The Data Agenda

Friday, March 15, 2013

Top 10 Things to Know about Certified EHRs

Advocates claim federally certified electronic health records (EHRs) are poised to transform the delivery of health care in America. There are some things to know.

Citizens' Council for Health Freedom in Minnesota has released a one-page briefing on these EHRs. Below is expanded information on each of these points.

1. Electronic health records go beyond records. EHRs are the gateway for public officials into the private patient-doctor relationship.

In a confidential patient-doctor relationship, how would public officials know the diagnosis and the care being provided?  The Electronic Medical Records (EMR) in an EHR record everything eliminating patient privacy.

2. The federal government is paying $20 billion to doctors and hospitals to buy certified EHR systems.

These incentive payments under the 2009 HITECH Act only cover about a third of the system cost, and covers none of the hidden costs of EHRs.  These payments precede penalties for not having and using EHRs to the government’s satisfaction.

3. EHRs are cutting clinicians’ productivity in half and fundamentally altering and reducing the necessary interactions among clinicians, and the consequences of this have included harm to patients including death.

Especially in emergency medicine where delays can be deadly, federal mandates on the practice of medicine for documentation have held up necessary care and doubled pediatric fatality rates.

4. The requirements for meaningfully using EHRs are set to enter stage 2 in October 2013. 

The screws are ratcheting down except for a reprieve granting the requirement only holds for three months out of the 12 has also been announced for 2014.

5. Patient engagement is a euphemism for patients feeding more data in to the system.

The Personal Health Record (PHR) or collaborative health record has been touted as patients having access to their own data, yet most data medical practices have is from the patients themselves. Low and manufactured demand belies the true motive. Biometrics is expanding patient monitoring and control.

6. EHRs are part of a larger agenda to statistically analyze everyone’s patient information.

The HITECH modifications to HIPAA expand access to patient data to 2.2 million entities for study and analysis.  The theory is we can create an algorithm that can see things in the data that people cannot see and this will lead to cures for cancer.  Failure would be blamed on insufficient data, and data withholding criminalized.

7. Doctors will be expected to comply with ‘best practices’ that are found ‘in the data’ or face payment ‘adjustments’ and prosecution.

In this world, “decision support” takes over at the command of the government, and doctors become “agents of trust,” as HHS describes.  Prosecutors watch.

8. EHRs have the interest of the business community.

Private equity companies (the kind that only acquire companies making at least $100 million already and hope to add a comma to that number) have been bidding on adding EHR providing to their portfolios.




9. There are actions Congress can take on EHRs.

Repealing HITECH, defunding it, or at least repealing the penalties it imposes would all be effective in turning back the data agenda.

10. There are actions States can take on EHRs.

Blocking a health information exchange (HIE) in addition to the health insurance exchange (HIX), and not allowing any massive data storage or analytics to occur in their states would all be effective.


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