Monthly Archives: January 2008

Disenfranchising just got creative

And you thought the healthcare system couldn’t get any worse. That’s right a group of geniuses have decided it’s appropriate to develop a medFICO score that will inform hospitals and doctors of your ability or inability to pay medical bills. Before I begin what is inevitable to become an angry and frustrated tirade I should give the appropriate background information. The medFICO score is currently in development by Fair Issac corp. (the ones who developed the already flawed FICO score) along with Healthcare Analytics, a health technology firm. Funding is being provided by Fair Issac, Tenet-Healthcare and the venture capital firm North Bridge Venture Partners. According to Jason Roberson of the Dallas Morning News, each of the funding partners kicked in $10 million. You read that correctly a total of $30 million dollars has been invested to actually decrease access to healthcare.
The first thing that will come to mind is that medFICO scores could be checked while patients were in the hospital and then care could be denied. This is the obvious flaw in the logic behind medical credit scoring. Of course those involved predicted this and the powers that be say that the medFICO score will only come into play after a patient has been discharged. First, we know this is bull**** there really is no way to control when a hospital or doctor may look-up a patient’s medFICO score. But lets assume there is and that scores are only checked after a patient is discharged, then will someone please tell me what will happen with follow-up care? What if a patient is discharged after a successful surgery but there is an unforeseen complication that requires hospitalization? People who are ill and need to be in the hospital tend to have multiple inpatient hospital stays. So when will a hospital administrator be able to determine the exact appropriate time to investigate a patient’s medFICO score and not have the information impact care? I am sorry, but this is ridiculous and is in complete opposition to the responsibilities doctors have to their patients. It’s bad enough that patient care is affected by ones insurance status, now they are trying to further subdivide the population by a formula that determines someone’s ability to pay for unexpected and exorbitant medical bills. A person’s health cannot fall under the same rules as buying a car or obtaining a credit card. And I don’t want to get into how a child’s illness may affect a medFICO score and the issues it could raise for families.

The argument for such a scoring system from the perspective of Tenet Healthcare, the third largest hospital system in U.S., is their inability to collect on healthcare bills. Apparently Tenet through the first three quarters of 2007 had $433 million in bad debt, 75% of which is from the uninsured. I am not quite sure how the fear of a bad medFICO score is going to motivate the uninsured to pay for their hospital bills, but apparently it will. According to Tenet, the medFICO will allow them to determine whether to just write-off a bill as bad debt or whether to further pursue payment. This is hilarious, that’s why credit card companies check your credit just to see if you’ll pay the bill. Give me a break. If Tenet wants to be reimbursed by the uninsured maybe they should spend the $10 million on lobbying for universal healthcare! See this CNN story as well.

Welcome to the SavvyDoc Blog

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The concept behind SavvyDoc was created in response to the nuisance of obtaining a doctors appointment. I usually took the brunt of this frustration as an intern where patients often complained of the months required to find an open appointment (and of course after months of waiting they were greeted by me, a doctor fresh out of medical school).As members of the first generation to fully adopt the internet as a tool for everyday life, it seemed logical that we should be able to find a doctors appointment with the same ease of booking a flight or making restaurant reservation. However, due to my experiences in medical school and as a general surgery resident I was well aware of medicines inability to incorporate IT into healthcare. It was the discord between the desire to integrate IT into healthcare and the reality that it is a slow and expensive process that led us to create SavvyDoc. We have created a web application that will allow doctors to easily create a profile to market their practice without incurring the high cost of web development and site maintenance. In addition by procuring a network of highly qualified doctors, SavvyDoc will be a reliable resource for people in need of medical attention.
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By creating a transparent appointment system we are looking to make the task of finding a doctors appointment easier, especially in those circumstances where a last minute appointment is desired. Our goal with SavvyDoc is to make quality healthcare more accessible.In this forum I hope to illustrate the need for IT integration into the healthcare system. With my experiences at various hospitals as a guide I want to give my insights into how our current healthcare system functions and where I believe simple solutions such as web based appointments can have a huge impact in making U.S. healthcare more efficient. This is a pivotal juncture for healthcare in America, especially as we have begun the process of choosing the next President. A lot of what is being proposed by presidential candidates is sweeping change, which I agree is necessary, but more attention and resources need to be placed on making the healthcare system streamlined. This way we can ensure all persons receive quality care without burdening us with high costs. My goal is for the subject matter of my posts to be stimulating enough to provoke real conversation about ways to improve our health through technology.