The Simplest Rx: Check on Your Patient

On a computer in his St. Louis medical office, Dr. John Rice often pulls up a list of his 10 patients with the largest bills. They suffer from diabetes, heart disease, or emphysema. They sometimes land in the hospital where they rack up a long list of charges.

Rice's job is to make sure they don't set foot in that emergency room. To accomplish this, the chief medical officer of Esse Health, an 80-physician practice, does what policy makers say too few doctors do now and what they hope all doctors will do in the future. Using technology supplied by a private insurer, Rice has a window into his patients' health that extends far beyond the clinic's examining rooms. He can tell when patients have stopped taking their medication or when they're overdue for a routine test. Armed with that information, he can direct his staff to fill out a prescription and deliver it to a patient's home or schedule an appointment at a diagnostics lab. Rice once spent $40 on cab fare for a patient whose daughter couldn't pick her up from the hospital—a bargain, considering an additional day's stay would have cost $1,500.