Problems in Healthcare

Healthcare is one of the top social and economic problems facing Americans today.  As much as they try, our healthcare system is still in the dark ages compared to today’s technology standards. As a matter of fact, the government and the healthcare industry struggle to agree upon a single standard. This has plagued our healthcare system for too long and we as a society deserve better.

Policy makers and professional organizations have become increasingly concerned about physician professional satisfaction. Because of this incentives and penalties to adopt electronic health records (EHRs)—have provoked widespread and intense responses from practicing physicians.  Despite recognizing the value of EHRs in concept, of those physicians who do use an EHR system struggle to use their EHRs effectively, which they describe as negatively impacting patient care in several important ways and undermining their professional satisfaction.

We’ve addressed the major points, which only scratch the surface:

A single medical record for each patient

  • A 50-year-old patient on average has 22 medical records.
  • These records are static and do not “talk” or exchange information with one another.
  • Most are forgotten, misplaced or lost – losing valuable information and your history with them.

Saving lives

  • On July 17 2014 it was disclosed at a public senate hearing that preventable medical errors persist as the No. 3 killer in the U.S. – third only to heart disease and cancer – claiming the lives of some 400,000 people each year.
  • This equates to 1096 deaths every single day.
  • It was revealed that current information technology is falling short.

Significantly reduce medical fraud

  • The FBI stated that in 2014 Medicare alone paid $98 Billion dollar in fraudulent claims, including private insurers such as Aetna, BlueCross, Health Net, etc. that number jumps to a staggering $600+ Billion dollars each year.
  • The FBI only recovered $211 Million of Medicare fraudulent claims.
  • Recent cases show that medical professionals continue, and may be more willing, to risk patient harm in furtherance of their schemes.

Fraud consist of:

  1. Medical Identity Thief – Medical identity theft involves the misuse of a person’s medical identity to wrongfully obtain health care goods, services, or funds.
  2. Billing for Unnecessary Services or Items.
  3. Billing for Services or Items Not Furnished.
  4. Upcoding – is a term that is not defined in the regulations but is generally understood as billing for services at a level of complexity that is higher than the service actually provided or documented in the file.
  5. Unbundling – Unbundling occurs when multiple procedure codes are billed for a group of procedures that are covered by a single comprehensive code. The way this form of fraud works is that the reimbursement for the individual
  6. Kickbacks – defined as offering, soliciting, paying, or receiving remuneration (in kind or in cash) to induce or in return for referral of individuals for the furnishing or arranging of any item or service for which payment may be made under Federal health care programs.
  7. Medication abuse – because the current tracking mechanism is obsolete & antiquated, with standard photocopies many criminals can obtain the same prescription such as Vicodin and OxyContin hour after hour. It takes the current system 6 months to 1 year to catch up. Drug dealers use this method regularly.

Create an easy and cohesive environment for Physicians, Insurers and Patients alike

  • Create an easy to understand platform bring all three parties together in a LIVE environment.
  • Patients no longer need to fill out multiple medical history forms, it is collected one time, in the patients home and they can updated as needed.
  • Medical history can be updated automatically from family members, (father, mother, brother, sister, etc…) when patients op-in, no matter the clinic, hospital or physician office.

There is currently no permanent standards for the Healthcare sector

  • Interoperability is problematic – there is no single standard to transfer patient information from one location or physician to another.
  • Information exchange is mostly still printed on paper and mailed or couriered.

To literally drag the Healthcare industry to current technology standards

  • The majority of medical records are built within the MUMPS platform (Massachusetts General Hospital Utility Multi-Programming System), which was creating in 1966. It was last updated in 1995 – 20 years ago. To put this in perspective – the first generation Smartphone was announced in 1997.

Quick Reporting

  • Under the current model, health related infectious & diseases are reported to CMS & CDC after 9 months of the Physician/Patient visit
  • CDC uses this information for epidemic & pandemic purposes, example – the flu vaccines.
  • Because the information the CDC is 9 months old, the CDC has to guess which vaccine to use.
  • The 2014/2015 flu season vaccine was a bust. The vaccine is only 10%-20% effective.
  • Within World Inter-Med’s (WIM) system, we can report this information to the CDC with 5 seconds of the Physician/Patient visit

Reducing bill cycle time

  • Hospitals & Physicians typically get reimbursed for their services within 6 months.
  • Within our system, we can reduce this to 19-25 days.

Here is the Fact Check of our numbers:

Saving Lives: (400,000 people die annually)

Medical Fraud:

Drag Healthcare to current technology: (MUMPS)

Quick Reporting: (Flu)