Obama's Electronic Medical Records Scam

Townhall.com ^ | December 14, 2012 | Michelle Malkin

[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.

[Sooth2222]

I've reviewed thousands of medical records over the years, including VA and US military medicine files. If the goal of VISTA (Veterans Health Information Systems and Technology Architecture) system is to quickly and efficiently convey information about the patient to the patient's care givers, it fails miserably. If the goal is to "CYA" and to obfuscate, it's a success.

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.

[bert]

-——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.

[Kaslin]

They do military Records at Fort Campbell, KY BACH

[bmwcyle]

ping

[Travis McGee]

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!”

[Kaslin]

It always depends on what is put into the computer

[bert]

———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

[RetiredArmy]

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.

[listenhillary]

Wait until they tie it all into the gun registry database. Hmm. This guy took antidepressant medication back in 1979.

Permit Denied.

[Kaslin]

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.

[Travis McGee]

GMTA. See #25.

[listenhillary]

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?

[khelus]

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.

These are all good points.

This is just another intrusion into our privacy and chunk of lost freedom that has been eased in over the Bush, Clinton, Bush, Obama surrender or our sovereignty to their cronies (global bureaucrats, global corporations, global finance), and transfer of our wealth to the same.

Once again Obama is the icing on the cake. To focus solely on him is to miss the process that got us here.

[shoff]

I would tend to believe it came from a list of approved software compatable with dictates from Obamacare. (IE: vendors that donated to Obama’s reelection)

[Travis McGee]

Wanna bet that all of the “accidentally damaged or lost EMR files” will belong to conservatives?

To the ‘rats, politics is a blood sport.

[Resolute Conservative]

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.

[UCANSEE2]

Those who purchased the software made a decision to buy cheap and mediocre rather than more expensive and very good.

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.

[MD Expat in PA]

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 Rx’s were due to be refilled as the EHR system prompted him and when proscribing, he could also link to my insurance company’s 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.

http://www.hitechanswers.net/about/about-the-hitech-act-of-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.

http://www.hitechanswers.net/ehr-incentive-program/hipaa-and-security-compliance/

Now I’m 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 EHR’s or that I necessarily trust the government, but overall I have to say my experiences with EHR’s 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.

[UCANSEE2]

It always depends on what is put into the computer

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.

[worriedinoregon]

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.