Presentation to

Minnesota Futurists

“A forum for the discussion and communication of

alternative futures and to assist society in

understanding and creating positive futures”

January 5th, 2008

“Two Shots of Espresso and a Strep Test To Go, Please”By John Fraser, CEO, MEDNET USA

The Problem

MN Futurists Question

• If current Healthcare system is:– Slow– Inefficient– Hard to work with– Inflexible– Expensive– Lack of lifetime care information

Then how do we get to:

• Fast health care

• Convenient

• Inexpensive

• Life time care recordkeeping?

Three Part Solution

• Consumer Experience

• Infrastructure behind the scenes

• New Technologies emerging

Healthcare Consumer Expectations

• Fast• Convenient• Secure• Inexpensive

I call this the “Starbucks” Model

Potential Solutions: Retail Clinics?

• What are Retail Clinics?– Clinics in Pharmacies– Clinics where you work– Examples:

• MinuteClinic – 400+ clinics in 25 states

Retail Clinic Experience?

Online poll - 2,245 adults by Harris Interactive:• Convenience (92 percent satisfied);• Quality of care (89 percent satisfied);• Staff's qualifications (88 percent satisfied);• Cost (80 percent satisfied)

Connecting Health Care

Wiring Up Healthcare

1. Connecting Docs

2. Transportable Patient information

3. Security

Connecting Docs1. Regional Health Information Organizations (RHIOs) 300+ in the US

2. Community and National Organizations1. American Academy of Family Practice (AAFP)

2. AARP

3. AAA

3. Insurance and Payers

4. Hospital Groups and healthcare providers – 300,000+

5. Public Health Organizations – 1,000 +1. Medicare, Medicaid and public health agencies

6. First Responders1. Police, Fire Depts., Ambulance

2. First Responder Authentication Credential (FRAC) Users

7. Employers1. Optional HSA upgrade

8. Research Networks1. ePCRN already collaborating

Transportable Patient Information• VISA solved this

problem for your banking information years ago!

• Why not adopt the same model for healthcare?

• Supports linking a lifetime of medical information together supporting continuity of care

Security• Need national and International model• PKI most likely technology• Public Key Infrastructure (PKI)• Used by all Militaries – most trusted technology• Allows encrypting information that only recipient

can read. (Doc A sends to Doc B)• Supports digital signatures

– Electronic version of handwritten signatures

• Why do I think this?

LARGEST PKI SYSTEM IN HEALTH CARE

What does MEDNET USA do?

1. Protects Patient Privacy

2. Provides critical patient medical and payment information ANY TIME ANY WHERE

3. Uses advanced PKI security model

MEDNET USA PRODUCTS• Health care “Desktop” Application

– Like “Cable TV”– Basic cable = low cost– Connects doctors for referrals, encounters reports, etc– $50-$100 per month in volume – low entry price

• Patient Health ID Card– Magstripe card ID number pulls up patient record from the

participating systems, using a VISA™-like system.

• Healthcare Provider (Doctor) Identity– Healthcare worker (Doctor) must provide ID to access any

patient records– Using HIMSS/GSA Federal Model – FRAC Compliant

• National Clinical Routing Service– Not a database, but a network allowing the transfer of patient

records to and from authorized workers (Dr.’s)– Uses Federated Identity Management (shared) system

Why is this needed:

• It’s estimated that medical errors kill between 30,000 and 90,000 people annually in the U.S. and costs $17-$29 billion.

Reduce Costs• It’s estimated that $500 billion may be spent each year on duplicate or unnecessary treatments and fraudulent claims

Save Lives

MEDNET USA

MEDNET USAUser Card

MEDNETUsers

John Q.

MEDNET USAPatient Card

MEDNET USA

MEDNET USA

Federated Partners

Identity Directory

RolesPrivilegesClearance

RolesPrivilegesClearance

InternetInternet

Health Insurance

Health Plans

Patient’sMedical

Information

Hospitals

Patient’sMedical

Information

Clinics

Master Patient Indexes

MEDNET USADirectory Index

MEDNET SERVICES:

The Future• Patients carry single card to allow access

to important medical information• Doctors are “plugged-in” to a national

PKI system to share information quickly• Standards allow direct computer to

computer exchanges of health care information

• The emergence of the “Semantic Web” in healthcare.

Semantic Web – Next Generation Web

• 1998: Semantic Web technologies were outlined by Tim Berners-Lee

• Vision of User Agents managing everything from trip planning to your medical records

• 2008: 10 years later:• Heavy Semantic Web research at Mayo Clinic,

Cleveland Clinic, the National Institutes of Health• Docs not using it yet• Currently proprietary silos lock data up where it does

not easily travel with a patient as they go to specialists, change providers or show up in emergency rooms

Conclusion

• Health care needs to wire up

• Future requires advanced security

• Information flow easily between docs

• Semantic Web make free text understandable by computers

• Other expert systems will support life-long continuity of care for individuals

Thank You!

John Fraser, CEO

MEDNET USA333 Washington Ave North

Suite 208

Minneapolis, MN. 55401

612-435-7602

john.fraser@mednet.orgwww.mednet.org