Apps that will help you take control of your health care (and save everyone money)

Lawyers, insurance companies, bureaucratic inefficiency, flawed regulation, corporate greed — I listened while pedigreed panelists at a conference in St. Paul, Minn., rattled off reasons why U.S. health care costs were skyrocketing.

The usual scapegoats led to the usual explanation: Health care is muddled in complexity —and it always will be.

I asked the experts this question: “Given the fact that the U.S. spends roughly twice as much money for the same outcomes as Western Europe, is there an apples-to-apples budgetary comparison out there that explains why American health care costs twice as much?”

I know firsthand that our health care system is convoluted. A pediatrician turned my newborn son away three times before we convinced doctors that vomiting 40 times in 10 hours — and eventually vomiting blood — was cause for concern. My son was diagnosed with (potentially deadly) pyloric stenosis only when my wife and I brought our own research to the table.

As I waited for the panel to answer my question, I sat with my father, who invented the model for health care pricing in Sweden that enabled efficient billing between provinces, and my mother, who ran five nursing homes as the resident physician.

The panel’s response: crickets.

When there’s a persistent inefficiency in an economy, it usually means that someone is profiting from it. In this case, if you follow the money, the American health care system is structured through incentives: It’s a fee-for-service scenario (or “Accountable care,” which can promote cutting corners) where providers are encouraged to keep their patients coming back. And unfortunately, those profit goals are often opposed to smart health care choices.

I know we’re not going to fix the U.S. health care system overnight — I’m not naïve — but in a connected world, we have the tools and data to help consumers make informed choices about their individual health care needs.

Recent legislation has given us unprecedented access to both electronic medical records and data about Medicare reimbursements, and a wave of apps, websites, and platforms are poised to let individuals take ownership of their health care.

Seven apps to power your health care participation

Developers don’t treat patients, but they can create smarter tools for accessing and effectively interpreting health care information. These are just a few of the platforms that help us track how our bodies work, clarify how we pay for health care, and allow doctors to communicate more effectively with patients.

1. Apple iOS Health Kit SDK / Health App: Along with their iOS 8 iPhone operating system, Apple announced an app called Health and for developers an SDK called “Health Kit” enabling smart sensors such as the upcoming iWatch or a Fitbit to integrate data into an app thusaiming to provide a one-stop hub for fitness and health tracking in your smartphone. With sensors the app lets users track metrics like heart rate, blood pressure, reparatory rate, and weight so that they can better understand their bodies.
2. iTriage: Using simple questionnaires, iTriage identifies possible causes of patient symptoms, and then matches them with a health facility databases via the Department of Health and Human Services. The app even helps patients book appointments instantly with providers that are equipped to treat their symptoms.
3. BetterDoctor: BetterDoctor is compiling data on doctors’ specialties, insurance networks, qualifications, and patient feedback to help consumers make informed decisions about their long-term medical care. They’ve also introduced price maps that can compare the cost of care and procedures between doctors.
4. Prime: A smartphone app that allows users to collect all of their medical records from any doctor and access them through a simple interface. Prime is facilitating smart health decisions and preventing expensive mistakes.
5. Aidin: By using public data from the Center for Medicare and Medicaid Services to automatically generate a list of post-acute care providers, Aidin helps hospital staff give patients specific options for follow-up care.
6. Purple Binder: Purple Binder aggregates information about community services to connect users and providers. Effective use of community services like public clinics, food pantries, and mental health counseling lowers the social cost of health care.
7. OpenNotes: Transparency is the name of the game for OpenNotes, which helps patients get better visibility into their physician’s or therapist‘s notes

Eight questions that will help you get the most from your health care

The scientific method is at the root of any good medical diagnosis: data gathering, analysis, forming a hypothesis, and testing that hypothesis. Being an active participant in your own health care means respectfully questioning the doctor’s hypothesis and supplementing with your own research.

Here are some guidelines that will help you ask the right questions for your particular situation, plus some examples from my personal experiences with my wife and our son:

1. What is your hypothesis of my diagnosis, and what led you to it? Thoroughly questioning the doctor’s diagnosis that my son’s vomiting was due to overfeeding probably saved his life in the long run.
2. What are the alternative hypotheses, and why did you reject those? When my son didn’t recover from surgery quickly, we asked the doctor to consider alternate complications, which led to the discovery of a threatening blockage in the pyloris.
3. If your primary hypothesis is not confirmed, when will you revisit it? My wife sought treatment for a skin condition thinking it was eczema. But when her condition didn’t improve, we had an allergy test done and found out she had allergies to dust mites and nuts. We avoided those things and her skin condition improved almost instantly.
4. Ask specific questions about common issues for people in your age group. Knowing that pyloric stenosis is more common in first-born Caucasian male babies at 3 weeks of life this would have helped us diagnose our son faster. The Mayo Clinic has a great breakdown of how your needs will change with age.
5. How will you communicate your progress to me? For instance, after surgery for pyloric stenosis, normal recovery is 24 hours, and if symptoms have not abated in 72 hours, then we will discuss revisiting hypothesis.
6. How will you involve me in the decision making for my (or my dependent’s) care? For instance, what are the timelines, check points and triggers you’re looking for? When my son started vomiting, I wasn’t aware of how much constituted an abnormal amount. If we knew the benchmarks, the right diagnosis could have been reached quicker.
7. How do I get a hold of you if I learn about something I want to ask about? The surgeon for our son gave us his business card with his number, which was much appreciated and helpful.
8. Study up. It’s amazing how a little research while you’re at the hospital can empower you to be a better co-participant in your care. Doctors are short on time and use a lot of specialized terminology, so some smartphone-aided research goes a long way. Here are some tools to help you do so:

• The Mayo Clinic’s website
• WebMD
• Google
• Wikipedia

The next time you’re told you can’t have access to a certain piece of health care data, ask why until you get an answer that you’re comfortable with. Trust your instincts, and if you’re not satisfied, don’t be afraid to write your legislator asking that he or she helps to improve data transparency in health care. We owe it to ourselves — and the country — to continue improving health care through both our participation and technology.