Who Pays for Health Record Banks?

Banking health data like a financial transaction is the simplest solution to healthcare’s networking challenges, says William Yasnoff, MD, PhD, founder of the Health Record Banking Alliance, in the May feature “Taking Medical Records to the Bank.”

So far no one has started a health record bank, though several states are considering or planning them. One question still to answer is how to finance their ongoing operation. There are several options, Yasnoff says.

A health record bank would operate in a broad sense like a financial bank, and patients would control which providers, payers, and others had access to the information in their accounts. One approach is to charge the account holders. Health record bank consumers could pay a monthly service fee, which would come either from the consumer’s own pocket or from their health insurance company.

A substitute for the monthly fee could come from revenue generated by advertising in the health record bank. Some advertising could be tied to the patient’s actual health records, though patient consent would be necessary for this type of marketing, Yasnoff says. Consumers could also opt to pay the monthly fee in order to have an ad-free bank.

Other revenue could be generated by consumers paying for optional health record bank services. An example of these extra services is bank-generated patient reminders that notify people to get needed preventative tests like a cholesterol screening and colonoscopy. Daily reminders could prompt patients to take their prescribed medications.

“Peace of mind” reminders could also be purchased for an extra cost. These reminders would instantly notify a person if a loved one’s medical record is accessed by an emergency room physician. Medical researchers could also be charged to access population health data in health record banks. This act would also need to be fully disclosed to health record bank customers, giving them the choice to opt-in or opt-out, Yasnoff says.

Some of the money generated by the bank could be used to pay physicians for electronic record submissions. But what about those doctors who don’t have electronic medical records? To start they could fax in records, but that wouldn’t enter the information in a structured way. Yasnoff says the best health record bank systems would offer physicians free or low cost electronic health record systems as part of their health record bank network. This would both entice physicians to submit patients’ records, as well as enable them to do so electronically.

A major issue with getting physicians to buy EHRs is demonstrating their inherit value to a medical practice. This solves the problem of buy-in, and transforms the entire health record bank community into an electronic entity, Yasnoff says.

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