Following the CMS patient access deadline on July 1, 2021, the nation’s top EMR vendors and large provider organizations are aligning themselves with a future in which their patients are more active participants in their own care.
And as healthcare delivery moves increasingly virtual — and clinical and claims data becomes newly accessible — health plans and providers have an opportunity to deliver more targeted and higher-quality care more effectively, at a savings, to a geographically disparate patient population.
This all depends, though, on the patient having the right tools and resources to interact with their care team and clinical data in an actionable way (think: condition-specific mHealth applications).
One challenge that patients, health plans, and provider organizations will face is deciding which apps each side of the care equation should use to access and share data.
If I, as a patient, want to use a blood pressure monitoring application that my provider doesn’t integrate with, then do I really want to use that app? If I can’t get feedback from my doctor because she can’t see the data my app is generating, then the app has little benefit.
One way health plans and provider organizations are starting to take the guesswork out of healthcare consumer app adoption is by creating organization-specific digital health formularies of preferred apps, devices, and solutions.
These formularies are easiest to understand in the Apple App Store model. Apple only allows its users to download applications to Apple devices that Apple has deemed meet their minimum level of scrutiny, ensuring these “Apple-approved” apps deliver a quality user experience and security to all Apple users.
Providers and health plans are approaching these formularies in the same way — scrutinizing the apps, devices, and solutions — and ensuring they’re confident in the solution.
The flipside of this coin, which health plans and providers will grapple with, is that the approved list of apps limits consumer choice.
In-housing the app-approval process puts the provider and health plans in a bit of a precarious position because historically they have not been the approver of third-party applications they don’t control or license. They don’t want to take on the risk of recommending an app for download if that app turns out to have glaring security flaws.
Generally speaking, these organizations don’t have strong in-house resources to evaluate all applications and medical-device security criteria, yet they will need to retain a level of scrutiny regarding who accesses their organization’s clinical data. They will either need to outsource this task to a trusted vendor or build that expertise, including complex authorization, authentication, auditing, and security practices, in-house.
These healthcare application formularies started in a cynical way: as a tool to encourage patients to stay within a specific provider ecosystem. But as patients become more empowered to steward their own healthcare data, formularies are being structured around better informing the patient of the best options for their specific needs.
It remains to be seen where the line will be drawn between patients using whatever apps they want vs. staying within a network’s preferred vendor list. Regardless, patient stewardship of their clinical data has unlocked countless new care delivery and reimbursement models.
My guess: following the first major application security breach or HIPAA violation, provider organizations and health plans will batten down the hatches on apps they allow into their ecosystems.
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