University of Pittsburgh Medical Center Launches Smart Card Project, Allowing Patients to Carry Own Medical Information in Their Wallets
PITTSBURGH, August 27, 2001 — A small plastic card with an embedded microchip capable of processing information and storing numerous pages of a patient's vital health and demographic information will enable better care, quicker retrieval of important medical information and fewer billing errors, according to University of Pittsburgh Medical Center, which, in conjunction with UPMC Health Plan, has issued these so-called "smart cards" to some 300 Health Plan members.
UPMC's smart card -- dubbed the Healthcare Passport -- addresses the desire of a growing number of patients who want access to their medical records as well as their concerns about privacy and security of such information. In response to the latter, UPMC's smart card uses a number of sophisticated security measures that make it nearly impossible for strangers or unauthorized personnel to retrieve a patient's medical information.
In times of emergency, paramedics and emergency rooms equipped with card readers will be able to rapidly access potentially life-saving information about a patient, such as allergies to medications and chronic medical conditions. Plans are to have card readers installed in the emergency department of UPMC Presbyterian, a Level-I trauma center and one of the busiest emergency departments in the state.
The Healthcare Passport means patients will no longer be required to fill out clipboard forms every time they visit their doctors. And the likelihood of their receiving an inaccurate bill should drastically be reduced. About 90 percent of services denied by insurance companies are due to clerical errors made at the time of registration for a clinical service, insurance industry statistics indicate.
“This smart card – which is really a computer on a card – is going to make it much easier for patients to interact with the health care system on all levels. That’s what is really important here, making things easier for patients,” says Patricia Liebman, chief executive officer of UPMC Health Plan.
“This smart card technology will result in better health care, better management of limited health resources, and better health outcomes for patients. This will also allow patients to be more actively involved in their care treatment planning,” Ms. Liebman says.
"Smart cards are gaining in popularity in the consumer financial sector, and we see tremendous value for their use in healthcare. Not only do these cards have the potential to improve patient care and reduce administrative and medical errors, the technology enables patients to have access to their own information," adds Francis Solano, M.D., president and chief medical officer, Community Medicine, Inc., University of Pittsburgh Medical Center.
Dr. Solano's practice, Solano, Fiorillo, Coyle, Schmeltz and Associates, is the site of the first phase of the UPMC smart card project. The office will have card readers for staff to access and update patient information during doctors' appointments, and a kiosk will allow patients to view and suggest changes to their medical information in privacy and to obtain a printed copy of the smart card record.
"It won't be long before most, if not all, emergency departments and physician offices, even those not affiliated with UPMC, will have smart card readers, which currently cost less than $50. And readers are being integrated into most of the newer personal computers. There is every reason to believe that the technology will be in wide use across several industries," explains Scott Gilstrap, project director for technology solutions, University of Pittsburgh Medical Center.
"This technology not only solves our immediate security concerns for granting access to electronic health records, but also provides a feature-rich alternative to include a host of other applications which provide improved medical care, improved access and convenience of care, and at the same time enhance our business relationships. "
Few health care organizations have introduced smart cards. Those that have done so, even in the past two years, have had to use less advanced technology than is currently available. Typically, these cards allow about 8 kilobytes (8,000 characters) of information to be stored. In contrast, the UPMC's Healthcare Passport takes advantage of the latest technology. The card contains a 64-kilobyte microchip, with 32 KB, or 32,000 characters, devoted to applications and security, such as log-on applications and operating systems. The remaining 32 KB is devoted to data storage. That's about the same capacity of some of the earlier computers. And the information is compressed, so that more can be included.
"With compression technology, we can include quite a lot of medical information. Imagine if all the volumes in the Encyclopedia Britannica could be compressed into a single book. We are using the latest technology to compress medical information in the same fashion," says Christine Henderson, who is the technical director of the UPMC smart card project.
All of the information is encrypted, or in an unreadable format. Each card contains a unique secret "key" that is required for deciphering or decrypting the text. Patients will receive a unique personal identification number that will be required for them to access their information. Unauthorized or questionable use of the card will automatically deactivate it.
A patient's demographic, insurance or basic medical information, such as allergies, conditions and immunizations, will be updated at each doctor visit.
Soon, through a partnership with Mellon Financial Corporation's Global Cash Management Division, patients will be able to deduct co-payments for visits or pharmacy items or tap into flexible spending accounts, no matter where they do their banking.
Other plans for the future include being able to store a patient's list of current medications as well as a cash value for hospital parking, gift shop and cafeteria purchases. Patients with smart card readers will be able to access their medical records over the Internet; patients without Internet access will be able to access and receive copies of their information when visiting their doctors.
While UPMC's smart card project initially involves a limited number of Solano practice patients -- all of whom are subscribers to UPMC Health Plan and employees of either University of Pittsburgh Medical Center, the Health Plan or Mellon Bank -- plans involve getting the Healthcare Passport to patients throughout UPMC's integrated healthcare system, including those covered by other insurance carriers. This eventually could include nearly 3 million patients who are seen at any one of the system's hospitals and more than 200 physician practices in western Pennsylvania.
The smart card project is just one component of an ambitious information technology initiative that University of Pittsburgh Medical Center has committed approximately $500 million to develop and deploy over the next five years. The centerpiece of the initiative is the development of an electronic health record to be totally integrated across the entire system, a system that represents the full continuum of care, including 16 hospitals -- in both urban and rural settings, hundreds of physician practice offices, and nursing, personal care and long-term care facilities.
The goal of UPMC's information technology initiative is to improve the quality of patient care, reduce errors and duplication of services and to be a more cost-effective system. Importantly, UPMC believes information technology allows patients greater access to care and for a more informed, interactive health care experience.
For three years running, University of Pittsburgh Medical Center, which is affiliated with the University of Pittsburgh Schools of the Health Sciences, has been recognized by Hospitals and Health Networks Magazine as among the top 100 Most Wired hospitals and health systems. Last year, Information Week ranked UPMC eighth among health care and medical industries for technology innovation.
UPMC Health Plan, a subsidiary of University of Pittsburgh Medical Center, provides enhanced-access HMO and other health benefits products to some 315,000 people in 22 western Pennsylvania counties. Health Plan members are served by more than 5,500 physicians in partnership with 66 hospitals throughout western Pennsylvania.
The March 2001 issue of Managed Healthcare Executive named UPMC Health Plan as the fourth fastest-growing Health Plan in the nation. Its employer client roster grew 190 percent from 1999 to 2000.
The Health Plan operates under what it calls the “Accountable Provider” ™ model of business. It provides physicians, hospitals and other providers in the network great discretion and decision-making authority to provide the best possible medical care for their patients. In return, the Health Plan asks its medical providers to be medically and financially accountable for their decisions.
UPMC Health Plan’s 2000 Annual Report is available at its website, http://www.upmchealthplan.com.