FICO® Medication Compliance Score: #FAIL

Today, on my list serve group at the Society for Participatory medicine, the question was raised about the NY Times Well Blog post by Tara Pope on FICO®s new Medication Adherence Score. I was also inspired by @epatientDave pointing out that @nyceve1 had a blog post this morning. FICO-scoring-millions-of-Americans-on-medication-compliance .

And yes I am angry...because if you look FICOs website here is what they say about their new tool, that is easy to implement. I recommend that any self respecting patient contact them, because they are not in the business of helping patients, they really seem targeted to the Pharma companies, and  "Care Organizations" and "Health Care Payers" (I don't think they are talking about us).

Check out the tabs and pdfs for some fun reading...this is a dangerous tool that doesn't really meausre true compliance...if someone took the medication. So what if I picked up the medicaiton, or opened the glowing cap. As someone on the #SPM list serve group pointed out, "We will not be able to fix compliance problems if the denominator is as wrong as the numerator!!

The words that rub me the wrong way are highlighted in bold. Nor do they really say what data they are pulling...only the following: "third party data sources, name and address, prescription claims when available."

So, yes, I have got my cynical hat on....and my take away is (unless we revolt) Pharma companies are given tools so they can better target their marketing budget and relationships can be further leveraged with doctors ... and, enable deeper relationships with insurance companies who can have further control of what medications are on their formularies, or potentially use the data to develop additional criteria (of course they will use pretty words to make it seem fine) for dropping coverage for patients due to a poor  FICO® score.

It is bad enough that Pharma companies sell their drugs direct to patients, and take doctor offices out to lunch...Anyone see the movie "Love and other Drugs"?

So, I sent them an email. Let's see what they say.....and you can too on their contact page or call US (toll free): +1 888 342 6336

Here is information from the FICO site: (Cynic Hat on)..... highlighted a sampling of text all in blue Oh, and its easy to implement....

FICO® Medication Adherence Score is a powerful tool for predicting individual consumer’s likelihood of adhering to a drug regimen over the next year. This fully HIPAA-compliant solution helps brands identify patients at highest risk for non- compliance, direct marketing tactics where they have the greatest impact on medication adherence and health outcomes, and maximize the return on the consumer marketing budget. While pharmaceutical marketers typically rely on self-reported adherence data to identify non- compliance, FICO can score an entire patient database or list quickly and efficiently using only an individual’s name and address. Many pharmaceutical companies help address this challenge through a variety of consumer-directed programs. FICO can boost the effectiveness of these programs through a revolutionary data-driven approach to identifying a patient’s propensity toward medication adherence. Using the same world- class predictive analytics used to create the FICO® Score, the FICO® Medication Adherence Score accurately predicts an individual’s adherence propensity using a wide array of third-party data sources commonly used by direct marketers in a variety of industries. 

FICO® Medication Adherence Score leverages a patient’s prescription claims history when available and pulls on other third-party data sources when no other information is present.  The result is a powerful and versatile score that can be applied universally across a patient base to predict each patient‘s adherence over the next 12 months. This tool enables care organizations to gauge the right level of action across the patient base to optimize care, case and utilization programs— setting a universal baseline assessment on which survey results or other information can be overlaid if desired/present. The result is a powerful and versatile score that can be applied universally across a patient base to predict each patient‘s adherence over the next 12 months. This tool enables care organizations to gauge the right level of action across the patient base to optimize care, case and utilization programs—

The Medication Adherence Score is available for common chronic conditions, including diabetes, asthma, high cholesterol, hypertension and depression. Harnessing the predictive power of multiple, rich third-party data sources, Medication Adherence Score improves the effectiveness of all intervention targeting efforts.

Recent FICO research has shown that third- party data sources can effectively identify drug adherence propensity and can enhance the precision of models using claims data only. While some of these predictors, such as age and gender, are known to be associated with disease prevalence and adherence trends, FICO has unlocked the predictive power of other data sources, such as retail purchase behavior, geo-credit profiles and income/wealth indicators. The result is a powerful assessment tool that works across a prospective, new or existing patient base with minimal information requirements.AA-compliant solution helps brands identify patients at highest risk for non- compliance, direct marketing tactics where they have the greatest impact on medication adherence and health outcomes, and maximize the return on the consumer marketing budget.

Learn how your organization can benefit from the most advanced analysis solution for predicting medication adherence. Email us at info@fico.co

MoveOn.org Political Action: Stop the gift to Big Insurance

MoveOn.org Political Action: Stop the gift to Big Insurance

I have been a bit hunkered down, but am resurfacing to take on the "good" fight....and add my support to making a difference. And, one of those steps is healthcare reform. I never felt moved to be politically active. But, after my experiences in the current healthcare environment, I have been moved. And, the system needs to change. So, if have called my Congressman and Senators to add my support to retaining the public option. We need to create a competitive environment. Currently insurance is run by a few major organizations and they are primarily in it for the profit. So, we need to change that. Right now, the public option looks as good as any....

Tips for Understanding your Medical Insurance

Dealing with and understanding any medical insurance requires some talent, patience, and mostly perseverance. What happens when you have to change policies? That can be a stressful experience. 

Recently, I had to change from my fabulous traditional indemnity policy (straight 80/20 split) with no distinction between in- and out-of-network benefits) to what is considered by modern day standards pretty darn good insurance a PPO - Plus (boo hoo). The "Plus" only means you have additional out of network benefits.

After I whined and moaned for a while about my fate, I decided to bootstrap it and understand the new animal I was dealing with. And, boy, can it be complicated. Pay special attention to the language; it can be very obfuscating.

Here are some basic questions for the insurance company

1. How do copays work? Do they apply to deductible? Most don't.  That is simply what you pay out of pocket. Your deductible is the "co-insurance" part of the deal

2. What is the definition of in-network and out-of-network benefits? It is important to understand what they mean by whatever breakdown figure they use (for this example I am going to use a  70/30 split).

   What you will ultimately pay is not necesssarily based on what the doctor bills you. It is dependent on what the insurance company deems as "allowable". (And, all use different fee schedules there are no federal or state guidelines, although all insurance companies go off certain standard metrics).

   So, let's say you get a bill for $150 for an out-of-network doctor. Your insurance company may say that $100 is allowable by their schedule. They base their reimbursement on the allowable fee of $100. So, that means they pay $70 and you pay $30. The other shoe that will drop for you is the $50 that insurance did not allow. The docts office will "balance bill" you that amount + your coinsurance. So, your total out-of-pocket costs will be $80. (Sometimes, you can get a doctor to write off that $50, but you have to be proactive and ask.). This is not the same as a co-pay.
   

The other part of the equation is to understand how you provider works with the insurance company. Usually, doctors offices know who they contract with and who they don't. Remember it is your job to ask, so you know what your cost could be. 

There are many flavors of the same insurance company. Just saying Anthem won't get you very far. For instance, Anthem in California is only run by Blue Cross (not both Blue Shield and Blue Cross). You need the specific insurance info, which is determined by ID and Group numbers on your ID card. Those numbers do more than simply identify you and will let you know what the score will be. Think of it as your medical credit card with your personal rate information.

1. If you are not sure how your new insurance will treat a provider (this is usually only significant in the out-of-network scenario(s)) You can always ask for the diagnosis code(s) (ICD9) and procedure code(s) (CPT) the docts office will use for your treatment/visit.

   Then go back to the insurance company and ask to run a test claim. That should give you a good guideline on how insurance will pay. When you do this, make sure to ask if the call has been recorded, and always take good notes that summarize the discussion and outcomes (include name of person, date, and summary). Insurance companies always say that no claim quote is valid until it is completely processed. Good data is key. In the event that something goes wrong, you can point to the conversation you had. It is always more difficult to recreate your memory.

2. If you go to a hospital in your area, make sure you find out if both the facility fees and doctors fees are covered. Ask this of the billing department. The receptionist checking you in is often not a reliable source of information. I have come across cases where the facility is covered but not the doctor (i.e. radiologist, pathologist, emergency). It is a serious drag to not know this in advance. You think you are all covered, but then you get a $450 or more doctor's bill.  

   The hospital is generally not proactive in telling you this (unless you get someone who is on the ball, which in my experience is not very often.) Tell me, how many times have you asked the same question from multiple representatives of a facility or insurance company and gotten as many answers? Please note: Most say, that they do a courtesy billing. That does not mean that they are preferred providers of your insurance company. 

These are some simple techniques to help you better manage your costs. Until our medical system changes and patients have better consumer control over their costs, these simple techniques have been the only way I have some measure of understanding and controlling costs.

I highly recommend doing these basic steps before you need to use services. An emergency can happen at any time, as I have found out the hard way. Once you get a handle on what the expenses are (especially your out-of-pocket ones) before you have any treatments, procedures, etc... you will be much better in control of your outcomes.

Never assume, always ask questions, because it is in your best interest to manage the nuances of your healthcare and be a better CEO of your healthcare and body.

Hospitalization Recap and Analysis: How you survive a hospital stay

One would not think that lying around and recovery could yield so many different unique experiences including the good, bad, and ugly. But, it is true. I have had one of the wildest health and life adventures starting when I came out of traditional hip replacement surgery ten days ago, at Stanford hospital.

Veinipuncture: Each day a new vein supply had to be found since I kept reacting to the needless IV.  They had to bring in the vein specialist, which took over 4 hours, who put my IV right in the bend of my wrist which really was unpleasant. At the end of it all I was left with marks and bruises all over my hands and arms. The first days my blood pressure was so low that I couldn't lift my head off the pillow without spinning out. That was fine, where was I going. Not far.

Rounds and Sleep deprivation: There was the usual routing of being woken up every 4 hours throughout the night to check vitals, and then of course as soon as you do fall asleep the docts start the rounds at a god awful 4 AM. I desperately kept the sheets over my head with the hope of sleepy some  Thank goodness I brought lavender essence, an eye pillow, headphones, and my Ipod to play spacey music. (these were the essentials to maintain sanity and get some sleep). 

Neighbors: Unfortunately I had a pain in the ass neighbor, who, decided because she was up at 5 AM, so should everyone else. She had no sense of others. Asking for coffee, talking loudly with the nurse at all hours of the night, and tweaking out when her friends didn't show up when she expected them to. She is the only neighbor in all my years of hospital visits that I wanted to throttle.  I know I should be compassionate, but she really lacked it.

Pain Management: There was a young resident from the Stanford Pain Management Clinic, Carlos assigned to my case, who despite countless conversations with me still had it stuck in his head that I was on Methadone for pain management since last year. I kept reiterating that was not the case, but he clearly did not get it as evidenced on my discharge summary, that I needed to quit methadone. Clearly they are so immersed in their own process/bureaucracy that they believe their own bullshit. The pragmatics of that experience evade me. I guess because they wrote something down it must be true.  Isn't that a logical fallacy? A couple of times the whole team of 5, including head honcho, would come in and talk to me for whatever reason. I will be curious what that bill will be like. 

The EHR system, EPIC: Stanford now has a "sophisticated" and probably expensive electronic health record system. To provide meds, they have to scan your wrist band. However, when they record vitals, they only confirm your name. As a result I noticed last one evening that despite a nurse checking my name, was entering data into another patient record. WOOPS. She asked my name, but the name on the screen was somebody else's. Although in my situation it was not life threatening, it could have been. That definitely raised my blood pressure. It seems more foolproof to use the same protocol as they use with medications.

Nurses: Nurses come in all forms, good, compassionate, old school, those that go through the motions, and those that are somewhere in between. The last night I was there I had one unbelievable experience. It was the first night without a catheter and the first day I started ambulating with my little walker. I needed to go to the restroom and requested help due to the mobility restrictions and lack of stability. The nurse said, "Oh, just go to the bathroom on your own, and drag the IV rack with you using the walker." I didn't respond because I did not know what to respond with. Are you fucking kidding me? is what I thought and wanted to say. Finally, I got an nurses aid to help me. She left me on the toilet for over 20 minutes. Finally, I got fed up and tried to drag myself back to the bed with the IV rack in tow. Despite my gingerness, the IV rack got stuck in the wall mounted television's cords. I was so pissed. I tried tugging at my IV to no avail. I was stranded between my bed inches away and the TV. I wanted to teach them a lesson and was seriously thinking of ripping it out and having them find me on the floor. That would learn them, but maybe not.

Discharge Planner: Discharge planners come in many shapes and sizes.  They are supposed to help you with the transition home and arrange for essential equipment to be brought to your home. They are very sweet, smiling, reiterating how they are here to help you, saying, "Please ask me any questions and let me know if I can do anything for you." When I asked for a wheelchair and shower chair (due to my restrictions and concern for preserving my other joints) the conversation went south. They said, "Oh no, insurance won't pay for that, you will responsible for the charges, it will be cheaper to get that on your own." I even spent several hours in the wee morning the evening before discharge highlighting the relevant sections, criteria, and codes of my insurance's clinical policy bulletin governing durable medical goods (DME) to  show them what my benefits were. And, all I was met was with resistance. They wouldn't even look at the document. All they kept saying was that we want to help all our patients but you realize you will be financially responsible. I kept saying, "... fine, but please if the criteria are met, can you please use the codes and terminology that my insurance requires to get things covered." I believe, if I have insurance, I should get it to work for me as much as possible. For Christ sake, for a shower chair, the requirement is that I cannot stand, which I cannot. Finally, I asked, through a torrent of tears, what is the worst case out-of-pocket scenario for these items. For the shower chair it was $27.00 and the wheelchair it was $56.00 a month.  That is far cheaper than purchasing on my own. The cheapest shower chair is around $45.00. At the end, I got what I wanted, but it was a horrid experience. Thankfully, I was right, insurance covered all the DMEs I requested. (I found out later through the case manager that my insurance company assigned to my case that the situation should not have happened. She never was asked what my benefits covered.)

So, that is a not so summary of the highlights of my 3 night stay at the great Stanford Hospital. An acme of California's medical systems. I remembered from my last experience how much I hate that system, and this time it was even worse. It is shocking. Everything is so specialized and no one seems to know what the others are doing. The continuity of care and follow through are fragmented. Dr Maloney's team, was at least on top of the things they needed to be on top of. This experience reminded me and reinforced the reasons why I have stuck with the Colorado team and Vail Valley Medical Center for so long. Increasingly I am thinking smaller is better. People are less disassociated from the larger picture and service is overall better. For instance, I prefer Ace Hardware store to Home Despot (oh, that is Home Depot). The prices may be higher, but you get good customer service and knowledgeable staff. 

The lesson in this tale is multi-fold:

1. Don't blindly trust the system including the people in the system. It could have dire consequences.
2. Be educated about your insurance policy.
3. Make sure you know what is happening around you. 
4. Be your own advocate or have someone else be your advocate.
5. Have notes written summarizing highlights of important conversations including names and dates.
6. Bring personal small comfort objects, whatever that is for you. 
7. Bring earplugs and try to get the bed farthest from the door (very helpful for sleep).
8. Bring a good dose of humor. 

Struggling

I am 6 days post op total hip replacement. Although this should be a relatively easy surgery I am seriously struggling -- mostly emotionally. I feel like I am free falling and cannot get any firm hold on anything. The rest of my struggling joints are being hit hard by my weakened state. I am struggling with being overmedicated by the Stanford pain management team. Who I now personally hate.  Since I came home, Friday, I have not been able to stay awake. It is a horrible type of drowsiness. Saturday, I woke up at 11am, then despite my efforts fell asleep during my uncle's visit, at 1 PM and slept through 6 PM. I desperately needed to wash up, but I couldn't be bothered, nor had the equilibrium to stay alert and upright.  Basically the same thing happened Sunday and Monday. Yesterday I woke up for 1 hour and then slept until 6pm. This is so unlike me. I have never had such an extreme reaction to meds. Also, it brought along a serious desperate depression of not being loved, forsaken, raging jealousy across a wide spectrum of  "things" -- not having children, no one sending me flowers, none of my friends calling (although my neighbors have been so terrific, and Larry too), why is my life so difficult?,why do my friends have such fine lives. you name it I am feeling it. It has been a very long time since I have plummeted so far and deep. I have lashed out at Larry and succumbed to my most immature reactions. So much anger and hate. To top it off, my brain is not functioning at all. I feel like there is a hole in it. I am clearly not firing on all cylinders. My negative experience in the hospital set the stage for a lot of these issues. Larry keeps telling me to let go, let it ride, but I am not succeeding very well. Every little thing is getting under my skin. This PM I have somewhat stabilized trying to hold it together. I yearn for so much and need so much. There is no filling the hole inside. So, I keep looking at the picture of Genesha that I have here in my room, the God who removes obstacles. I am looking forward to a little peace and hopefully happiness. I have struggled for so long.

It has been so long, and where do we go from here?

I have been thinking a lot about the direction of this blog. What's the point, why bother, etc. so forth. After a while, simply bemoaning the system and my personal health dilemma dashed with a little patient advocacy tips seems rather self absorbed. And, then, why don't I just write it in one of my binders. So, I am sitting back and reviewing how to reframe this activity, connect it more to the FB identity, and then there is Twitter. Everyone can write about themselves, the trick and purpose to writing publicly is to connect it to the rest of the world. That takes purpsoe

What should we expect from a doctor

For the last 5 months I have been interviewing doctors. Imagine that. See post below hunting for rabbits, or is it doctors and this post local ortho elimination process

We think of interviewing employees, nannies, schools that our children go to etc., but we don't interview doctors, who can have a big impact on your life, in more ways than the obvious. This becomes especially apparent with the chronically ill patient, because they usually have a much higher interaction with the medical community, usually have complex cases, and have a higher level of investment in the outcomes. Those people who go to the doctor a few times a year, or less, probably don't think too hard about the quality of their doctor's. (Or, I am just guessing)

After the first couple orthopaedic appointments I had early this year in CA I was so disgusted with the talk down to you approach that I decided to do what I have been needing to do and that is create a supportive medical team to help me navigate my increasingly complex medical situation. As I have eluded to in other posts this has been a difficult and often traumatic experience. Everyday brings new insight as well as more confusion when I interact with medical people. And, lately I have been doihng this alot. I have on average 3+ appointments per week. Some weeks I have had two a day, Monday through Friday. This includes maintainence appointments, such as allergy shots, chiropractic, physical therapy, and mental therapy. Then I have followup appointments with specialists: orthopaedic, cardiology, urology. Currently, I have a high rate of appointments because I have been trying to have a good team of people I can trust and rely on. The anxiety of not having that is very stressful. There are days I have been hopeful and there are horrible days, like when a doctor thought I was trying to be self important by seeing many doctors. I am beginning to believe that I am getting closer to creating a team of people who are thoughtful, compassionate, and will be a great support to my overall care. They may not have all the answers, but, they certainly seem willing to help me through the mess I am in. I have had to create a personal patient schema to keep track of the specialists that I need to deal with on a regular basis and how they overlap with other doctors.

I wonder if I am crazy sometimes because sometimes it seems I am pushing the system to do something that it is not designed to do. I keep wondering how do other people who have a long term condition that is less straightforward deal with this. There are days I want to crawl into a fetal position out of despair because I feel unsupported. Most of the local doctor's are new and I feel like I have to convince them of how difficult life is for me. Sometimes, I want to throw up my hands in despair and just stop trying, and crawl into a hole. Then there are those few occasions, when I want to throw my arms around a doctor and say thank you for hearing me, caring for me. Those are the doctor's that really surprise me! I get so prepared for what I think is a difficult conversation related to paperwork, or questioning of their proposed approach to dealing with my multiple conditions, and they simply say ok, no problem, let's try that. Sometimes, they even say, maybe they should talk to someone else. And, that is often times the most refreshing statement I ever hear. I got inspired to write this post after reading the following article Get Yourself a Thinking Doctor

Am I crazy to expect that a doctor should listen to you, not pretend to know everything, and ask questions to better understand what you are going through?

I have become increasingly amazed how doctor's actually think. On the one hand they say to me, boy you have lots of problems with your joints, or, boy you are a mess, and will keep us busy. On the other hand they think I am working full time after I have told them how devastated my life has become, and that I rely on my partner to take care of managing cooking, cleaning, grocery shopping. I just wonder who is listening. After those appointments I wonder what is wrong with me? I wonder, what did I do wrong? I generally come home dejected and worried about my future. These are the people who hold my future in their hands. OY!! Thankfully, those appointments get balanced out by those doctor appointments that hold a lot of compassion, understanding (or at least not dismissal), and feeling of care. And, those are the people that I move towards, embrace, and feel buoyed by in the midst of my own personal storm. That is when I feel calm and cared for.

So, what do other's experience? Am I the only one out there that is puzzled and surprised by the medical institution? Sometimes I really do feel alone in this mad mad world.

What do you do when a doctor says that you are not Ted Kennedy

You write him and his boss a letter.

I went to a highly regarded Pain Management specialist in my area. I filled out the questionnaire. Signed all the release forms, answered all the questions the nurses had. Then, I sat in the exam room waiting for him. He came in, annouced that I was seeing too many doctors (which I already knew) and that I was not Ted Kennedy and that all I needed was a hip replacement. I did not need to see specialists. My jaw dropped, and I said but what about all the other joints that are causing me such difficulty? He said, "You just need to bite the bullet and make a choice of what is hurting most. I lost my composure, I teared up and started crying, sobbing, etc..... That was a first. In all the years that I have struggled with my medical problems, I never had someone, who did not know me, be so cavalier, opinionated, and generally gruff. He did mention that he was being tough on me. It took me several minutes to regain composure.

In hindsight, I wish I stood up to him more than breaking down and sob. I did tell him I was affronted by his behaviour. Frankly he was demeaning, unprofessional, and egotistical. Am I not important enough to have good quality care to help preserve my mobility? He apparently does not know what it is like to have several joints inflammed and non cooperative at the same time.

What was he trying to impart to me...that this is not life threatening and that I was not a deserving patient of his time. Oh, and was he making a judgement of the number of doctors I am currently seeing? Did he even enquire as to why? No! I did explain that I was working on interviewing doctors in my area to be apart of the team that helps me manage my lifelong condition of serious joint problems. And, he was apart of that process.

In the end, he provided some reasonable suggestions for means to help me deal with chronic pain in the joints. So, I am grateful for that.

This week I called the clinic back and spoke to the head nurse letting her know how angry I was by his behaviour. She said she heard from him what he said and she told him that it was inappropriate. Apparently he agreed and said he was sorry. She said to me, that she told him that, too bad the patient won't hear it.

I have decided this is one situation I am not going to let go silently. His behaviour, along with his posture -- slouched in chair with legs splayed -- was unprofessional. I am resolved to write him a letter telling him what I think. I will cc his boss.

There is no reason why a doctor should treat anyone poorly, especially a Pain Management Doctor. Thank goodness I have a fair amount of home support and am not suicidal. He raised doubts in me of not deserving good care, or being proactive about my care. I really hopes he treats his terminally ill patients with more tenderness. Maybe they are more deserving in his eyes.

Has anyone else had such an experience, and if so, what did you do?

It's no LOL: Few US doctors answer e-mails

I came across this article a week or so ago. It's no LOL: Few US doctors answer e-mails from patients | ajc.com

I am really intrigued with this area of the medical management process. I love email as a mean of communicating and receiving information. I find I am more thoughtful about how I am communicating I am always surprised, that something that would seem like such a time saver, from the patient POV, would not be embraced by doctor's. It seems like such a no brainer. I have read there are security issues.... patient confidentiality challenges, and . While I can understand, I think it ultimately comes down to the fear factor of patient liability issues.

I am wondering what other people think about this issue. Please share your thoughts.

Google Health.COM

Today there was an announcement about the launch of Google Health care. NyTimes Google Healthcare article. I am really excited about about the direction of the IT industry into the healthcare space. From what I can tell, this is one of the most innovative approaches to moving into this space, and could better enable healthcare management into the hands of the consumer in a way that will empower the patient. I obviously need to look further into what they offer and how they structure their legal agreement, in addition to patient privacy issues.

This type of service offering has enormous potential and potentially enormous pitfalls in relation to patient privacy and targeted consumer pharmaceuticals advertisements. See this article about the business skeptics: Google Faces Skeptics on Opening Day.

Personally, I have been a big proponent of moving the healthcare industry into the electronic space. I come from the information industry, and based on my personal experiences am really keen where this will all go.

Coming from the patient care and healthcare management perspective I really want to see something change especially for patients that have complicated healthcare issues, such as myself.

Although I love technology, I have found that when I go to doctors that have adopted healthcare IT solutions, that there is something missing in the doctor patient experience, especially when they are looking, typing, or dictating notes into the computer with their back to me. Here are some issues raised by Dr. Jerome Groopman in the following article: Do Electronic Records Impede Care. In addition read the following article from Australian news: For medical history, read hit and mystery


I foresee that the healthcare industry can only benefit from electronic record management, undoubtedly there are many powerful benefits of technology in the healthcare space, if used judiciously. Imagine emailing your doctors questions, getting a tailored Physical Therapy protocol through the internet, among other things. The flip side of the coin is that without interoperability standards will make this whole thing useless. If one system cannot read the information from another system there is no point in capturing the data if it cannot be shared. That is a common problem with technology, the ability to share information.....with other systems.

No matter what, we are moving into the technology age for healthcare. Google is making a valiant first stab at the problem. Here is a link to Google's explanation of what they are doing: Google Health, a first look I am going to review further what their service offers. The first thing that comes to my mind about how they have chosen their adisory board is that there are no patients, only doctors and healthcare admins. The exchange of information should not preclude the importance of patient input. If I had a voice, I would encourage the Google team to include a pure play patient, as opposed to a committee that is healthcare industry based. Here is the link to their healthcare advisory board: Google Healthcare Advisory Board