test measures several cell types (as we mentioned above). CBC results are usually available for your provider within 24 hours.
  • Blood chemistry tests (Basic and Comprehensive metabolic panel). You may be asked to fast for a certain period of time before having your blood drawn. These results are also typically sent to your doctor within 24 hours.
  • Blood Enzymes. Since Troponin and CK are usually ordered after a suspected heart attack, it is essential to receive the results as fast as possible. Luckily, with current lab advancements, these results can be produced in less than an hour.
  • Lipid panel. Lipids are usually measured on routine visits, and your doctor should receive results from the lab within 24 hours as well.

 

What if the Lab Tests are Abnormal?

When you receive your lab result printout, you will notice each component on the left of the page, with a corresponding number next to it which is your result.

Usually the normal range is printed out as a reference. For instance, if your blood work includes potassium levels in the blood, your lab may list the normal range for potassium as 3.7 to 5.2 milliequivalents per liter (mEq/L). If your result falls within that range, then you can rest assured that your potassium level is normal.

What if your results are outside of the normal range? Our advice: FOFO, find out before you freak out.

Don’t jump to conclusions. But do contact your physician to schedule an appointment. Some tests can fluctuate from the normal range due to various reasons that are not pathological. These reasons can include:

  • Side effects from medications
  • Recently treated infections
  • Gender
  • Stress
  • Faulty lab procedures
  • Strenuous exercising
  • Age

It is also important to look at your entire picture of health to interpret a blood test. Numbers on paper cannot paint a story, but you do. Taking your lab results into consideration along with your general health track record, your habits and mental status is imperative.

There is no substitute to seeing your physician to help you better understand your lab results. But knowing what each test means can help you take full charge of your health. Understanding what your doctor is telling you leads to formulating more informed questions, and ultimately allows you to make the right decisions about your health.

Fahad Alsabhan

Fahad Alsabhan is a lead medical researcher and subject matter expert at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan

Now Two Decades Old, Does HIPAA Have the Muscle to Protect Patient Rights?

Now Two Decades Old, Does HIPAA Have the Muscle to Protect Patient Rights?

Critics contend that some parts of HIPAA are hindering health tech innovation, while others argue it doesn’t protect privacy on emerging channels.

HIPAA, the Health Insurance Portability and Accountability Act, has been one of the most hotly debated pieces of healthcare legislation ever since it was enacted in 1996.

It was originally designed to protect employees’ rights to health insurance between jobs. Today, it is far more synonymous with privacy measures that were enacted along with the bill to address the use and disclosure of individuals’ health information—called protected health information (PHI).

HIPAA is From a Different World

Despite many updates to the regulations since the law was first implemented, HIPAA critics contend the bill is in much need of an overhaul to reflect advancement in technology. At the time HIPAA was first written into law, society and technology were incredibly different from what we have today:

  • A new Internet experience. The World Wide Web was just emerging as a more usable version of the Internet, and lawmakers could have done little to predict just how much it would change the way we share and exchange health information.
  • Search 1.0. While we had Yahoo! and AOL, Google had not yet launched.
  • Internet use. Americans with Internet access at that time spent fewer than 30 minutes a month surfing the Web.
  • Early days of cell phones. Cell phones were just emerging in 1996, but they were large and limited. Consumers were more likely to receive text messages on a pager than a phone.
  • Social what? Social media as we know it didn’t even exist.

 

HIPAA Limitations

HIPAA critics argue that the law is now out of sync with the digital and mobile technologies that dominate consumer communication and that are increasingly used within our healthcare system.

For starters, the law only pertains to healthcare providers, health plans and healthcare clearinghouses involved in the transmission of PHI, known in the bill as “covered entities.” Developed more than a decade before Fitbit was even founded, the law was never intended to be a measure for managing the flow of healthcare data that exists in today’s digital ecosystem.

With more than 300,000 health apps and a growing number of devices capable of tracking health data, some question if the law is still the best measure for safeguarding consumers’ health privacy.

Needed Changes to HIPAA

While most can agree the law needs some modernization and reform, there are distinctly different philosophies driving demand for change:

  • Digital age demands. On the one hand, some critics don’t believe the law goes far enough to protect consumers and their privacy in the digital age.
  • Hampers the healthcare industry. Others believe the law presents an undue burden on the healthcare industry and is, in turn, stifling innovation at the time we need it most.
  • Patients are paying the price. On both counts, patients are the ones paying the price, caught in a healthcare system that has not yet evolved to make accessing their personal health information easy.

 

Is HIPAA Negatively Affecting the Patient Experience?

An unforeseen consequence of HIPAA has been its impact on patient communications. A top complaint among providers is that the law restricts them from delivering an experience in-line with today’s consumer expectations.

Consumers are used to easy, seamless electronic communications and they want the same from their health providers. They want to be able to text their doctor directly, get emails from their care team and they don’t necessarily want to deal with logging in to a secure portal to make it happen.

 

HIPPA

 

While electronic health portals have been positioned as a solution, security measures often make them cumbersome, and as a result, consumers fail to engage. Those pushing for a modernized bill say it should be as easy for patients to communicate with their care team as it is to conduct online banking.

Hindered Access to Information

Despite its intent, HIPAA has in some cases made it more difficult for patients to secure access to their health data and history. Patients are often told that due to the privacy constraints of HIPAA, they can’t access their records and they can’t be shared with another provider.

Healthcare administrators who have been drilled to protect privacy, too frequently use HIPAA as a scapegoat not to provide access to health data and records. A study conducted by Yale University School of Medicine confirmed the scale of the problem, finding only 53 percent of hospitals they surveyed provide an option for patients to obtain their medical records.

This runs counter to a key goal of HIPAA which guarantees patients’ rights to their protected health information. The HITECH Act extends the requirements, specifying organizations must provide patients with an electronic copy of their file.

It can be especially difficult for loved ones who are caregivers to get access to the data and health information they need. Despite updates made in 2013 to ensure individuals can designate a third party to receive health data via a right of access request, many providers still are not familiar with the rules and are overly cautious in the release of information to caregivers.

Is HIPAA Holding Back Health Innovation?

Many argue HIPAA is holding the healthcare industry back by placing restrictive burdens on data use that make it difficult for healthcare providers and patients to access information and to use health information to its fullest potential. They contend that HIPAA is slowing the pace of innovation and adding to skyrocketing costs that already plague our health system.

In fact, fifty-nine percent of physicians, hospital administrators and health IT professionals cited the complexity of HIPAA requirements as a major barrier to modernizing the healthcare system in a survey by the Ponemon Institute.

HIPAA critics believe the law’s ambiguity and fears of costly fines have created a risk-averse culture. The result is that HIPAA is often over-applied, which then poses negative consequences for our health system and the patients the law was intended to protect.

 

HIPPA

 

Unrealized Potential of Big Data

Big data is transforming the way we process information and solve problems across industries, and nowhere is its promise greater than in healthcare. However, many contend HIPAA is a barrier to using health data to its fullest potential, and they maintain that compliance fears have hindered improvements in and from health data.

A 2013 Bipartisan Policy Center report, titled A Policy Forum on the Use of Big Data in Health Care asserts that HIPAA is causing delays in the sharing and movement of data in a meaningful way. They believe that federal regulation is “misunderstood, misapplied, and over-applied in ways that may inhibit information sharing unnecessarily.”

The unintended consequence of HIPAA is that patient data is often siloed. Clinical data and analytics that could lead to better health for the population is instead locked away and not put to optimal use.

Undue Burden on Start-Ups and Innovators

Among the chief complaints of HIPAA are its complexity and lack of clarity. The law’s ambiguity, particularly for new market entrants that don’t neatly fit the “covered entity” definition can make it difficult to interpret and navigate.

Critics argue that those who are trying to innovate in the space face a high barrier to entry and unreasonable exposure to fines or lawsuits. That HIPAA-driven reality keeps many of the best and brightest away from the healthcare industry altogether.

For the many start-ups in the health tech field, the consequences are real and significant:

  • Legal burdens. Entrepreneurs must shoulder hefty legal fees as they try to interpret applicable laws and regulations.
  • Compliance. Start–ups face increased development fees to achieve, maintain and ensure compliance with HIPAA requirements.
  • Capital. Innovators often encounter hesitancy from potential investors due to compliance risks.

 

Many Argue that HIPAA Doesn’t go Far Enough

While many argue for a loosening of HIPAA restrictions in the name of innovation, others argue HIPAA does not go far enough to protect patient rights and privacy. These pro-privacy critics argue that HIPAA leaves consumers vulnerable in the wake of increased use of electronic health records, rapid advances in mobile health and unclear guidelines of data from wearable devices.

Consumers themselves lack trust in the system and want better protection and privacy assurances. According to a recent Black Book survey, consumers have serious concerns about healthcare organizations’ abilities to protect their health data and to ensure that it will stay private.

  • More than half of consumers who had used technologies provided by their physician or hospital such as electronic health records, portals, and apps, noted they were concerned about the privacy protections put in place. They questioned whether their data could, in fact, be kept private.
  • Their lack of confidence was causing many to hold back from sharing their full medical information with their providers.
  • Eighty-seven percent were unwilling to share comprehensive information for fear of how it would be shared.

This lack of consumer trust isn’t surprising given the increasing prevalence of health data breaches. Despite HIPAA safeguards and protections, medical data breaches have increased seventy percent since 2010 according to a 2017 study published in the Journal of the American Medical Association. It found there had been 2,149 healthcare data breaches reported to the Department of Health and Human Services’ Office for Civil Rights between 2010 and 2017.

Health Data NOT Protected by HIPAA

Those who believe HIPAA doesn’t go far enough argue the law needs more teeth and better enforcement to truly protect patient privacy. They are also focused on growing gaps in the law’s protections posed by advances in technology that they believe leave consumers vulnerable.

HIPAA was originally intended to cover the information exchange between healthcare providers and health plans. But the unintended consequence of this limitation is that app developers and device makers often fall outside of the law’s purview.

Wearable devices like the Fitbit and Apple Watch are generating and handling a lot of health data. But because they are not covered entities under the law, the data from these devices remain unregulated by HIPAA.

Furthermore, thousands of apps have launched aimed at helping consumers collect and track various health data points. While these apps collect and store personal health information, they may remain unimpacted by HIPAA regulation because they are not transferring the data between covered entities.

Insufficient Updates to Regulations

Updates including HITECH in 2009 and rule changes in 2013 have sought to bring about better protections for the digital age, but critics argue they don’t go far enough. In 2016, the Department of Health and Human Services issued a set of guidelines to clarify when health apps need to comply with HIPAA. Many found the scenarios to be confusing.

Worse still, critics worry this measure did nothing to protect consumers from data and security breaches in scenarios their information is not required to comply with HIPAA.

Attempts to Modernize HIPAA Continue

The American Medical Informatics Association (AMIA) and the American Health Information Management Association (AHIMA) recently called for officials to reform HIPAA to close loopholes created by the law’s “covered entity” distinction. The groups want all health data to be protected the same way, regardless of where it originates or who it is transferred to, ensuring that patient data from Health apps, devices, and social media is protected.

In addition to ensuring that these entities put technical safeguards in place to protect data, they also want to ensure patients’ rights to access their data generated by such tools is also guaranteed. The Department of Health and Human Services (HHS) also plans to revisit HIPAA guidelines this year as it looks to make changes to promote better flow of information required to make value-based healthcare a reality.

Health Privacy and Security is Fundamental to People-Driven Health

While there is much that can be done to modernize HIPAA and make it simpler for providers and patients, its underlying premise to protect patient data is correct, and one that we at HealthChampion feel is essential to build upon, even when the law itself doesn’t require it.

While some argue technology has made HIPAA obsolete, we believe technology can be leveraged to deliver on the very promise of HIPAA. In fact, at HealthChampion, our goal is to harness the power of technology to make it easier for everyone in the healthcare ecosystem to securely and efficiently access their health data.

We believe health app developers have a responsibility to advance security, and we take our role as a steward of health data quite seriously. We know your health data is one of your most valuable health assets and it should be treated as such, with the utmost care. At HealthChampion, we are building a fully HIPAA-Compliant and HITRUST-certified system. And we are developing blockchain powered protocols to ensure safe and secure delivery when you need to share your data with family or other third parties.

Regardless of what happens with HIPAA moving forward, patient access to their health data and the privacy and security of that data are fundamental ideals we must all support. As we move toward a more people-driven system of care, health, and wellness, information is critical.

When patients own their health data, they are empowered to take better care of themselves and their families and make better health decisions. But for this to be possible, patients need to trust that information is accurate, safe and secure, regardless of whether the information originated from their physician or their smartwatch.

Fahad Alsabhan

Fahad Alsabhan is a lead medical researcher and subject matter expert at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan

Too Heavy to Fight: How the Obesity Epidemic Is Threatening U.S. National Security

Too Heavy to Fight: How the Obesity Epidemic Is Threatening U.S. National Security

The obesity epidemic has decreased the number of young Americans able to meet the physical conditioning requirements of the U.S. military.

Obesity is no longer just a population health challenge. This nationwide epidemic is now an emerging national security threat.

Almost one-third of American youth are unable to join the military due to being overweight. This poses a major challenge for the U.S. military in its attempt to recruit the next generation of soldiers. Potential enlistees must satisfy a physical evaluation in order to be eligible for service, and the largest reason for disqualification – 31 percent of all new recruits – is obesity.

The largest reason for disqualification – 31 percent of all new recruits – is obesity

While a third of 17-to-24-year-olds are too overweight to qualify for military recruitment, the issue begins much earlier in life. Children as young as two are exhibiting rising obesity rates, which increases with age. 42 percent of teens aged between 16 and 19 are suffering from being overweight. These concerning numbers emphasize the need for preventive measures beginning earlier in life and continuing as our children grow.

 

How is Obesity Really Affecting Our Security?

A recent study conducted by Mission: Readiness titled “Unhealthy and Unprepared” states that American youth with obesity are going to have a serious impact on the military’s effectiveness. As of September 2018, the Army had a recruitment goal of 76,500 soldiers, yet only 70,000 recruits joined by the end of 2018.

It was found that of the 29 percent of young Americans who graduated high school with no criminal record, and no chronic medical conditions, only 17 percent would qualify and be available for active military duty, and 13 percent would qualify and achieve a satisfactory score on the Armed Forces Qualification Test (AFQT).

National security relies on those who are willing to serve to meet the standards of eligibility.

 

Obesity Affecting Recruitment Rates

In 2017, just 11 percent of 16- to 24-year-olds said they would definitely or probably be serving in the military in the next few years. This is a decrease from 13 percent in 2016, further illustrating the challenges of recruiting new personnel. Estimates suggest that the eligible population will stall at 29 percent through 2020.

National security relies on those who are willing to serve to meet the standards of eligibility. Increasing obesity rates, particularly in the southern United States, prevent otherwise eligible young people who are interested in serving from qualifying. 44 percent of military recruits in 2016 were from the South, which also has the highest rate of obesity in the country (32 percent in 2017).

Army recruits who are less active are much more likely to be injured during basic training

 

Is Obesity That Bad?

Based on a study conducted by The Citadel, Army recruits who are less active are much more likely to be injured during basic training. While not all injuries can be blamed on obesity, one study found that there were 72 percent more medical evacuations from Afghanistan and Iraq for stress fractures, serious sprains, and other similar injuries— injuries that are associated with poor fitness and nutrition—than for combat wounds.

Members of the armed forces should be physically fit and healthy to meet the requirements of their hard and demanding jobs. But military recruits are not immune from the obesity epidemic the nation is facing. In 2015, 8 percent of active duty service members were considered overweight based on height and weight, a 73 percent jump since 2011.

Obesity in the military

Check, Please!

Obesity is not cheap. Each year, the Department of Defense spends around $1.5 billion on healthcare related to obesity for active duty and former service members and their families. Muscle and bone injuries among Army soldiers cause over half of all disabilities, resulting in $125 million in spending each year.
To avoid the major harmful impact of obesity on our society and military’s adequacy, preventive measures should be set in place to help solve this epidemic much earlier in the process. Children as young as two are experiencing rising obesity rates. Unfortunately, obesity increases with age. It was found that 18 percent of children ages 6 to 11 have obesity, as do 21 percent of 12- to 19-year-olds.

Children with obesity are much more likely to face other chronic illnesses as they grow, like asthma, fatty liver disease, type 2 diabetes, and heart disease. The increasing prevalence of obesity should be a concern to everyone involved. It further highlights the need to create a lifelong preventive plan that begins very early in life and continues through high school and beyond.

 

Solutions to Halt Obesity

Creating the most effective solution to obesity requires a multifaceted approach that involves the military, policymakers and parents. Policymakers can help prevent obesity by promoting policies that encourage healthy eating and physical activity that can be implemented in schools.

Parents play an integral role in their kids’ eating and activity habits, but schools are where children spend most of their time. School programs are proven to have a major effect in improving their health. Schools can help children develop healthy habits at a young age by serving nutritious meals and ensuring children get adequate exercise. For instance, the MyPlate plan which is introduced by the U.S. Department of Agriculture (USDA) is a new food guideline that replaces the conventional food guide pyramid with healthier alternatives.

Children consume most of their daily calories while in school and away from their parents, making cafeterias an important outlet to promote healthy eating habits. The Child and Adult Care Food Program (CACFP), passed in 2010, is a policy that provides child care services and programs financial support from the U.S. Department of Agriculture to serve nutritious meals and snacks to children in school. Children are eligible from infancy through age twelve and may receive up to two meals and one snack a day.

Over 90 percent of schools now serve meals that meet the healthier standards, with fruit and vegetable consumption by participating children increased by 16 and 23 percent, respectively, since the implementation of CACFP.

Motivating children to move and be physically active from a young age can prevent obesity later in life. The Active Early program employed in 20 care centers in Wisconsin ensures children are physically active and moving for 2 hours each day. The program lasted for a year and showed a significant increase in physical activity.

 

Let’s Do It Together

Physical activity and healthy eating habits are crucial parts to ensure that our children grow up healthy, and that those who are wanting to serve are suited to meet the military’s application and eligibility requirements. Adults, like parents and teachers, are influential in a child’s life, and they should teach children healthier eating and exercising habits.

Preventive measures will slow down the epidemic of obesity, increasing the number of eligible recruits and enhancing our national security. These measures are vital keys to eliminating obesity and the negative effects on our society and security. But with obesity rates higher in adults than in children, efforts should be made by individuals, communities, states, and the federal government collectively.

Fahad Alsabhan

Fahad Alsabhan is a lead medical researcher and subject matter expert at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan

Despite More Data Than Ever, Interoperability Remains a Barrier to Patient-Driven Health

Despite More Data Than Ever, Interoperability Remains a Barrier to Patient-Driven Health

 

The people-driven healthcare movement holds great promise as a solution to today’s broken healthcare system.

By empowering patients to take control of their own healthcare decisions and costs, we can improve quality of care, increase the efficiency of our healthcare system and tackle skyrocketing healthcare costs. But to unlock the true potential, we’ll first need to tackle the data interoperability issues that plague healthcare today.

Interoperability refers to the secure, and nearly effortless, exchange of electronic health information across technology systems. It is one of the biggest challenges facing the healthcare industry.

Despite the mass adoption of Electronic Health Records (EHRs), however, most of our health data still sits locked in silos across disparate providers, unable to be acted upon. This lack of integration is a key driver of rising healthcare costs. It’s a roadblock to innovation and a fundamental source of frustration for all healthcare stakeholders from hospital executives and their IT departments, to federal agencies and insurance companies, on down the line to physicians and their patients.

HealthChampion

 

Interoperability challenges stands in the way of realizing people-driven health, leaving patients and their providers without access to the information they need to be informed participants and advocates for their care. According to a recent Quest Diagnostics survey, nearly three-quarters of physicians feel they have insufficient information about their patients. So how can we expect patients to take charge of their health when their physicians can’t even unlock the data they need?

To truly put patients in charge of their health, we must break down the barriers that are holding back their health information.

 

Not for Lack of Data

The problem we face isn’t a lack of data, rather meaningful access to that data and the tools to make it meaningful to patients and their physicians.

Today, more than ninety-five percent of healthcare providers use electronic health records (EHRs) – a digital version of a patient’s medical history under that provider – to document patient conditions and overall health. Theoretically, this should make it easier to capture, store, and share patient medical information; however, that’s not the case.

Each individual’s health information is created and stored in numerous ways and places by multiple players in the healthcare ecosystem.

Think about doctors’ offices, urgent care facilities, hospitals, health insurers, Medicare, Medicaid, nursing homes, dentists, medical specialists, and more. The information recorded for patients by each of these parties is spread across multiple information systems, locations and formats, some even still in paper files.  Sharing the information across these platforms, which were not designed to easily transfer information, is neither easy nor cheap.

App data tidal wave

EHR data is hardly our only source. New forms of patient data have exploded. SO MUCH MORE information about our overall health is now available, and more is being generated every day.

Depending on who you ask, there are anywhere between 259,000 and 325,000 mHealth apps (apps enabled by mobile and wireless technology) are available today. These include health and fitness apps, medical diagnostic, management apps, and nutrition apps, which generate potentially valuable information about our health.

Personal history data

In addition, family history and genomics data hold important insights about the prevention and treatment of diseases based on our genetic makeup.

The value of this information depends wholly on what we do with it. While people hold more of their health data in their hands today, it is not easy to integrate it across health apps, genomic databases, and EHR systems so that together, it can tell us more about our health than ever before. Lack of interoperability is leaving too much powerful data locked in systems where it can’t work together to help patients and their physicians improve their health.

 

The Problem with EHRs

EHRs have a long-promised future that has yet to deliver. Though frequently touted as the cornerstone to improved outcomes, a tool to reduce administrative inefficiencies, and a conduit to lower the cost of care, the reality is EHRs were never intended as tools for patient care.

They were designed as and still exist primarily as a tool for payers (primarily health insurance companies) to get paid – end of story.

Should they really be the lynchpin of our medical data strategy? Do patients and providers want to leave one of their most important assets, their data, at the hands of payers?

Physician frustration

Given their intended purpose, EHRs, while the best source of data we currently have, do little to enhance care. In fact, many physicians are frustrated by how much time they take away from patient interaction.

Instead of helping doctors, nurses and healthcare providers assess health and coordinate care, the cumbersome system prompts, and coding requirements needed within EHRs add to the red-tape that increasingly fills their days. Moreover, because of interoperability challenges, EHRs only give physicians a slice of the patient’s history as opposed to the comprehensive view they need to make the data worthwhile.

Unmet health data interoperability goals

Despite efforts going back more than a decade, federal regulations, standards and incentives, interoperability of EHRs remain a far-off goal. The HITECH Act of 2009 specified that one of the required capabilities of a certified EHR system was “health information exchange,” yet today, not even a third of hospitals can meet the key metrics necessary for true interoperability.

A recent Black Book study found 36 percent of medical record administrations reported that they have EHR interoperability issues when exchanging health records with other providers, with more than a quarter noting that transferred patient data was not presented in a useful format.

Among hospitals, the study found that the majority, 62 percent, are simply not using information from outside sources because external provider data is not available in their EHR systems’ workflow. Perhaps this is the reason only 18 percent of hospitals report that their providers, when treating patients, “often” use patient health information that has been received electronically from an external source.

 

Why is EHR Interoperability so Hard?

Most other industries have attained a high degree of IT interoperability, but it is much more complex in healthcare. While it seems only natural that data should flow seamlessly, many factors have kept it from happening. HIPAA compliance, data security and patient privacy all play a role.

Among the top factors, health systems have not prioritized interoperability. Despite the scope of the problem, 78 percent of hospitals said they have not prioritized or budgeted for improvements in interoperability or patient communications for 2018.

No profit = low priority

Why put resources behind costly and complex IT projects that aren’t seen as an immediate boon to the bottom line? Health executives who are under pressure to turn a profit would much rather invest in the development of a new revenue-driving patient care center than in a costly infrastructure project.

Health executives who are under pressure to turn a profit would much rather invest in the development of a new revenue-driving patient care center than in a costly infrastructure project.

Furthermore, there is little business incentive for health providers to make interoperability a success if they can keep patients beholden to them through their data.

Technical challenges

Profits alone aren’t the only thing holding health executives back from taking on this challenge. They also face huge challenges presented by legacy systems and platforms, data variability and staff expertise and resources to handle the work on top of routine system maintenance.

EHR vendors share in the blame. They have benefited from selling and maintaining complex proprietary systems and have been given little incentive to work together.

Lack of EHR Interoperability Hurts Patients the Most

Patients are left paying the ultimate price for our current state of data disarray. Everything from the cost to maintain IT infrastructure, to wasteful spending on unnecessary tests because records can’t be easily shared, trickles down to the patient. Even the incentives offered to health systems to meet standards comes from the consumer in the form of higher taxes.

Patients costs for care are spiraling out of control, and they are getting little in return. The greatest cost is their health itself. Sadly, many pay the ultimate price.  Eighty thousand Americans die every year because doctors don’t have in hand the information they need. Better data flow could enable life-saving cures, more effective care, and healthier patients.

 

Armed with Their Data, Consumers Will Drive Change

In his HIMMS keynote address, former Google CEO Eric Schmidt proclaimed that the future of healthcare lies in a killer app and that the transition to a better health future will depend on a system of them working together.

We are beginning to see that play out, as the explosion of mHealth apps is empowering patients to take charge of their health and offering value that engages them in a way their current EHR does not. These apps are likely to be the fuel for change. As consumers see more value from the data they have in their own hands, they expect more from the health system and demand integration.

They no longer have patience for shortcomings in hospital interoperability. According to the 2018 Black Book EHR User Survey results, 92 percent of younger healthcare consumers were dissatisfied with their inpatient provider experience, where complete medical records were not offered.

Consumers under the age of 40 were also more likely to desire reliable technological options at their provider. 84 percent said they are looking for the most technologically advanced and electronically communicative provider.

We are hitting a tipping point where consumer demand for solutions is forcing industry change. The attitudes of today’s health consumers will impact the health decisions they make and the providers they choose, eventually putting downward pressure on the health system to change or become irrelevant.

HealthChampion

 

Progress is on the Horizon

While it’s most likely that patients themselves will lead the charge to enable data as part of a successful patient-centered care movement, 2018 has been an astounding year for progress driven by policymakers, healthcare leaders and emerging technologies.

Though the industry has grappled with the interoperability for more than a decade, there have been several signs that change is now coming more rapidly. The pieces are beginning to fall into place, and the industry has coalesced to the fact that true data interoperability is essential to advance innovation, patient satisfaction, better outcomes, and its financial viability.

Policymakers are Taking Further Action

Policy makers are using their leverage and managed platforms to bring about much-needed change to policy, as well as to innovate new programs and platforms. With 130 million beneficiaries, the Centers for Medicare and Medicaid Services (CMS) is uniquely positioned to help drive transformation, and the department is calling on private health plans to follow their lead.

Just this year, CMS has already overhauled the EHR incentive programs to prioritize and reward interoperability. To qualify for federal incentive payment, providers will need to use 2015 edition certified EHR technology, to demonstrate meaningful use and qualify for payments by 2019. This includes the use of APIs, which have the potential to improve the flow of information between providers and patients.

CMS is also advancing the MyHealth EData initiative and rolling out the Blue Button program. These initiatives make it possible for patients to collect their health information from multiple providers and incorporate all their health information into a single portal, application, program, or other software.

CMS also announced the launch of a Data Element Library (DEL), a new database that supports the exchange of electronic health information. It will allow the public to access the specific types of data that CMS requires post-acute care facilities, such as nursing homes and rehabilitation hospitals, to collect. It already allows Medicare patients to download and print their health records and will aid portability as developers work with Medicare to create apps that will make patients’ records shareable. At launch, more than 600 developers had already signed on to the initiative.

Much to the delight of providers, CMS has also taken steps to simplify coding and patient records for physicians. Among the changes, physicians are now only required to document any new problems or new aspects to a patient’s family history as opposed to documenting the entire history at every visit.

For an organization that has a perception of bureaucracy and being slow to adapt, it is moving quickly to modernize government health programs.

New Technology is Speeding Progress

While technology changes can sometimes hinder progress, emerging technologies are finally helping to advance the cause of interoperability. From artificial intelligence (AI) to application program interfaces (APIs) and blockchain, there are new standards, platforms and capabilities to help healthcare IT professionals advance the cause.

  • Cognitive computing can go beyond what traditional data analytics systems have been able to do to distill both structured and unstructured data to form meaningful insights for decision makers.
  • APIs are being used more and more to interact with health systems. This is a critical first step to allowing the appropriate flow of information across healthcare stakeholders and allowing patients and health systems to connect their data together.

While it will take time to realize the promise of these new technologies fully, it represents progress, and EMR vendors and healthcare IT teams are stepping up and demonstrating their commitment to implement.

Health Leaders Embrace New Possibilities

There is a growing understanding that individual health systems will need to work together and cooperate.

If nothing else, as payments become increasingly tied to patient outcomes, health executives will have more skin in the game knowing this can only be achieved with true interoperability. And while far too many remain out in the cold when it comes to budgeting, planning and implementing compatible systems, a handful of leaders have emerged with a new and exciting outlook on what is possible.

They are paving the way in their approach to interoperability and are innovating at a breakthrough pace that should serve as a model to other systems moving forward.

Groups like the National Academy of Medicine are also taking a stand on the issue with recommendations for IT purchasing and procurement that emphasize interoperability above all else. To ensure that healthcare dollars are spent in pursuit of healthcare delivery systems reaching desired levels of care quality, safety and efficiency, they are advocating for health systems to establish purchasing strategies that demand functional, system-wide interoperability and that they move away from buying siloed systems and instead look to technologies that operate on open, vendor-neutral platforms.

 

Interoperability Will Be Worth it in the End

While interoperability is no small task, it’s every bit worth pursuing. With the seamless flow of data, we can finally realize the full potential of people driven healthcare. A successful sprint to the finish will require the cooperation of all stakeholders working together with renewed optimism for what’s possible.

Health leaders and tech giants must unite in innovation to help America’s healthcare system reach its full potential, fueled by data to lower costs and drive better outcomes. Their efforts to advance access and exchange of information will make our health system work better for those who matter most – the people.

Fahad Alsabhan

Fahad Alsabhan is a lead medical researcher and subject matter expert at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan
3 Ways Technology is Returning Individuals to the Center of Population Health

3 Ways Technology is Returning Individuals to the Center of Population Health

Returning patients to the center of population health — and empowering them with the right tools — can help solve many challenges faced by population health programs.

 

Ever since Greg Stoddart coined the term “population health” in 2002, health organizations, providers and payers have been continuously learning more about its dynamics, the constant challenges that come with it, and how to overcome those challenges.

According to Stoddart, population health focuses on “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” This includes patterns of disease, treatment results and healthcare outcomes, as well as the policies that link them together.

A Diminished Role for Individuals – Until Now

Population health has been a hot topic among healthcare providers and payers for nearly a decade. But it’s been a non-issue for most consumers.

Nevertheless, the use of population health strategies by providers and payers have real impact on consumer health and healthcare costs.

It also doesn’t matter that individual patients know little about population health. By its very definition, population health was intended to be patient centric. Population health programs are supposed to focus on improving individual patient health, in the context of groups of consumers with similar conditions, environments or challenges.

The simple fact of the matter is that individual consumers have so much to offer population health programs. But this resource has often been overlooked by population health initiatives. Until now.

Technology is giving population health programs the tools to empower individual patients to drive improved population health results. With the increasing number of healthcare apps being added to online app stores every week, healthcare payers and providers now need to adapt to evolving consumer behavior and expectations.

Technology is giving population health programs the tools to empower individual patients to drive improved population health results.
 

It would be a mistake to consider this a challenge for population health programs. Technology-empowered consumers actually offer a golden opportunity or payers and providers.

Patient Participation

The primary challenge for population health has always been the evolving needs of each population demographic. Patients with multi-chronic disorders using high demanding services drive healthcare costs up. But there’s often only so much that providers and payers can do.

It’s now clearly understood that social and economic factors are more important in the rise of chronic illnesses in various populations. In some cases, it’s the low price of unhealthy fast food or less active lifestyle. In others, it’s environmental stressors or lack of awareness about healthier lifestyles.

Unfortunately, health systems have often been the active healthcare providers, while patients are the passive care recipients. Once the patient leaves the clinic or hospital, they too often fall back into their unhealthy environment without any real support for impactful change. Healthcare providers want to help patients change their behavior and improve their health, but they can’t be there to continuously monitor and guide patients.

Now, there’s an app for that. Actually, there are now hundreds of apps available to encourage and support patient participation.

Today’s apps and the more powerful ones emerging give population health programs the tools to provide more continuous support for individual patients. From nutrition apps to self-managed care apps, individual patients can now use readily available technology to make healthier daily life decisions – every moment of every day.

Dirty Data

Another major challenge facing population health programs is inaccurate or dirty data. This is found by providers in their patient’s health record, as well by payers in their member’s claims file. Incomplete or incorrect information in a patient’s personal health records can lead to medical management errors and could negatively affect their healthcare outcomes.

Correcting errors for each patient can be time consuming and costly, as each individual patient’s records may have different inaccuracies or errors. Most hospitals and health organizations already address the issue of dirty or inaccurate data by improving their digital records and training their employees on proper data entry.

But it’s often still not enough.

Once again, technology and increased patient participation offers new opportunities for addressing the challenge of dirty data. Through apps that give consumers direct access to their personal health records (PHR), individual patients can help clean up a lot of the inaccuracies and errors in their own records.

From there, machine learning systems can learn from those consumer-driven app-powered corrections to develop new rules to prevent similar inaccuracies and errors in the future.

Data Privacy Issues

Another challenge for population health programs is gaining permission to utilize a patients’ critical health data to generate impactful recommendations and conclusions.

We know we can use population data to find answers. But many patients are hesitant to allow sharing their personal clinical data between their healthcare provider and insurers for good reason.

They’ve heard about or directly experienced the impact of major security breaches to health systems in recent years. For example, Exellus Blue Cross Blue Shield and Anthem Blue Cross both suffered separate breaches in 2015 that affected more than 10 million and 78 million patient records, respectively.

With nearly all current medical records in the United States now being stored in digital form, it’s much easier to share data. But it also means that there are more ways for data thieves to get that data.

So how do we ensure that patient data is secure and their privacy concerns maintained?

Most health systems with digital records have already woken to the threat of data breaches. Fear of fines, penalties and damage to their brands have forced most payers and providers to improve their security, training and compliance monitoring.

But the truth is that the weakest links are often not the data record storage system themselves, but the different access points to those storage. And as patient access to digital records is now the new rule, these vulnerable access points greatly increase the potential risk for electronic health records.

Again, however, technology and increased patient participation can provide solutions to privacy- and security-based challenges to population health. By providing patients with secure and intuitive apps, consumers will be able to better control how their data is accessed and shared.

This also helps address some of the privacy and security concerns that drive patient reluctance to sharing their PHR data. By giving individuals more control over their health data, population health programs can more easily gain permission directly from individuals in specific populations.

Final Thoughts

Traditionally, patients are only motivated to engage after being diagnosed with a disorder. Healthcare providers need to participate more in the community and activate patients to be more involved with their health and management plans.

To do so effectively, healthcare professionals should provide patients with the right set of information, as well as provide continuous support and an open dialogue. This will allow patients to make a more informed decision about their day-to-day decisions.

Again, there are apps now emerging that allow providers and patients to do this more easily and consistently.

Concurrently, healthcare organizations need to develop a sound and reliable technology infrastructure to make population health work. This technology should be flexible enough to allow intuitive and quick data entry, accessibility, and easy data retrieval. This technology should also be adaptable and evolve in alignment with the population’s shifting needs.

Allowing consumers access and control over their own electronic health records is a crucial part in making population health effective as well.

 

Allowing consumers access and control over their own electronic health records is a crucial part in making population health effective as well.

It simplifies the process of improving public health reporting and surveillance, enhancing the ability to prevent disease, and expanding communications between users and their healthcare providers. This can be achieved by using self-management mobile apps that consumers can obtain from their provider or independently.

The healthcare industry is in dire need for a reliable structure to manage population health and their data. In order to understand healthcare information; claims, clinical and personal health data should be used together rather than separately. In other words, healthcare providers and payers need to work together to take on the challenges faced by population health.

Call to Action

Since its emergence, population health has relied heavily on data and available technology to address the needs of specific population groups. But the individual patient’s participation was often missing, especially when looking at it from the population level.

Returning individual consumers to the center of population health – and empowering them with tools for more ownership of their PHR and health management – can help payers and providers solve many of the challenges facing their population health movement.

We invite you to join HealthChampion in this movement to empower individual patients and create a more people-driven approach to population healthcare.

Fahad Alsabhan

Fahad Alsabhan is a lead medical researcher and subject matter expert at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan
Why Isn’t Our Healthcare System Easier and More Transparent?

Why Isn’t Our Healthcare System Easier and More Transparent?

Today’s Health Consumers Want Easy Access to True Costs and Quality Services

When we purchase something at a store, we’re given the price before we decide to buy. But when we go into the doctor’s office, we’re provided a service where we may (or may not) pay out of pocket or we have a co-pay but rarely check on costs beforehand.

Sometimes we don’t even know the price until we receive the bill and rarely ever question the portion of costs paid by our insurance.

And it isn’t just healthcare costs that seem a mystery. Knowing where our personal health records are, how to access them, what is in them, let alone how to use that information with other personal health data to create an overall picture of health and improve personal health seems nearly impossible.

It seems backwards and outdated. Probably because it is.

 

While this has been the norm for decades, in today’s changing healthcare landscape, it seems backwards and outdated. Probably because it is.

Consumers are done with the old way. Today’s health consumers want easy access to true costs and quality services. They want a transparent healthcare ecosystem that allows them to shop for healthcare services much like they do other products and services, and they want to own their own records and the data associated with their health journey.

As the saying goes, you’re either part of the problem or part of the solution. In order to achieve this solution, we should understand some of the factors driving the movement for health transparency and why the consumer is at the center of making change happen.

Healthcare Consumers Have Evolved Into Healthcare Shoppers

In the employer-based health insurance system on which we’ve come to rely, most health consumers typically select a provider for themselves and their family and then see that provider at any time with either a slight co-pay or deductible.

As prices have continued to rise for care and deductibles grow, however, consumers have become more aware of pricing and the complexities that come with trying to track down pricing and determine value for services. As a result, today’s health consumer has been turned into a shopper – researching, making careful purchasing decisions, and ultimately buying health services and care.

It’s a small but important distinction, because shoppers inherently want options, transparency, and honesty about the healthcare choices they are making and they most definitely don’t want their healthcare experience to feel veiled in secrecy or mired in confusion.

So, when we talk about the healthcare consumer today, know that we are referring to the emerging healthcare consumer: the consumer who assertively shops for the best care for the best value for themselves, their family, or the loved-ones in their care.

But let’s take a step back and get a closer look at just a few of the trends that have pushed consumers into a position to start demanding a more transparent healthcare ecosystem.

Cost Tops the List of Consumer Pain Points

An Experian Health study estimates that 20% of all consumer earnings will go to healthcare by 2025. People are worried about paying for their healthcare bills, with good reason.

In a poll conducted by NPR, The Robert Wood Johnson Foundation and Harvard’s T.H. Chan School of Public Health, more that a quarter of adults said than healthcare costs have caused them serious financial problems.

And according to a Becker’s Hospital Review article reporting on an Experian Health study:

“The top pain points for patients in their healthcare experience are related to payment. Specific dissatisfaction issues included: comprehending the amount of money they owe for care and whether those out-of-pocket costs are fair market price, as well as ensuring they are financially able to pay for their care, Experian reported. Patients also identified ‘determining what financial support is available,’ ‘ensuring that what is owed to the provider is accurate’ and ‘understanding the amount covered by their health insurance’ as dissatisfaction issues.”

Nearly Universal Adoption of High-Speed Internet in the U.S.

While there are still areas in the United States that don’t have high speed Internet, particularly in rural areas, most Americans do have access. In fact, more than 92% of Americans have access to high-speed Internet, according to the Federal Communications Commission.

This unprecedented access allows nearly anyone in the U.S. to research and learn about nearly any healthcare topic imaginable, from prevention to treatment.

Health consumers suddenly have instant access to…

  • Estimates for medical care pricing in their area, 
  • A variety of choices for seeking treatment,
  • Quality and patient satisfaction rankings and repor1ts,
  • Alternative medicines, and telemedicine, and
  • So much more!

This information is coming from everywhere. A recent Accenture report states that websites are still the top technology people use to manage health, but mobile, electronic health records (EHRs), social media, and wearable technologies, among others, are on the rise.

People are expecting to find exactly what they need to know at the touch of a button, but finding accurate, understandable healthcare information online is still a barrier with wide gaps in pricing for a single procedure and challenges determining value.

Health Technology is Rapidly Advancing

From EHRs and telemedicine, to wearables that track health and fitness levels, technology is upping the healthcare game on all levels.

  • Wearables are able to sense a variety of body activity, produce real-time data on caloric output, track both aerobic and anaerobic activities, and pass that data along to users.
  • EHRs grant what could be near instant access to patient records that are accurate and up-to-date.
  • Telemedicine is helping consumers reach healthcare experts in real-time from around the globe, giving rural consumers access to doctors if they are unable to get to one easily. Telemedicine also supports health consumers at home if they are unable to leave the house or need medical follow-up that doesn’t require being at a hospital or medical facility.

This is just the tip of the iceberg, but for health consumers, these technologies and others are setting the table for game-changing personal health opportunities and choices with maximum convenience.

The “Internet of Things” gives us unprecedented access to nearly unlimited data. The Internet of Things (IoT) is transforming the way consumers look at and use healthcare data for improving their own health. It is also changing the level of detail and types of data consumers are able to give their providers.

Additionally, providers are able to proactively collect and interpret a history of health and wellness data for care.

Wearables are the most obvious example, but we aren’t just talking about fitness trackers. Wearables are breaking new ground every day. Today’s wearables track newborn oxygen levels and temperatures, monitor blood pressure, measure insulin delivery, track caloric intake through contact with skin, and the possibilities are endless.

With all of this new health and wellness data available, how are consumers using it to improve health?

There are the obvious drivers – to lose weight, walk more, get fit. Then there are the life-altering examples – an urgent notice of low blood sugar or notifying medical personnel or loved ones of a fall. Now, technology is emerging that will allow consumers and healthcare providers integrate all of that IoT health data with the data from hospitals, medical records, etc. to alert you proactively of your healthcare needs.

Whether to remind you that it’s time to book a follow up doctors appointment, your child needs certain immunizations for school, or your blood pressure has been unusually high and you need to schedule an appointment, the pieces are now here to provide you immediate service.

These are no longer out-the-realm possibilities but current and future technologies that can lead to better health.

The Healthcare Shopping Journey is Complex

The basic healthcare shopping journey, unlike a traditional product or service purchase, is quite complex.

Given the challenges that still exist in sharing records among health systems, it’s clear that there is a lot of work to do to create a transparent healthcare ecosystem for consumers. Integrating personal health data (such as from wearables) with medical records and data, and even being able to compare basic pricing among providers for the same visit or procedures can still take a lot of time and hassles.

The timing seems right as consumers are ready and able to take a more proactive and assertive approach to their personal healthcare journey.

 

That said, the timing seems right as consumers are ready and able to take a more proactive and assertive approach to their personal healthcare journey. But what might that transparency look like to the consumer during a typical healthcare experience?

There is a lot of research out there, but we’ve boiled it down to these:

1. Managing the Data From Your Personal Health Journey

From the moment you are born, you have a healthcare history, or health story.

As health-related technologies continue grow and expand, the data that accompanies that story will only increase and become more complex. The challenge here is effectively communicating that story: for the young and healthy with no pre-existing conditions, this doesn’t seem to be much of a challenge.

However, for a large number of Americans, the story is more complex. Data from the Centers for Medicare & Medicaid Services vary widely, but the estimate is that 19% – 50% of non-elderly Americans have some type of pre-existing health condition.

As we mature, our health story grows and finding ways to use technology to help manage years of medical history and health data becomes increasingly valuable and important. Additionally, tackling important, tough ethical discussions along the way is worth considering:

  • Can a health consumer manage which data is granted access to a payer or provider?
  • How can a doctor trust the data they are seeing?
  • Is the health consumer’s data secure?

2. Finding Out if Your Health Requires Intervention

What is wrong with me? How do I lose weight? Do I have a cold or the flu? Should I go to the ER? Is my blood pressure too high?

As mentioned earlier, Accenture recently reported that websites are still the top technology people use to manage health and find the answers to these and other health questions.

Generally, this is great for consumers. For example, infographics showing the difference between the common cold and the flu can help head off a doctor’s visit, saving time and money. But outside of simple Internet searches, what happens when an informed consumer tries to engage with the healthcare system. Suddenly complexities arise.

  • Am I seeing the right doctor?
  • What tests will they order?
  • Are those the right tests?
  • Where are the results coming from?
  • How do I get the results?
  • Would having data from my fitness or food tracking app help make a diagnosis?
  • How do I get that information to my provider?

Let’s revisit our shopper-oriented consumer. Can you imagine having a conversation your provider about these and other types of diagnoses questions, especially when you might already be feeling unwell or anxious about your condition?

There is so much to know and manage and none of us want to lose time with poorly informed or incorrect diagnosis. Technologies are beginning to emerge that can help the health consumer collect that data, provide analytics surrounding it, and inform a physician diagnosis based on that personal health story.

3. Health Treatment and Transparency

Once a diagnosis is reached, determining treatment options can become a daunting task. For the majority who have health insurance coverage, the first question revolves around what will the insurance plan cover and what will I pay out of pocket? Then the consumer will likely conduct research with his/her physician and on his/her own, which means entering the chaos of the Internet. Not only will consumers need to contend with evaluating the treatments recommended by their own physician, but what other options are out there? Trying to validate or find new treatment choices online is difficult. How do you determine fair market price and value?

4. Paying for Treatment

This new healthcare ecosystem must allow consumers to know costs associated with their choices. Given that 98% of people surveyed by Experian Health said worrying about how they will pay their medical bills as “a very important to extremely important pain point,” consumers are going to begin to expect to know how much a service is going to cost before receiving that service — just like purchasing any other product or service.

5. Determining Value

Which brings us to our final destination: did the quality of care received and payment paid align for the consumer?

Those of us who purchase economy vehicles have vastly different expectations than those of us who purchase luxury ones. Right now, however, our healthcare options rarely offer that same opportunity. This is not necessarily an outcomes-based discussion. However, there are consumer reviews available for care, polls, and opinions.

If there were a way to measure those against a transparent price and the consumer’s own personal experience, there may be a way for the consumer to determine if they feel they received good care value for the price paid.

The Need For a Transparent Healthcare Ecosystem is Clear

Healthcare in the United States is changing rapidly thanks to cost concerns, access to information, technology, and connectivity. Consumer behavior is also changing, and the shopper journey has already shifted away from its linear beginnings.

The current state of the healthcare ecosystem is ripe with opportunity to meet the consumer’s needs (and, quite frankly help improve provider’s lives while we help improve patient care). We’re working to reshape the conversation and ignite the movement toward more transparency, and we think the healthcare consumer is ready to join the movement.

 

 

Fahad Alsabhan

Fahad Alsabhan is a lead medical researcher and subject matter expert at HealthChampion, with demonstrated experience in the hospital & healthcare communications industry in the US and the Middle East. His knowledge within the clinical and writing spectrums of medicine allow him to view the healthcare world from multiple angles.
Fahad Alsabhan

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