Health Information Technology: An Untapped Resource to Help Keep Patients Insured

Abstract

The recent confluence of: (1) changing state and national insurance-related policies, and (2) the rapid growth in electronic health record (EHR) use, yields an unprecedented opportunity for patient-centered medical homes (PCMHs) and other primary care practices or care settings to use health information technology (HIT) and health information exchange (HIE) in novel ways to impact patient health. We propose that HIT is an untapped resource for supporting clinic-based efforts to help eligible patients obtain and maintain insurance coverage. This commentary presents a conceptual model and guiding principles for this idea. Additionally, it describes insurance support tools that could be used to conduct 'inreach' and 'outreach' with patients around health insurance, similar to how HIT is used to manage chronic disease and panels of patients, and to improve population health outcomes. 2014;12:568-572. doi: 10.1370/afm.1721. Ann Fam Med INTRODUCTIONE xpansions in health insurance are concurrent with increasing implementation and adoption of electronic health records (EHRs) and other health information technology (HIT). Such changes present a unique opportunity for patient-centered medical homes (PCMHs) and other primary care practices or care settings to use HIT to maximize coverage among eligible patients.1,2 We propose that insurance coverage gaps are often preventable, [3][4][5] and that HIT is an untapped resource for closing these gaps. Since even short gaps in health insurance can negatively impact patient outcomes, 6-8 these opportunities for increased coverage have the potential to improve health.In a previous essay, we discussed how PCMHs could view uninsurance as a chronic illness and apply tenets and tools of the Chronic Care Model to treat it. 9 In follow-up, this commentary: (1) provides guiding principles for HIT infrastructure development to support health insurance enrollment and re-enrollment, and (2) describes how HIT and health information exchange (HIE) could be used to organize and communicate this information to patients. Guiding Principles For the Use of HIT and HIE to Help Keep Patients InsuredPatients are usually affiliated with multiple organizations which impact their health. For example, a patient may simultaneously: (1) be enrolled in an insurance program (eg, Medicaid); (2) receive medical services; and (3) receive educational and social services from local, county, or state facilities. Historically, information relevant to a patient's health has not been integrated or coordinated across multiple organizations; in particular, data from insurance payers were rarely made available to medical care teams. Though As HIT and HIE capabilities have grown, the potential to share diverse data across organizations in ways that could benefit patients' health has also improved. For example, HIT is being used in some health care settings to improve communication between patients and care teams and to address federal priorities to improve the 'Meaningful Use' of EHRs. 13 Our guiding principles...

In This Issue: Research Briefs and New Clinical and Policy Insights

“…Angier et al identify health information technology as an untapped resource to support practice-based efforts to help patients obtain and maintain insurance coverage. 11 Bodenheimer and Sinsky see the essential and underappreciated peril imposed by health care workforce burnout and dissatisfaction. The authors suggest improving the worklife of clinicians and staff as a fourth item necessary to achieve the Triple Aim goal of enhancing patient experience, improving population health, and reducing costs.…”

Designing Health Information Technology Tools to Prevent Gaps in Public Health Insurance

“…CHCs seeking to provide support for families navigating the insurance application process might benefit greatly from health information technology (health IT) tools designed to track and manage patients’ insurance and application information 17 , 18. Electronic health records (EHRs) have the potential to automate and support such tools.…”

A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

“…For a family medicine clinic or community health center, having higher percentages of continuously insured patients correlates with better quality performance scores [7]. Family medicine and community health clinics are in a unique position to assist their patient populations with maintaining health insurance [8]. Many clinics now have great resources at their fngertips to help with these actions: the EHRs and population data analytics [8–10].…”

“…Family medicine and community health clinics are in a unique position to assist their patient populations with maintaining health insurance [8]. Many clinics now have great resources at their fngertips to help with these actions: the EHRs and population data analytics [8–10]. Here we describe current efforts for EHRs data use in US primary care settings to track and improve insurance coverage rates and potential opportunities to improve quality and health outcomes.…”