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How much does that medical procedure cost?

by Hayward Zwerling, BS, MS, MD

A mobile app which will allow a user to input their demographic and insurance info, a medical procedure and hospital and the app will return an estimate of the cost of the procedure.

North Chelmsford, MA Health Information Technology

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All Team Company Patients Physicians Mission Supporters

About this project

The problem we solve:
It is nearly impossible to get an estimate of the cost of the procedure, prior to procedure being done. Unfortunately this situation gives fiscally inefficient healthcare institutions a way to avoid dealing with the deficiencies of their institution.
About our solution:
Massachusetts is a unique healthcare market as all the "players" (MMS, politicians, physicians, hospitals, insurers, public and businesses) are committed to the same goal… lower cost and higher quality. In addition, there is a "transparency in healthcare cost" on the books. As a result of this confluence of factors, MA provides a unique environment to create an app that will allow for the accurate calculation of patient responsibility of the cost of a procedure. As I envision this app, the user will enter their demographic and health insurance data, the proposed procedure and the name of the institution. The app will then reach out to the institution and obtain the billing charges for the procedure, take that information and submit it to the insurer, which will then calculate the total allowed payment and the patient charges. I would propose that the app start with BCBS and one large Boston hospital and if successful, serially add insurances and hospitals.
Progress to date: This is a new idea and no implementation has been attempted to date.

About Our Team

Dr. Hayward Zwerling, BS, MS, MD
Endocrinology, Practicing Physician
Location: North Chelmsford, Massachusetts
Medical school: SUNY-Upstate Medical Center
Bio: I have been involved in HIT since 1991, I created ComChart EMR (www.ComChart.com) which had the highest KLAS rating in the Ambulatory Care EHR group from 2004-2012. I currently serve as the vice-chair of the Mass Med Society Committee on Information Technology and blog on HIT at The Health Care Blog.
Practice: Lowell Diabetes & Endocrine Center
Hospital Affiliation: Lowell General Hospital
Title: M.D.

About Our Company

ComChart Medical Software, LLC
Location: North Chelmsford, Massachusetts
Website: http://www.ComChart.com
Product stage: idea
Sales: Working on it
Employees: 1-2

How We Help Patients

Transparency in healthcare cost is absolutely essential if we wish to get the cost of healthcare under control. When I tell a patient they need a procedure done in the hospital, they will ask me "what will this cost?" Many times, despite my best efforts, it is impossible to get timely and accurate cost information to my patients. This situation is incredibly frustrating both for my patients and for me (the healthcare provider) especially when there are more than one equally effective treatment options available. This app would solve this problem.

How We Help Physicians

It is not uncommon for a physician to be able to offer the patient more than one treatment option for particular medical problem. When there part two or more treatment options, which are nearly equally effective, the patient's first question is always "what will it cost?" Currently, it is nearly impossible for me to answer this question in the vast majority of situations and both my patients and I are left frustrated. If this app is able to do what is proposed, it will help solve this problem.

Challenge Mission

Mission: Transparency in healthcare cost is essential to improving our healthcare system. This app would greatly advance that goal.
Use of funds: While I can handle the design of the app, I will require both legal, technical (and potentially political) expertise to build the app and ensure the cooperation of the hospitals and insurance companies. As I have been involved in HIT in MA for more than 2.5 decades and know many of the major players, and they know me, I should be able to use these connections to move the project forward. The first thing that required will be legal (and potential political ) assistance to coax the individual hospitals into opening their fee schedule to the app while pushing the insurers to allow our app to interact with their databases, preferably using open-source code and state of the art tools, like FHIR.
Intellectual Property Status: I intend to do this using open source tools to make the code available for others. There will be some security issues that will have to be dealt with but this should be achievable.
FDA Status: There is no FDA clearance required for this project.
Personal Message: The lack of transparency in healthcare costs is a major problem and an embarrassment for the healthcare industry and an impediment to taking care of patients. My proposed app should help rectify this situation and would cost nothing for patients to use. The app will be a "win-win" for all involved in the healthcare industry.

Supporters

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    05/19/2016 William Kelly - Engineer

    Interested in trying the project.

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    05/19/2016 William Kelly - Engineer

    Liked the project.

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    05/19/2016 William Kelly - Engineer

    Followed the project.

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    05/17/2016 Helen Muhlbauer - Physician

    Liked the project.

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    05/05/2016 Nadia Silva - Medical Student

    Liked the project.

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    04/28/2016 N Zalavadia - Pharmacist

    Liked the project.

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    04/25/2016 Vishnu Ravi - Resident

    Followed the project.

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    04/25/2016 HEATHER SANKEY - Physician

    Followed the project.

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    04/25/2016 Vishnu Ravi - Resident

    Interested in trying the project.

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    04/25/2016 HEATHER SANKEY - Physician

    Interested in piloting the project.

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    04/25/2016 Sumaiya Iqbal - Resident

    Liked the project.

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    04/23/2016 Hannah Reed - Other

    Liked the project.

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    04/23/2016 Alex Fair - Investor

    Liked the project.

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    04/21/2016 Alex Fair - Investor

    Interested in other factor.

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    04/21/2016 Mr. ASASD ASFSADF - Physician

    Followed the project.

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    04/21/2016 Meg Barron - Private

    Interested in trying the project.

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    04/21/2016 Alex Fair - Investor

    Interested in piloting the project.

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    04/21/2016 Alex Fair - Investor

    Interested in mentorship.

  • image
    04/21/2016 Alex Fair - Investor

    Followed the project.

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    04/21/2016 Alex Fair - Investor

    Interested in trying the project.

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    04/21/2016 Alex Fair - Investor

    Interested in partnership.

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    04/21/2016 Meg Barron - Private

    Followed the project.

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    04/21/2016 Meg Barron - Private

    Liked the project.

8

likes

6

Follows

1

Pilots

0

Partners

49

Interest
Score

7

Adoption
Score


Hayward Zwerling, BS, MS, MD
Physician
M.D.
SUNY-Upstate Medical Center

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