Skip to comments.Obama's Electronic Medical Records Scam
Posted on 12/14/2012 3:59:39 AM PST by Kaslin
Here's more evidence that government "cures" are inevitably worse than the "diseases" they seek to wipe out. Buried in the trillion-dollar stimulus law of 2009 was an electronic medical records "incentive" program. Like most of President Obama's health care rules, this top-down electronic record-sharing scheme is a big fat bust.
Oversight is lax. Cronyism is rife. The job-killing and privacy-undermining consequences have only just begun.
The program was originally sold as a cost-saving measure. In theory, modernizing record-collection is a good idea, and many private health care providers have already made the change. But as with many government "incentive" programs, the EMR bribe is a tax-subsidized, one-size-fits-all mandate. This one pressures health care professionals and hospitals across the country into radically federalizing their patient data and opening up medical information to untold abuse. Penalties kick in for any provider that hasn't switched over by 2014.
So, what's it to you? Well, $4 billion has already gone out to 82,535 professionals and 1,474 hospitals, and a total of $6 billion will be doled out by 2016. But the feds' reckless profligacy, neglect and favoritism have done more harm than good.
Don't take my word for it. A recent report released by the Department of Health and Human Services Inspector General acknowledged that the incentive system is "vulnerable to paying incentives to professionals and hospitals that do not fully meet" the program's quality assurance requirements. The federal health bureaucracy "has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments postpayment is also limited," the IG concluded.
Translation: No one is actually verifying whether the transition from paper to electronic is improving patient outcomes and health services. No one is actually guarding against GIGO (garbage in, garbage out). No one is checking whether recipients of the EMR incentives are receiving money redundantly (e.g., raking in payments when they've already converted to electronic records). No one is actually protecting private data from fraud, abuse or exploitation.
Little is being done to recoup ill-gotten payments. In any case, such "pay and chase" policing after the fact is a crummy way to run government in lean times -- or in fat times, for that matter.
As for the claim that the EMR conversion will reduce paperwork, many doctors say the reality is just the opposite. In Greensboro, N.C., Dr. Richard Aronson told local TV station FOX 8 that the mandate doubled the amount of paperwork in his private practice. Everyone from optometrists to general practitioners to chiropractors to podiatrists must divert precious time and resources to conforming with Washington health bureaucrats' imposed vision. Some medical professionals are now warning that the dangerous phenomenon of "distracted doctoring" is on the rise as a result of data-driven imperatives that direct health care providers' attention away from their patients and onto their screens and hand-held devices.
You know who is benefiting from the initiative? Put on your shocked faces: Obama donors and cronies.
Billionaire Judith Faulkner, Obama's medical information czar and a major Democratic contributor, just happens to be the founder and CEO of Epic Systems -- a medical software company that stores nearly 40 percent of the U.S. population's health data. Another billion-dollar patient-record database grant program has doled out money to the University of Chicago Medical Center (where first lady Michelle Obama and senior adviser Valerie Jarrett both served in high-paid positions). As I've previously reported, these administration grants circumvent any and all congressional deliberation as part of Team Obama's election-year "We Can't Wait" initiatives.
Even as the White House touted the move toward gee-whiz 21st-century electronic databases, health care professionals in the know have debunked that claim, too. Companies like Faulkner's, which lobbied loudest for the mandates and "incentives," represent traditional hard drive-dependent software firms that are already dated. As Athenahealth Chairman and CEO Jonathan Bush, who advocates cloud-computing alternatives, put it: The Obama electronic records mandate is "healthcare information technology's version of cash-for-clunkers."
Then there's the still-growing and untold number of doctors nationwide who are closing up shop or limiting their practices and converting to "concierge care" to escape this and myriad other Obamacare intrusions. My own primary care physician in Colorado Springs quit her regular practice and converted to "concierge care" because of the EMR imposition. Creve Coeur, Mo., doctor Shari Cohen made the same move.
"The demands of caring for my patients while navigating through the current health care delivery systems dictated that I take more and more time away from patient care and spend an increasing part of my day on the system itself," she told the Creve Couer Patch. "Electronic Medical Records was the final shove for me. It added another whole layer in interference in the doctor-patient relationship and one I was not sure I wanted to take on."
More paperwork. More waste. Less accountability. Less care. Government malpractice at work.
The VA does electronic records and the military does too now. I kinda like it. You can go to any VA and get immediate treatment and they have the history. I liked that the military had electronic because so many Sailors would lose their medical record and have to start all over again with SHOTS...very costly for the government on their irresponsibility. This is actually an incredibly great idea that the government came up with. I know we all hate government but some ideas are just good and this is one of them.
I am with you. I honestly think Ms Malkin is off on this one.
Forget about electronic medical records.
This is another slush fund setup to ensure DNC victories into the next century.
There is no convincing data that shows EHR improve patient outcomes. The systems are many upgrades away from being useful. Very expensive. Very cumbersome. Productivity plummets when they are introduced into health systems. Why would any organization/business turn its most highly compensated employees into clerical workers? Clearly modernization of records will occur and should but forcing it into the system by the government as usual is not working.
The trial lawyers know it. They are already suing for mistakes made because of the changes.
My wife works in the medical field. The group she works for switched over to electronic records to take advantage of the incentives. Now she is no Bill Gates on software but her description of this software tells me it was produced by the lowest bidder. She must re-boot several times a day when her keyboard locks out, like every time she leaves the computer for a while. Some records of previous visits just disappear and show patient as a new one. It is now more time consuming than with the old program and that doesnt include time when it is just down.
One reason why this administration and his allies like these records is because they can use it against citizens. If you ever consult a doctor over depression issues or have any kind of subscription to drugs such as prozac, zoloft, etc, I can guarantee you that information will end up in these records and will automatically move your name to the “no-buy” list with the ATF. This will be used to automatically deny people their 2nd Ammendment rights and it will disqualify huge numbers of American citizens. This is their revenge against the Supreme Court ruling in the summer of 2008.
Not sure how anyone can pin this on Obama, the HiTech Act happened under Bush and I believe, Clinton before him. It was simply signed by Obama.
It’s another ridiculous bubble building government program. There are more companies selling EHR applications now than there has ever been for any other application in the history of man, 400+ or so. Can you imagine 400 different web browsers, word processors, etc?
It’s a $20 billion spend in a healthcare system that costs are already out of control. Why? To gain control of the citizens health data and give government power over doctors and their patients. Meanwhile, CMS doesn’t have enough money to pay docs for care.
BTW, the Feds are also spending great deals of money on incentivizing “electronic prescriptions” and “quality reporting” at the same time they are dropping reimbursement for actual medical care. So, hundreds of billions of dollars are wasted and new government entities are empowered at the same time the government is broke and doesn’t have enough money to pay docs for medical care.
This fails the common sense test as does most government ideas. Anybody that thinks this is a good idea is either in the business, or not a conservative.
I agree. Couple this now ‘government information’ with
U.S. Terrorism Agency to Tap a Vast Database of Citizens
They have everything they need to call every citizen a criminal on some level.
“The VA does electronic records and the military does too now. I kinda like it. You can go to any VA and get immediate treatment and they have the history. I liked that the military had electronic because so many Sailors would lose their medical record and have to start all over again with SHOTS...very costly for the government on their irresponsibility. This is actually an incredibly great idea that the government came up with. I know we all hate government but some ideas are just good and this is one of them.”
You really should rethink this one. It’s not an idea, it’s a mammoth, non-free enterprise, goverment created bubble that takes power away from private citizens.
....depends on WHERE the VA is located. Here in Jersey it’s a mess. I’m told by a long time VA worker that over half of the employees at the two locations don’t have a clue of what their doing when it comes to finding their way around the system. I dealt with an employee who kept telling me “the system was down” when in fact looking over her shoulder, I was watching another navigate fairly well.
They also say they can’t just print out a request for records which I know is BS because I had a nurse do just that a week later. Everything is WAIT
Now the latest bit of info I got was that the government or VA is deciding which of the two to close down, while we (VETS) were told the waiting period for any request is because of volume of requests.
Four months for an assessment,(appointment) that was changed twice by them (put back)that lasted 2 hours and could have been done in 20 minutes, (blood pressure,ear exam,chest xray, blood work) three of which I get done regularly with sched’ appointments with their doctor seems wasteful. Whatever you do, don’t complain, your appointments will suddenly have a longer waiting period. It’s a total mess here in Jersey
Searching through VA records for impottant info is a nightmare!! I’m a physician and do it daily. I know.
Searching through VA records for important info is a nightmare!! I’m a physician and do it daily. I know.
MM is correct it is “distracted doctoring”!
EMR takes a difficult job, tending to the sick and injured in a busy ER and makes it an impossible task.
All for the benefit of the watchers, not the doers.
With ERM I am 25% doctor and 75% ward clerk as I have to order all the lab tests on computer, order the suture trays and when I need a foley cath placed, I order that on the computer and dressings and antibiotic ointments. They do not make me order a change of linen between patients, but I suspect it is coming around the bend.
Yeah, the hospital got a million dollars to implement the EMR and all I got was the inner ward clerk released from my deep recesses.
Job satisfaction down after 25 years practice.
I made the mistake of asking if there was a “on call” list, where a Vet could be on call if another appointment was cancelled to fill the spot...you would have thought I stumbled upon a secret. When I asked my friend “what’s up with that?” he said, that’s the game they play to “open” time for themselves during the day. Cancelling an appointment gets you two hours of free time......call for information to the specific office and get told by a recording to leave a message, then be told by another recording that that mailbox is full,call back later....so the trick is call another department, tell them you can’t get into the place you want to contact, (give them the person)...they page the specific person you want to get to, NOW they pick up, put you on hold, and you conduct your business,IF THE SYSTEM IS UP.
I currently have an appointment that was originally scheduled for Oct 16th...my newest date is Dec 19th, that appointment was changed three times by them
Hey, your connected to one of the better locations...
Our son’s wife’s father is a family doctor and he is part of a private country practice that computerized records even before the federal push. He loves the way it allows him to keep track of his patients, even if they become ill on vacations. Of course, he is the diligent sort who actually *reads* every one of his patient’s records forwarded to him. He told us the county hospitals used to never notify him when a patient was admitted or sent test results only after their office called. Now he claimed he has almost instant access to information. You could see the joy on his face!
For one example, I've read through a VA file that went on for pages and pages with negative findings about POW abuse (the patient never left New York State) and about quitting smoking (the patient never smoked) but then had a single, two-line comment about his 4-vessel coronary bypass surgery buried in the middle of the file. I'm semi-retired, and I'm somewhat compulsive, so I have the time and the motivation to read through these pages, but the chance that a rushed ER physician is going to find this information at 3 AM is remote.
IMO, the large HMO medical records -- like Kaiser -- are almost as bad. My theory is that these record systems are designed by gov't bureaucrats and hospital administrators in conjunction with computer programmers. Active health care practitioners seem to have had minimal if any input, and any input they gave was probably ignored. (But the records look much neater and prettier than the old-style handwritten records!) One notable exception is the Mayo Clinic that seems to have created a usable electronic records system. But Mayo is the exception, and far from the rule.
-——many private health care providers have already made the change-——
My medical group made the change years ago and it is working well. They are a national leader in the effort. All the different specialties in the group can and do access the baseline data collected by the primary care doctor.
The hospital was recently added to the ability to accesses and add to the personal record.
I absolutely don’t understand the problem. For me, it is a decided health care edge.
They do military Records at Fort Campbell, KY BACH
EMRs will be interfaced with the Rat political machine.
“Sorry Mr. Conservative, but we are all out of funding for knee replacements this year. And your daughter’s surgery? Not on the approved list. Sorry. Try again next decade. NEXT!”
It always depends on what is put into the computer
———Now she is no Bill Gates on software but her description of this software tells me it was produced by the lowest bidder——
What you have described is a purchasing error. Those who purchased the software made a decision to buy cheap and mediocre rather than more expensive and very good.
There is no relief from bean counters making technical purchasing decisions in any field
Every doctor my wife and I have gone too in the past few months, either he or his staff spend a lot of time typing in our information, what we are there for, what they prescribe to us, results of exam, etc. They spend more time typing that they actually do talking too us. It is all going in the computer and the gov-mint is going to have it all. More info for the death panels in the future.
Wait until they tie it all into the gun registry database. Hmm. This guy took antidepressant medication back in 1979.
I was supposed to have an appointment with a Neurologist on December 7th, the evening before they called to confirm the appointment. Then an hour and a half before the appointment they called and said there is a scheduling conflict with the appointment and it needs to be rescheduled. So they rescheduled it for December 20, at 3 pm which is time wise very inconvenient for me.
GMTA. See #25.
If the databases are put together as bad as they say, some may slip through the cracks. Others may be harassed and persecuted or prosecuted because of bad data.
To whom does one appeal to correct faulty data in the master database?
I would tend to believe it came from a list of approved software compatable with dictates from Obamacare. (IE: vendors that donated to Obamas reelection)
Wanna bet that all of the “accidentally damaged or lost EMR files” will belong to conservatives?
To the ‘rats, politics is a blood sport.
As a software engineer in this field and data access in general I can tell you it is the drive to make everything mobile and cloud driven. Desktop applications that access data locally or in the same network are on the order of magnitudes more reliable, faster, and easier to fix issues when discovered (the re-deployment is the deficit).
Having your data on a server(s) out of your network may save money on hosting data and server licenses but you will pay in performance. There is so much transferring over the line with the webpages alone and once you add data to the mix it is just slow. However the powers to be and the younger “mobile” generation in a quest to generate consistent service revenue have sold a bill of goods that the cloud is the nirvana of data management and that is a load of crap. Any desktop app that pulls the same data requirements will outperform a web app 9 times out of 10. Especially when your out side connection is not fiber or T-1 or better, even then just traffic density alone is restricting. Not to mention that everyone thinks they need to pull MB or even GB of data all the time on every transaction.
This does not apply to point of sale apps that retrieve bascially a few kb of data at a time.
Oh... I am sure it wasn't 'cheap'. I am sure that WE are paying a hefty price for this 'software'.
The software is mediocre, only because that is what the 'customer' asked for.
When I lived in Maryland, my doctor (actually a PA) was part of the Johns Hopkins Health System and they moved to an electronic medical records system years ago and I liked it as well.
After they moved to an electronic system, I found it took less time in the waiting room waiting to be seen. My doc could easily see what Rxs were due to be refilled as the EHR system prompted him and when proscribing, he could also link to my insurance companys drug schedule to see if that particular Rx was covered or if there was a more affordable generic available, even telling me what my co-pay was for any particular Rx. And when he refilled or wrote a new Rx, he sent the Rx electronically to the pharmacy of my choice (I was using Target Pharmacy at the time) and by the time I got there, it had been filled and was waiting for me and I liked that a lot no taking a handwritten Rx, dropping it off and waiting or coming back later to pick up. And if I had any tests done, either a routine test like a mammogram or for a diagnosis like blood tests, if they were done by a Johns Hopkins provider, the test results were sent, almost instantaneously to the doc and added to my e-record, no waiting for snail mail, no need for someone to transcribe and handwrite into my chart. And if I had needed to be admitted to the hospital, my complete records were on their system as well, no waiting for them to be photocopied and sent.
As stevestras said, the HiTech Act happened under Bush and I believe, Clinton before him. It was simply signed by Obama. The Office of the National Coordinator for Health Information Technology (ONCHIT) was created by Executive Order in 2004, it was legislatively mandated in the ARRA in 2009.
As I understand the HiTech Act is supposed to provide standards and certifications for EHR systems and ensure those systems are HIPAA compliant to ensure the integrity and privacy of personal health information.
Now Im not saying that the HiTech Act accomplishes all their stated goals or that it is Federal (our) money well spent or that health care providers should be compelled to switch to EHRs or that I necessarily trust the government, but overall I have to say my experiences with EHRs has been good.
FWIW, I used to work in the third party health insurance enrollment and premium billing and later in COBRA administration and am currently in corporate HR, so I know a bit about HIPAA and how I cannot access any claims information unless the employee signs a limited release, a limited POA to discuss a specific claim for a limited time period, what insurance companies and 3rd party administrators and employers have to do to comply with HIPAA and the electronic transmission of claims data and even demographic data, which IMO is a good thing. HIPAA is cumbersome but also makes it very difficult to obtain personal health information unless one is specifically authorized to do so.
Actually, it is not as dependent on the 'data' put into the computer as it is the 'software' used to access the data.
I don't blame the programming people. Imagine trying to design a 'system' that has to deal with the bureaucracy and corruption of the government and the medical billing system.
I am an RN. Donna Shalala was the first person back in the late 90’s to put this monstrosity on us, in Home Health Nursing. We went from doing 6 out of an 8 hour day on pt care to doing 6 out of an 8 hour day on filling out paperwork for the govt. Then it was on paper—reams of paper for each admission/visit, etc. I knew then it was the harbinger of things to come. Ran tons of nurses out of home health. Then it moved over to the digital domain, but still the burden was 3/4 computer work, 1/4 patient care. They promised us, it was “just a pilot program” and would soon go away, but we all knew the truth. Now it has infected all of medicine. I now work in a clinic that uses EPIC and the emphasis is on the collection of computer information, not on the patient. It is a monstrosity—I don’t care if some bureaucrat back in our state capitol can access the pt file and find out if has been prescribed narcotics or not. It is a disaster, and why did we not kick and scream back in the Clinton days (yeah, republicans?) and put a stop to it then. Believe me, one-on-one patient care has gone into the toilet.
That is a fantastic post and delineates better than I could ever have a well functioning electronic medical records system.
The problem is for individuals or small groups unwilling or unable to participate. The fact is, their day is over. The scope of modern medicine is so broad, going alone in a practice simply can’t be tolerated by the evolving systemic change.
I would argue that what you experienced was not understood. You placed the blame in the wrong place. The reason for the ever increasing record keeping burden is not the use of digital records.
The reason for increase in written reports is to have evidence to produce in court when the lawsuit comes to trial.
Lawyers, blood sucking plaintiff lawyers, were to blame for your problems
Fast forward ten years. Unionized government doctors and healthcare.
What you describe is great if it was kept out of the evil hands of government who will use that information “for our own good”.
“I would argue that what you experienced was not understood. You placed the blame in the wrong place. The reason for the ever increasing record keeping burden is not the use of digital records.
The reason for increase in written reports is to have evidence to produce in court when the lawsuit comes to trial.
Lawyers, blood sucking plaintiff lawyers, were to blame for your problems”
The increase is due to the need to establish “meaningful use”.
Nobody says docs shouldn’t consider automating their records and do so it if it makes sense. What is ridiculous is for the government to pay them to do it in order to control the data.
The problem is for individuals or small groups unwilling or unable to participate. The fact is, their day is over. The scope of modern medicine is so broad, going alone in a practice simply cant be tolerated by the evolving systemic change.
Thanks. : )
As I said, I currently work in HR, my focus being in payroll processing and regulatory and tax compliance and in managing the Human Resources Information System (HRIS) so admittedly Im a bit of a tech-y myself but I have seen a big change in recent years of moving from paper record keeping and manual processes in payroll and HR to e-processing, biometric hand scan time clocks, cloud computing, direct deposit and what many employees want and what many now demand.
Employees, especially younger workers want things like being able to access their pay stubs and W-2s, view time off balances and request time off, make changes in their W-4 withholding or their direct deposit accounts in an on line in a secure environment 24-7 from their personal computers, tablets or smart phones.
For several years now we have held our annual open enrollment on line and new hire enrollment on line all employees log in to the secure site and make their new hire or open enrollment insurance elections rather than filling out paper forms and those elections are electronically transmitted to the insurance companies, greatly reducing the error rate of illegible hand written paper forms being keyed into our HR benefit system and then again into a separate insurance system by humans who may not always key the information correctly or the problem of the paper forms getting lost in inter office mail or USPS mail or sitting on someones desk.
Employees can also see their current enrollments and see what their per-pay deductions would be if they were to make changes before they submit those changes. They can print out their own benefit statements and print their own insurance cards, they can even find providers and even make appointments on line.
Employees are also given secure access to the insurance companys web sites so they can track their own insurance claims and EOBs, track their deductibles and track their FSA balances in real time giving employees those tools makes them more self sufficient and reduces the employers administrative costs and burdens. They can also get real time information on their 401k account balances, make deferral changes and fund changes, view any fund prospectus on line without having to wait for quarterly statements or on snail mail.
Being a manufacture, we have some employees who do not have personal computers or work computers or smart phones and are still rather computer illiterate but they are the exception rather than the rule now days. We accommodate them by providing an on-site computer kiosks with a printer in a private area and if they need help or support, we in HR provide it but they still must use the electronic systems.
There was a time when these sorts of systems were only available to large employers but now days companies like ADP and Ceridian offer affordable e-processing, direct deposit, scalable solutions for even very small employers. Employers that still rely on manual time keeping systems, manual live paper payroll checks and paper insurance enrollment forms and other HR forms and employees who cannot adapt are dinosaurs and will soon either adapt or go extinct. The same can be said for healthcare providers.
I cant wait until they do a database merge with the DNCs Votebuilder.
Im sorry (insert your name here) but our data base shows not only are you a registered Republican but you have been identified as spending time on the subversive site FreeRepublic. Take a number while we take care of loyal patients. Please stop bleeding on our floor while you wait.
In fact, I'll use your records to track you down, stalk you to the local Denny's where you're having a cup of coffee together, and plunk myself down in your booth and initiate a long and intimate discussion of your medical history and nagging problems that my patented Little Liver Pills can help you with. You'll be so glad you met me -- I'll be totally informed with a 360o panoramic perspective of your personal health, and several suggestions how you can make me rich.
And speaking of "three-sixties", I'll of course have access to your psych evals, workplace colleague- and supervisory-evaluation 360's and personality-sorter results, so I'll know you better than you know yourself, which will come in handy if I need to manipulate you a little bit.
We're going to have so much fun making me rich and powerful together!
That's how they do it in China.
Visitors there notice two things about Chinese health facilities.
Yeah, we should do it like those Workers' Paradises (R). Then we'll be all advanced and stuff. You know -- civilized.
All the advantages you mentioned occur only if the systems communicate. They don’t. Also, again you mentioned how much the doc does to keep the info flowing. Abstracting charts is done poorly by most people so when you request the records they are frequently out of place. BTW, I’m not in the VA system and to look at VA records I have to have the records printed off and it’s extremely volumonous just for the most simple of records.
Again, I’m not saying that EHR won’t work but it is many upgrades from being useful to busy practives. That’s not to say the tests etc. aren’t better electronically. They are. But all tests are not linked to exery system and therefore must be scanned into the chart. That’s not useful.
You absolutely know what I’m talking about. The systems don’t communicate. You CANNOT get a report from Johns Hopkins and it immediately show up in your EHR. It has to be printed off and scanned in the chart. The EHR does not recognize the scanned article as anything. What BS!!
I’m a MIT grad and have worked with computers my whole life. The EHR opush is a scam that will take some time to work through. Although I agree it will someday be useful.