Traditionally, there is nothing like a Personal Medical Attendance Record (PMAR), periodical progress report or medical certificate to slow down a claims or underwriting assessment.
Over the last five years, the Life industry has dramatically reduced the need for doctor-reliant medical reports by utilising the humble telephone. Client medical information that we only accepted from a doctor is now obtained directly from the client. This has resulted in improved turnaround times and reduced costs. Unfortunately the telephone cannot cover every situation and this is where the next phase of the medical information evolution comes into its own. To further explain, here are two perspectives from two leading Australasian e-health solution providers.
Connecting the dots
Dr Brandon Carp
Executive Chairman & Founder of UHG
Dr Brandon Carp graduated medicine with honours in 1987 and continued in clinical practice till 2008. In 1997 he founded UHG and led the organisation as Managing Director until late 2014 when he assumed the role of Executive Chairman. Brandon has a history of driving innovation in healthcare having been a co-founder of Salus Healthcare and Dr Know Magazine and in 2014 was nominated for Australian EY Entrepreneur Of The Year. Brandon holds an honorary position at Monash University’s Department of Public Health and Preventative Medicine and is a regular examiner for Monash University medical school candidates. He is a past member of the Ardoch Youth Foundation board and the development committee for Menzies School of Health Research, Australia’s leading indigenous health research body.
In 2016, whether we are shopping on Ebay, travelling by Uber or finding a handyman on Airtasker, we expect ease and convenience. Digital electricity bills, airplane boarding passes and party invitations just arrive into our inboxes. Data moves seamlessly across the internet to serve an endless array of needs. At the same time a person who visits the doctor and requires a medical certificate is handed a piece of paper, sometimes typed, but often hand written in a language that tis commonly known as ‘doctors scrawl’.
So what is the answer? Digital health or e-health is about electronically connecting points of care so that health information can be shared securely and quickly.
Today the technology exists to enable a doctor to deliver a medical certificate directly from their desktop to the end user in real time. This solution enables a doctor to pre-fill the certificate from information in their practice management software system. The certificate is also a ‘smart form’ with dynamic sections that change depending on the answers. A printed copy can still be given to the patient if they want.
This exists today… it is not science fiction. Return to Work South Australia, the agency responsible for providing work injury insurance and regulating the workers compensation scheme in South Australia, has just implemented this solution. Previously it took them about 30 days to receive a medical certificate – now it is received in real time directly into their system.
Well this same solution can be used in life insurance for receiving initial and progress medical certificates that are required by claims assessors enabling faster payment of claims. BT Financial Group is leading the way with this innovation soon to be launched but there is a real opportunity to standardise the medical certificate across the life insurance industry using this Smart form technology. There is even a push to have a single medical certificate stored in the doctor’s practice management system that can be used for life, workers compensation and compulsory third party insurers.
Information will be received faster and more securely. No more illegible and incomplete forms that delay payments to a customer. This means a better service for all customers at the moment of truth, not to mention a more efficient process for doctors and insurers.
Electronic Exchange of Medical Files
Today an entire medical file or parts thereof can be requested from a doctor and then exchanged securely directly from that doctor’s practice management system, with just a few mouse clicks. One of the biggest improvements digital health can bring is to improve efficiency and save time for doctors which is why the Royal College of General Practitioners (RACGP) is supporting such initiatives. Tomorrow, which is nearly here, there will be a solution that can highlight and even summarise the important and relevant parts of a medical file. This can then be passed through an underwriting rules engine.
So what’s next?
The Australian health system is complex, and made up of thousands of disconnected healthcare providers – GPs, specialists, hospitals, pharmacies, physiotherapists, pathology and the list goes on. The Government once had a vision for a health system existing on a single common technology platform but learnt the hard way that this is not realistic. Problems will be solved by connecting the healthcare ecosystem. Some of these dots are already connected the next big challenge is to get insurers and doctors to adopt these innovative solutions.
The Medical Certificate will be with you Smartly
Tom Bowden is CEO of HealthLink, a company that provides electronic communications services to more than 95% of Australian and New Zealand General Practices. HealthLink has led the formation of the Aduro Alliance and has developed SmartForms technology which is currently being deployed across more than 13,500 Australasian medical organisations.
Every now and then a simple change completely transforms an industry or marketplace.
The ability to sense and anticipate that change then take advantage of it decides the success or failure of every industry player. As Charles Darwin said “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.
Right now insurers and work-cover provider organisations are unable to get good quality information from general practices. The information they do get is limited in quantity, often late and by all measures very costly. The impact of this inadequacy is poor claims management and significant limitations in the ability to accurately triage and actively manage their claimants’ return to work. Given that information is the lifeblood of the insurance and work-cover industries; that is an unacceptable situation. But all is about to change.
An Australasian industry alliance to develop SmartForms technology is enabling doctors to quickly and accurately produce medical certificates in a few mouse clicks, pulling information from their patient records and sending it directly in real time, thus enabling insurers, work-cover providers and similar organisations to obtain high quality information directly from the medical practices’ computer systems.
The key initiative allowing this is the Aduro interface, developed by the open standards based Aduro Alliance, signatories to which include all of the major general practice computer systems, including Medical Director, Best Practice, Genie, Medtech, My Practice, IntraHealth, Houston Medical, a growing number of specialised software packages and other medical systems currently under development. These systems account for more than 95% of Australia’s and 98% of New Zealand’s GP desktops.
The Aduro Interface enables practices to quickly and easily call up a SmartForm and auto-populate it with a predefined set of patient information. The SmartForm itself is hosted centrally on a secure server and can therefore be updated and changed once before making the updated SmartForm available to all users simultaneously. The system is the product of an $8 million investment by the medical software industry, led by HealthLink, Australia’s largest Health-system Integrator, which has electronic links into almost all of Australia’s general practices.
SmartForms are fast, efficient and they are quickly becoming the preferred means by which information is exchanged. GPs are using Aduro and SmartForms to refer patients to hospitals and specialists, to order pathology tests and to communicate with government agencies. They are already using the Aduro interface and SmartForms technology to communicate with some insurers and workover organisations such as the New Zealand Accident Compensation Corporation and the NZ Ministry of Social Development.
In New Zealand where the Aduro Interface was developed, SmartForms are already being sent by GPs 1,000 times per hour. In Australia, New South Wales Roads and Maritime Services is currently building SmartForms to enable drivers licencing medical checks to be performed. A range of other SmartForms applications are underway.
Making form filling fast and efficient for GPs, means it is easier for them to do the right thing. Accordingly, they can much more easily produce a high quality patient summary or medical certificate and immediately send it to the insurer or work cover agency. High quality information, received in real time allows much greater precision in the triaging and assessment processes and reduces the likelihood of data entry errors, while containing processing costs.
Once again, the relentless march of technology is transforming another industry. Being an information based industry, the insurance and work-cover sector is ripe for change. The Aduro interface is currently being installed right across Australia’s medical practices and the first SmartForms are being sent. Are you ready to embrace that change and ensure that as the business environment changes, your organisation evolves with it?
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