Patients have access to more information than ever. Why aren’t we talking to them about it?

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The Information Blocking Final Rule from the 21^st Century Cures Act and federal transparency initiatives like the No Surprises Act have given patients more access to information than they’ve ever had before. On a recent episode of the Voices in Healthcare Finance podcast, Terry Hush, CEO of Roji Health Intelligence, discussed how that access should change the conversations providers are having with their patients.

Immediate access to medical information

The 21^st Century Cures Act of 2016 covered various aspects of healthcare, but one key component was the Information Blocking Final Rule, which went into effect in April 2021. Healthcare organizations now are required, with few exceptions, to release medical information such as test results to patients at the same time providers receive them. From the patient perspective, this means a shorter wait than they would have had previously, but it also could mean they’re looking at information they might not understand.

Hush said asking providers to interpret results quickly is not realistic given the greater volume of data available industrywide.

“We’ve just been inundated with information about healthcare and lab results and testing information … but the fact is, we have technology and data that’s surpassing the ability of both providers and  patients to manage that data,” Hush said. “While we have this data, we’re still stuck in this delivery model that we’ve been using forever and ever, driven by providers who are gatekeepers to testing and treatment services … but they have less time to be the primary communicators with their patients.”

Hush recommends providers get in front of the issue by speaking to patients before tests are administered about possible results and a plan to follow up with the provider.

“By the time the test results come through, the patient should already know what the possible tree of scenarios might be,” she said.

Systemic improvements such as improving patient health literacy also will take some of the pressure off of the provider to be the sole source of information for patients, she said.

The cost of care

Price transparency initiatives, including the recent No Surprises Act, give patients access to new information about their financial responsibility. According to Hush, such initiatives should trigger more proactive efforts on the part of providers not only to communicate with patients but make those communications more understandable.

“When you have a procedure that you’re getting price information on — let’s say you’re going in for a scheduled screening, colonoscopy. You know that there is going to be a gastroenterologist involved. There’s an anesthesiologist. There’s a facility fee. It isn’t like the organization does not have that data. They know what the prices are. They just haven’t combined them into episodes,” she said. “Price transparency should be based on episodes.”

“There’s no reason why we shouldn’t expect price transparency to be on a basis that patients can understand, and that understanding is based on [asking], ‘what is this whole procedure, this whole event, going to cost me?’” she said.