Got Medicare? Here’s How to Get Your Health Picture

Video Transcript

Tracey Welson-Rossman: Hear us. All right, here we are. Good afternoon and it is good afternoon on the east coast, a little frigid here. I'm waiting for some the the cyclone bomb, I think is happening. So we'll see what happens over the weekend. We took a little bit of a holiday hiatus and we're happy to be back and I am so excited about our guest today. What most of us may not know is that there are forces that are beginning to allow information that we haven't, as as regular people, we haven't had access to. And there there's been some legislation that is mandating that insurance companies are going to have to share their information with, you know, their customers so that they can see their tests and their medical records and have an easy digital access to it. Our guest today is going to tell us about a product that they've been putting together that is sort of a first step. There's other health exchanges that are happening. So we're also going to talk a little bit about that, but these are tools that will continue to help us as patients and as customers have a better understanding of what is happening. And it's all, you know, we keep talking about data on our Facebook lives. So this is just another step. Another source of data that is going to help us be to have more information that works for us. So I'm going to turn it over to my partner in crime, Joyce Griggs of United States of Healthcare and she will introduce our guest today.

Joyce Griggs: Thanks. Thanks, Tracey. And as Tracey said, at Journal My Health and the United States of Healthcare, we're dedicated to helping you with tips, tools, and resources that you can better manage your health and be a better advocate for yourself. And we're so delighted to introduce Carola Endicott from Health Data Analytics Institute. They're the creators of Health Picture which is this very easy to use app that gives us a very powerful tool and you don't even have to you don't even have to input any data to get access to data and that's what I think is so cool about it and Carola we're so delighted to have you here today. Can you just maybe start out by telling us a little bit about Health Data Analytics Institute and what, you know, what was the inspiration for Health Picture?

Carola Endicott: Sure. No, that sounds great. I Joyce it was such a pleasure to meet with you and I think what you're doing is just important. So I'm just very excited to be able to support to support that work and and hopefully some of the folks who join and listen and view will be able to get some help in what can be a very difficult moment, often, when, you know, you're trying to coordinate a lot of care, a lot of data, and bring it all together in one place. So, thank you so much for the invitation to both Tracey and Joyce. So Health Data Analytics Institute is a predictive analytics company. We largely work with healthcare organizations, like hospitals, health systems, accountable care organizations, to help find ways to improve the delivery and outcomes of the care they're delivering. And we do that partly by doing what we're doing with Health Picture, which is taking massive amounts of data and organizing it into care profiles for clinicians who are very busy and have a lot of data that they also are trying to work through and we've all read about burnout. You know, it's just a really challenging time for clinicians, whether it's doctors, nurses, care managers, care supporters, and to provide that information when and where they need it in a way that helps them with their clinical decision-making. It's still their judgment, their expertise, their intuition, but having a quick and easy way to look at that is something that we're very focused on providing to directly to hospitals and working with those organizations. But what happened in March 2020, as we all remember so well, is that Covid hit and the partners who we are, who we are working with became obviously very busy. And and so we said, you know, what can we do to support those seniors in particular who are now more isolated than ever from their loved ones and even from their caregivers and how do we, what can we contribute to to the to the sort, to helping people in those situations during a pandemic? And so we looked at both the data that we have access to, the kind of work that we're doing on curating and sort of digging through using tools to look at large amounts of data. And and we realized that we actually could create an application that would help Medicare seniors, in particular starting with the fee-for-service population, partly because as you mentioned, I think Tracey I think you mentioned it, you know, there are new tools and new new avenues available to to get the data out of Medicare into a usable form that maybe, you know, it builds on my medicare.gov but trying to make it a little easier to use. And so that's why we sort of pivoted over for that period to really create this tool, kind of out of nothing. And and, and that's kind of the genesis of it. I can go into more details, but I'll, I'll stop there.

Joyce: That was great, it's really great.

Tracey: So can you give us a little bit more understanding of what Health Picture is?

Carola: Yeah, so Health Picture is, it's a free application available on the web and and we can I'm going to do a little screenshot a bit later, but you can jump in through healthpicture.com. It's that simple. We are currently serving Medicare fee-for-service. Anyone who's on original Medicare. So some so so not the Medicare Advantage plans, except for Humana, and and we did add on Humana members and you can get to it from the myhumana.com portal also, and we'll be expanding this. But this is the, this is the amazing thing. This is where government mandates do work. Because, when when they said, look, there's this beautiful amount of information available to Medicare subscribers, but we are having trouble packaging in it and delivering it when and where they need it. Let's let's allow vendors to do that in a way that we can't do. Now all of this drives out of a very, very tightly managed authentication process. So, so they're so the the areas of security and privacy are not compromised in this process, because this is where the government thought really hard about, okay? There's a lot of sensitive information in there. How do we make it usable and available to seniors in a way that is secure? So they created the Blue Button data feed and, and that's, that's the that we use to feed to feed Health Picture and basically it, what it's, what it does is it takes every single Medicare claim, and it's now I think almost up to eight years of it, and it allows an auth– somebody who authorized their, an app, and in this case we're talking about Health Picture, there are other apps that are authorized by Blue Button. So we became authorized by Blue Button. They tested us, they put us through the wringer, they, we have to give them updates when we do updates to the application. So we were an approved Blue Button user and bluebutton.gov actually shows all of the different applications. So as I said there are others also. And so, what a Medicare senior can do is they can authorize us to be linked to their Blue Button account through mymedicare.gov, and then we get this beautiful information, but instead of putting it in the big pile and hoping someone could dig through it, we organize it. We put all the visits together. We take the medications for those people who have Part D coverage and we show that all of the medications they've filled every single fill. We show the conditions that anyone has diagnosed them with, whether it was the physician in Florida who saw them in an emergency department, the physician, their PCP up in Maine, the doctor in the Urgent Care Clinic in California. So those all of those claims that come through Medicare are fed through Blue Button for that patient, put into a nice neat package, and then provided whenever they need it and updated weekly.

Tracey: Right. Yeah. Joyce did you want to say anything?

Joyce: No, I was just saying wow. I mean, so essentially Health Picture is the organizer of the data, right? You're the filter.

Carola: Yeah, we're the filing cabinet. Just making it on one page.

Joyce: Tidy. Nice and tidy.

Tracey: And I, I love how you know, you're, you're putting that analogy out there because I think sometimes for people who aren't in the the tech side, we don't really understand that having the data is only the first step.

Carola: Mmm-hmm.

Tracey: How are we creating the data so that it's usable, understandable, visualized? You know, the these are pieces that are still part of what needs to get done and it you know I love hearing how government IT you know, does work. They were, you know, they understood that if they created the feed in a way that made it easy to pull that information out, somebody else can then take that information and, you know, just reorganize it in different ways that make sense for that audience. So I will, before we get into the demo, I did, I did actually want to give a little bit of a use case. And, you know, I think it'll be good if you can comment on this, because I feel like my family right now is, actually my husband's family, but of course my family, is this perfect storm of why is really important. So I have my father-in-law lives on the other side of the country. My sister-in-law lives near him, my brother-in-law lives up the east coast. So we're dealing with three siblings that are very involved in their father's care and, you know, there's there's been some decline and some, you know, they've been very fortunate that he's been very, very healthy up until say the last year, and there's a lot of going back and forth to the doctors and they just went through they needed a new doctor, they needed lots of other information. And, you know, my sister-in-law is doing an amazing job of managing everything on a day-to-day basis, but she doesn't remember everything. And I I showed this to my husband after our prep call and he's like, let's get on this. You know. Let's he wanted to send it directly to his his brother and sister. I said, let's go through it a little bit, but I think it's going to be tremendously helpful for them as they are just navigating this new, you know, place of this life that they have to, you know, go through. So I'm putting that out there as a use case for other people so that they have an idea of, you know, where this could actually work. So, I'm going to throw that back over to you to see how much you agree.

Carola: Joyce, did you want to comment on that? Or do you want?

Joyce: I was just going to say, like, maybe maybe pull up the, it's up to you, but maybe we pull up the demo. And as you can talk us through that because I think that's an amazing use case.

Carola: Yeah, that sounds great. So, what you're seeing now on the screen is actually the entry page and this is, you know, if you're on a computer right now, you can go right to healthpicture.com and you'll see this page and you can see up here, you can either click sign up as a Medicare member or sign up as a Humana member. The Humana members tend to come through their portal. I did just want to note again the privacy aspect of this. We don't store it, we don't keep it. We are using the data as it flows through. But we are very cognizant of the sensitivity and the privilege that we have. So I wanted to make sure that was clear. And you can sort of read here a little bit more about about how it works. And then there's a step-by-step guide to signing up because it will take you into mymedicare.gov and you will need your Medicare card because again, this is a serious authorization, we, it's carefully done and it's important to do it properly. So, assuming you've gone through all that, what I'm going to do is I'm going to jump over here to a Health Picture that is of a, you know, this is a kind of faked de-identified patient with a fake name but it's based on real information. And, and so, where we are right now is in the summary page. And you can see, it's just a web page. Now let's let's take your your example Tracey. And let's say that we are, Ernst has given us, so, Ernst signed up or with the assistance from his family, signed up, gave permission through mymedicare.gov and invited members of his family to also share his Health Picture. And so we are now authorized, he invited us, it's a pretty strict process where we send a separate number, it's outside the system so they, you know, Ernst had to connect with us separately to tell us what the pin was, so it's easy, but it's it's got a strong security on it. So we're now in the position, Tracey, that you talked about. So we're helping Ernst with with his care. We're helping him with his meetings with the clinicians, with his doctor. And honestly sometimes the doctors don't even know what happened with the other doctor.

Tracey: That is a good point. Yep.

Carola: Right? It's not just the family members who have to coordinate, it's the doctors who have to coordinate. So. So in this page here, we're sort of looking at an overall trend of the of the patient's health. And you can see there's a little bit of a decline. And, and here instead of sort of thinking there's a decline, it might be helpful to visualize the decline. And this is based on, again, looking at their health over time. And then you can, down here, you can see various healthcare events. I'm going to skip down. I'm going to skip the insights page for a minute and go right to the history section. This is what I think would have would be very very helpful for the kind of situation, Tracey, you described. So this is, this person is actually in an assisted living facility and you can, and and so the person actually the this person's daughter looks in here just to make sure that their, that the, that their father is getting the care that they need and you can see this is a really interesting way to double-check that in fact the visits that you have contracted for are taking place. And and what happened in this case was she actually saw that the assisted living facility was visiting less frequently than the level of care that she was paying for. She renegotiated with the with the assisted living facility and was able to to actually reduce her her cost because they realized that this patient didn't need the intensity of care that they initially thought and therefore, she could actually reduce her her payments. So that was an interesting use case that we hadn't actually anticipated. But like we could look here. Now this is just a long list of the visits at the assisted living facility, but you can see if we go down here. You know, maybe what you really want to know is, tell me about the ER visits for this patient. So you could just search up here and it'll filter out and just show you the ER visits for this person, not only the ER visit but also why. They were in for repair of wound again on two different date or rather this is the same date, it's because it's shown here twice and there was a laceration. Some, so this person actually did fall, they did have a fall and they last - but and then pain in right hip. So here you could see ER visit or you could see, you know, I just want to look at my hospital visits because those, maybe, were more dramatic. And this was actually a stroke and this was cystitis, urinary tract infection. So again you're getting that's why we call it Health Picture because the idea here is to be able to see all of those visits. Another use case that we heard was medications. So so let's say that we heard this example where one of the patient's family went with them to the dentist and the dentist asked them, Oh, is this patient on any anticoagulants? Which is a common which is a common use case and/or on antibiotics? So we could look, they actually brought this up on their phone and showed this list to the dentist in real time. And you can see it's not updated here because it's a demo, but this is updated every week and often it's no older than two weeks ago on the medications. So these are fills, these are not a prescription. So this means that somebody actually filled this medication. You can sort of see this person at 14 fills of three pills each for each day. You know, like there's just so much information in here. You don't need all the information all the time but sometimes you just want to know what medications is my is my loved one on? Or am I as a patient on? You know, you go to the doctor, they're like, oh what are all the medications you're on? Some of these are very complex, chronically ill patients with many medications, it's really hard to keep track of all that. 

Joyce: Yeah, this this is so incredibly important, you know, just speaking, thinking about the medications for a second. For the use case that you just gave, I have no idea and then just being able to pull that up on your phone for thinking about interactions and being able to show that to a pharmacist for family, like using Tracey's example, family in three different places. Are they filling their prescriptions, right? If you have a loved one that's still in the community taking care of themselves, are they even filling the scripts? So, it's just wonderful to have this window into what's happening because then you're not constantly asking questions of the person. You know, then you can have a dialogue about what's happening versus a dialogue about these, you know, little facts and so on which can lead to, you know, anxiety and complex. 

Tracey: There’s that and you know there's something that we talk a lot about at Journal My Health which is you don't have a lot of time with your doctors anymore.

Carola: No.

Tracey: So what you know to spend the time trying to remember what happened previously when you can be more efficient by having this information at, you know, your the the tips of your fingers basically with your phone or, you know, if you want to print, the print them out, but the whole point of your doctor's appointment is is, yes, the history is important because that's the only way that you can understand how to move forward, but if you're spending 15 minutes of your 20, 25-minute appointment on the history, you're never going to be able to have enough time to talk about what's next.

Joyce: Yes.

Carola: Exactly.

Joyce: So so true. One of the other things I wanted to just pivot to for a second were, like, some of the other people for whom this would be great. So you've talked about, it's only, right, for people who are in Medicare? And that we also mentioned that maybe you want to have been in Medicare for for a little while to have accumulated some data to look at. And if you're very active, if you're an active person going from, you know, a snowbird going from one part of the country to another, getting care in different places, here is a coordinating vehicle. Maybe you want to comment on some of that?

Carola: Yes, so those are excellent examples. I think the fact that all of the visits are getting in here, that's that care coordination between your care, your clinicians, your doctors and and especially if you you know more and more people are going to urgent care and and what happens to that data? I mean how do how do you kind of so people sort of are accumulating these EOBs, you know, Medicare sends out the, the explanation of benefit and I, when we were first putting this together, working with Medicare beneficiaries, I remember one of them said to me, oh, oh, I have this information. It's in a drawer and she's she sort of opened the drawer, and she's like, it's just like, full of paper. 

Tracey: Right. Right.

Joyce: Yeah.

Carola: So, that's not really easy to go through and try and find the one that was the urgent visit that you had when you were in Florida. So so again by having this, she when she saw that she was like, okay maybe I don't need to keep, you know, a file drawer full.

Tracey: Well she can still keep the file you know, the drawer, I still like to have paper sometimes. But and I think that that's one of the things that we also are talking about which is when you go to the doctor, if you come with this stack of paper or detail of what's happening to you, it's great that it's there, but this is about organization. So unless, you know, it's enough to get the paper into the file, but you have to be very organized, and to your point, we're now able, you've done all this filtering for, you know, for the person, taking all that data so that it just makes more sense. And, you know, is visually easy to find information. So, I think that, you know, this is I can't speak highly enough about this. So we've gotten the audience excited. Hopefully. How do they get started?

Carola: Yeah. So what I'm going to, I want to make one more little point, which is the problem of overtreatment. You know, there's the problem of undertreatment and overtreatment, and this also can help reduce unnecessary treatment. So like I'm showing here the labs that this person had done. What if this, you know, if for an invasive test let's say, you know, a CAT scan of the face? You know, if you know that this was done a year ago, do you really need to do another one? That's that's a lot of kind of you know, you have to, the person has to go to a special place and it can, you know, there's radiation and so forth. So, so I just wanted to make the point that I think, I think overtreatment and undertreatment could both be be helped with this. So anyway, okay, so I'll get off my high horse.

Tracey: But it's okay because I think we're going to continue to see more and more of this.

Carola: Yeah. 

Tracey: Of what of where these use cases are, I think you're going to hear more stories as more people begin to use this.

Carola: Yeah, yeah exactly. Thank you. So in terms of signing up, it's really as simple as going to healthpicture.com and and we'll walk you through all those steps. What what as Joyce said earlier, from this site signing up as a Medicare member, you'll create your username and password and it will send you, it will make sure that that's the correct email because we don't want people putting anything fake in. And then once we've verified that, then it'll take you into mymedicare.gov and once you're in mymedicare.gov, it will take you to the place where you would authorize Health Picture to be able to access your Medicare information through the Blue Button feed and to do that, they'll need your information from your Medicare card. And it should take about 10 minutes. If you have the Medicare card there, we do have, I know sometimes that we've actually talked to Medicare's Blue Button team about this, could they make it easier? Like you know, like if you forgot some part of your, your Medicare, if you don't have your Medicare number, it's actually a bit of a pain to have them find it for you and send it to you. That's not something we can control, but it is, it is hugely helpful to have your Medicare card with you when you sign up. If you do have Humana Insurance, even if you're not a Medicare member, we do we do have a link from myhumana.com or you can link to it here, but obviously the data is much more rich for those Medicare patients. They just have have more events to see. So I don't know if that answers the question in enough detail.

Tracey: I think that's pretty detailed. Now from a doctor's standpoint, physician's standpoint, are you are you getting help from them to let their patients know because I certainly hope you would?

Carola: That's a great question and actually this view that you're seeing here like this this summary view, and actually we didn't talk about it but we do a risk prediction for patients and they can have a choice of to see it or not see it, but for clinicians, this is very, very interesting. For them to be see, to be able to see, you know, what is this person's risk of a fall-related injury or of going to the hospital for an unplanned admission? Again. This is a little bit more sensitive, but some people really want to know and other people don't want to know, but clinicians find this as a distillation of this to help them help the patient and talk about the same information together from the same kind of view of their data. This is a very helpful tool and we are seeing there is an uptick in physicians who are looking for tools to help them engage the patients in their own care. And I think, you know, it to be able to say to a patient, you know, you are at a risk, an elevated risk of going to the ER, here are some things we can do. Let's work together. Those are some of the ways that that there could be a win-win in the way clinicians and patients could use this together.

Joyce: So this is, this is awesome. So healthpicture.com, have my Medicare card, and and then just begin to follow those steps. And then I can also allow others. I can invite others within my care circle to also access those those data as as well. And this is all free. Also, right? This is free and your data is not sold to anyone for access in any way. This is huge.

Carola: We're kind of regulated through the Blue Button requirements that CMS put out there. So I mean it's, we we're the point of this is to keep it free. This is not where we have another business.

Joyce: Right. Right.

Carola: You know? Where we work directly with hospitals and that's and with ACOs and that's becoming you know, more more powerful and I think, eventually, we'll see these two worlds, sort of helping each other. But yeah, this is free.

Tracey: We can only hope.

Carola: Yes.

Tracey: There, you know, there's so much that's happening within the healthcare that needs to be disrupted. And one of that, one of them is the ability to bridge that communication gap between doctor and patient and other healthcare providers. And this certainly is a tool that can help that.

Carola: I hope so. It was such a pleasure being here with you today. Thank you so much for the invitation.

Tracey: Oh, thank you for this. And hopefully we will you know, will get more people to understand that there are tools out there that can be helpful for them that empowers them to speak up for themselves and to understand more of what's going on in their own health picture.

Carola: Thank you.

Joyce: Thank you.