Online Verification of Eligibility Should Provide Major Benefits

◆In April 2023, medical institutions and pharmacies will be required in principle to introduce online verification systems for insurance eligibility, and it has been decided that the conventional health insurance card will be abolished by the fall of 2024. However, even at facilities that have already begun operating the system, patient information is being utilized very little, and patients themselves are not making progress in managing their health through viewing their own Mynaportal.

◆The government says that the use of online verification will provide better healthcare, but it has not clarified how to use patient information to improve the quality of healthcare for medical treatment and prescriptions. It is also expected that patients will proactively manage their health and participate in healthcare, but it is unclear how this will lead to behavioral change based on the information that patients can confirm through the Mynaportal.

◆In the U.S., electronic health records (EHR) have a function to alert physicians when they select inappropriate drugs or tests in order to improve the safety of medical care through the use of patient information. Patients can also use the portal to obtain post-practice follow-up from their physicians, increase their understanding of treatment, and also request a refill prescription for their physician. The benefits for both healthcare providers and patients need to be articulated in order to advance healthcare DX based online eligibility check.