A Multi-Application Medical Smart Card

A Multi-Application Medical Smart Card

A Multi-Application Medical Smart Card would serve as a complete and portable medical record file for consumers and a real time tool for clinicians, hospitals, health plans and researchers to better manage patients, data and outcomes.

What is a Medical Smart Card?
Similar to a credit card, a medical smart card has a microchip embedded in the plastic. This microchip can have 32, 64 or more kilobytes, allowing the smart card to store large amounts of data securely and accurately. This data can only be retrieved by using a Personal Identification Number (PIN). At the point of care, the data stored on the card can be downloaded and updated on a computer or a Palm device that has a UBS port to insure that the most accurate and up-to-data medical information is being used. The cards would have a built-in privacy shields and tiered access so that, for example, a pharmacist can read prescriptions but not medical records.

A network-linked smart card has the benefit of allowing better communication among doctors, hospitals, pharmacists, health plans and the entire care network. Improved communication at the point of care can succeed in delivering the most up-to-date medical records to improve medical decisions, review quality of care and convey feedback of best practices. A medical smart card can also play a major role in fraud reduction, improved patient tracking and disease prevention programs, improved tele-health, remote monitoring and controlling the pen-and-paper medical records drowning our health care system. A medical smart card would be in full compliance with the electronic data exchange and privacy mandates of HIPPA.

Smart Card Industry Now
In Europe, smart card technology is a $2.5 to $3 billion industry. France has developed an intricate smart card program, whereas Germany uses a very inexpensive 256-byte memory smart card. All 80 million German citizens carry a medical smart card. In Asia, smart cards have had extraordinary success in the financial arena. Recently, companies in Asia have been focusing their efforts on incorporating smart card technology into other product lines (PDAs and cell phones). With a smart chip embedded in a cell phone, consumers can store credit cards, address books, medical information and even Word® files. It is believed that within the next few years there will be very little need to even carry a wallet in Asia.

In the US, the medical smart card industry is still mostly in the talking and trial phase. Big companies like IBM and GE only discuss the potential of these cards and some smaller institutions, such as the University of Pittsburgh Medical Center, have piloted medical smart card projects, producing favorable results.

A secure medical smart card managed by the patient and the care network can help to:

- Reduce the $100 billion in health care fraud Americans are faced with each year.
- Reduce the $1.6 trillion spend on duplicative medical testing. Last year one out of every five lab tests and x-rays were conducted because previous tests were unavailable.

- Improve medical record storage, maintenance and access. The storage, maintenance and access of pen-and-paper records can consume more than 40% of a health care institution’s budget and 25% of the health care provider’s time.

- Improve patient compliance. Electronic driven reminders can be sent to the patient and the care network regarding outpatient preventative care, raising compliance from 29% to 49%. Red flags will be raised if a patient doesn’t renew his/her medication within a certain window, and patients can receive computer-generated reminders for yearly tests (PAP smear, EKG, etc)

- Reduce errors involving prescription medications. Currently these errors are responsible for up to 7,000 American deaths per year and the financial costs of drug-related morbidity and mortality costs nearly $77 billion a year.

- Keeping records up to date. Medical information on smart cards can be continually crunched, updating the algorithms with the latest scientific evidence and putting that relative data at the clinicians’ fingertips at the point of care.

- Staying in touch. Other health and awards based programs can be tracked using these cards

Medical Smart Card in Action

John Q is leaving his home in Ohio for a business trip to New York, but before he leaves he has to make a few stops. The first stop is to his doctor for a check up and to renew his prescriptions. John has been suffering from diabetes for several years and recently had a minor heart attack. When John sees his doctor he hands him his medical smart card. His doctor downloads the card’s information onto his PC and scans the data. The doctor looks at John’s blood sugar and blood pressure levels; John inputs this information daily after self-tests. John’s doctor performs the physical exam, after which he adds the most updated information on to John’s card and also adds three prescriptions for John’s conditions. John is a good patient and takes his medication as prescribed, but his doctor knows that if John was to miss an appointment or not refill his medications within a certain window of time, not only would he (John’s doctor) get an automatic email warning, but one would also be sent to his health plan and the rest of the members of his care network (diabetes educator, the staff nurse in John’s office, etc).

John’s next stop is to the drug store, where he hands his card to the pharmacist who is able to download John’s card in seconds and fill his prescriptions. Because John has to punch in his PIN number to fill the prescription there is little chance of fraud. Things are moving quite well and John has some free time on his hands, so he heads to the gym for his cardiac rehab. When John enters the gym he hands his card to a front desk staff member who inputs the visit on his card. Tracking these visits has allowed John to save several hundreds dollars on his medical insurance from his health plan.

Pleased that he’s gotten all these tasks done, John gets to the airport ahead of time and departs Ohio for New York.

It is John’s fifth time in New York and he has really developed a feel for the city. He grabs his bags and hails a cab like a local. Twenty minutes into the trip, his cab gets into a serious accident. John is left unconscious and banged up. Emergency services arrive, stabilize John at the scene, and load him into the ambulance. En route, the EMS tech finds John’s smart card and loads the data onto his palm pilot. The tech emails John’s records to the emergency staff at the hospital. Instantly, the care network knows who to notify, what medications he is on, allergies, his chronic conditions, his most recent MRI and blood work. The doctors also discover that John was born with a harmless blood protein disorder consistent in renal disease. This simple piece of information saved John, the hospital and his health plan over seventy thousand dollars in needless medical testing.


Providers and Medical Smart Card
-Real Time Data at the Point of Care
-Improved Tracking of Patients
-Improved Storage and Access of Medical Records
-Reduction in Fraud
-Reduction in Medical Errors
-Reduction in Needless Medical Testing
-Streamlined Billing and Improved Interaction with Patients and Health Plans
-Improved Tele-Health and Remote Monitoring of Patients
-Prevention of Dangerous Drug Conflicts

Health Plans and Medical Smart Cards
-Improved Risk Assessment and Risk Adjustment
-Improved Claims Processing and Pre-Certification for Procedures
-Reduction in Fraud
-Provide Better Patient Information (Billing and Benefits)
-Improved Communication with Care Network
-Improved Assessment of Disease Management and Disease Prevention Programs
-Reduction in Needless Medical Testing
-Improved Medication Compliance

Hospitals and Medical Smart Cards
-Real Time Data at the Point of Care
-Improved Tracking of Patients
-Improved Storage and Access of Medical Records
-Reduction in Fraud
-Reduction in Medical Errors
-Reduction in Needless Medical Testing
-Streamlined Billing and Improved Interaction with Patients and Health Plans
-Improved Tele-Health and Remote Monitoring of Patients
-Prevention of Dangerous Drug Conflicts


Conclusion

Aggressive disease care and prevention is necessary. Additionally, streamlining our bloated health care system should be a national priority, as it is vital for the survival of that system. Through technology there is now a greater ability to manage patient care, and link it to the entire care network. A medical smart card can empower not only the patient but the whole network, improving medical outcomes and saving money across the board. At this time the health care industry breaks the number-one rule that has allowed many other industries to thrive: Putting the right information in the right hands at the right time!