Similar to financial credit score, a health score system can transform the healthcare and insurance sector
The launch of Ayushman Bharat health id mission (a unique health id for every Indian) created the most basic and essential building block of the EMR (Electronic Medical Records) based healthcare. An integrated EMR system can transform healthcare and related industries such as insurance. It opens tons of opportunities for startups to tap into EMR based new products and services, and plug-in new ideas in the healthcare transformation journey.
Integrated EMR in a simple language – any health-related activity of an individual will be recorded in a centralized digital system. Be it a test, diagnosis, doctor consultancy, purchase of medicine, or even a gym membership, every activity will be recorded as a transaction in EMR, and can be easily retrieved (report out) using the unique health id. So, Doctors can refer to an individual’s EMR, which will increase both efficiency and effectiveness of diagnosis and consultation; and individuals can avoid re-test and overhead of record-keeping of previous medical tests. Off course, the appropriate consent mechanism and how much data one wish to share with doctors will be preserved with the individuals.
Integrated EMR will also enable digital-only doctor prescription for medicine and enforcement of no-sell of certain medications without digital prescription (tracked using bar code). And integrated EMR and digital only prescription can transform the way an insurance claim is process today, and will reduce the process cost dramatically. However, claim process is not the only thing that the integrated EMR will transform, its the way the insurer design (write) a policy or set the premium amount, can be completely transformed.
Similar to the financial credit score, if we may have a health-score system, then it can transform the way the insurer design a policy and set the premium.
Credit score – on any financial transactions related to credit (loan, EMIs, bank advances, credit card usage, payment, etc.), a centralized system (CIBIL) tracks all the transactions, records and creates a real-time credit score of each individual (based on PAN card as unique id). The scoring mechanism is based on a sophisticated algorithm. Whenever one seeks a loan, the bank or lender checks the credit score of the individual and makes a decision on the loan as well as offers custom rates based on the score. Additionally, the credit score system brings efficiency by reducing lots of manual checks and thus overall loan process time. The same thing can be applied to the individual’s insurance.
Health Score – On similar lines, every health-related activity can be recorded as a transaction in a centralized system. And based on Artificial intelligence – Machine learning (AI-ML) powered scientific algorithm (co-designed by healthcare experts, tech experts, and social & policy architects) a real-time health score can be created. One can retrieve the health score using the unique health id.
Benefits of health scorecards
- To insurance companies, it will enable to have health score-based customized premium; as well as ability to design individual’s need specific policy.
- Healthcare providers (hospitals, doctors, diagnosis centers, fitness companies) can use health scorecards to make better decisions and provide effective suggestions and consultancy.
- The biggest beneficiaries of health scorecards will be individuals. As it can be a guiding indicator to make the right lifestyle changes toward better health.
Start-ups, and established healthcare (hospital and diagnosis) organizations, and the government should work in tandem to create a secure, robust, and positive intended health scorecard system.
Integrated EMR based health scorecard is an idea whose time has come.
karanvivek 