HIPAA- You paid the cost. Don't throw away the rewards!

HIPAA- You paid the cost, now collect the rewards (2003 unpublished draft for article)
DON'T FORGET THAT THE P IN HIPAA STANDS FOR PORTABILITY. Not Privacy.
If we remember that, then HIPAA can pave the way for a quantum leap forward in medical effectiveness. HIPAA forced the medical industry to replace numerous outdated systems based on paper forms and outdated computers.
Think about it: What are medical records? They are, basically, the recorded saga of your life, your physical existence on this planet. To make the kinds of informed treatment decisions expected of us today as medical consumers, we need to have that information about ourselves in a form that we can find, access, and comprehend.

SCENARIO. Picture yourself meeting with your physician in her office. After brief greetings and banter about your respective families, she asks the purpose of this visit. You tell her about a pain you noticed a weeks ago, that's gotten progressively worse since. She studies the screen of her tablet PC. It occurs to you that the doctor appears to be working intently on an Etch-a-Sketch, a mental image that makes you chuckle. She looks up quizzically, then returns to her electronic slate.

The physician soon looks up again, smiles, and clips the tablet into a stand. She swivels it toward you, and comes to your side of the desk so you can both see the screen. It shows a generic, naked human torso-- not your own, you are relieved to see-- with your area of complaint pulsing slightly in red. Below the image is a table listing symptoms, as well as other input you gave in an online interview yesterday at your home computer, when you went online to schedule the appointment.

With a fingernail, the physician lightly taps an on-screen button. The image tilts and rotates into a 3-dimensional view, and the body image on the screen is overlaid with another body image. With a few words from the physician, it hits you, literally in the gut, that a little problem she warned you about two years ago has now grown into a big problem, and you have to do something about it. Now.

Details to expand
- Family history & personal profile fed into an actuarily-based condition predictor, that overlays the generic body picture with personalized potential trouble spots. May be a few pre-herniated disks or a dormant mass. Or, hypertenstion & infrared cold spots pointing to constricted blood flow in some parts of the body.

- Billing and Payments- These are especially bewildering to nearly all concerned. I, for example, don’t like getting first surprise, and then repeat, invoices for medical services. Did I receive that service? Didn’t I already pay for it? I thought that was covered by my insurance, when I gave them my card. Why are they billing me now?

Solution: Illustrate relationships between services received, billing, and payments using colorful, USA Today-style graphics, flow charts, timelines, and personalized labels. Adapt for what-ifs: What if I have a prolonged illness? What if I get extended coverage? What if I self-insure for that risk? The technologies there! How freaking hard can it be? Or do they PREFER us to stay confused?

Advantages:
Make the medical process visible and open. We’re supposed to take active role in our treatment and apply it to our lifestyle, right? How about giving us the conceptual tools to make that possible, and stop obfuscating it in distressing forms and paperwork?
In the online interview situation, you had more time to …

Obstacle: In preliminary interview, I wouldn’t know to the relevant questions to ask myself, that the physician would ask. Maybe the preliminary interview should be an interactive web conference with the Physician's Assistant?