Today, FoxNews.com published a hit job on health IT and EHRs in the guise of another hit job on Obamacare. I found out about it courtesy of this tweet:
First off, it’s clear that Mostashari feels unshackled from having to watch his words now that he’s no longer national health IT coordinator. Secondly, he’s right. This story contains so many errors and misleading statements that it’s almost funny. Let’s count down the top 10.
10. “Under a George W. Bush-era executive order, all Americans should have access to their medical records by the end of 2014, part of a concept referred to as e-health. President Obama then made electronic medical records (EMRs) central to the success of the Affordable Care Act”
When Bush issued the executive order in 2004 that created the Office of the National Coordinator for Health Information Technology, he set as a goal interoperable EMRs for “most” Americans. The “all” part came after Barack Obama took office in 2009.
9. Though Obama did reiterate the 2014 goal and up the stakes by saying “all Americans,” nobody realistically thought it could happen. After all, the HITECH Act, which created Meaningful Use, didn’t pass until March 2009 and Meaningful Use didn’t even start until 2011. Before the HITECH Act, ONC barely had any funding anyway. For five years, Congress failed to pass much in the way of health IT legislation, even though a federal EHR incentive program had bipartisan support, symbolized by an unlikely alliance between Newt Gingrich and Hillary Clinton.
8. “Doctors, practitioners and hospitals, though, have been enriching themselves with the incentives to install electronic medical records systems that are either not inter-operable or highly limited in their crossover with other providers.”
Meaningful Use was never intended for enrichment, or even to cover the full cost of an EHR system.
7. While systems mostly are not interoperable yet, that wasn’t the intent of Stage 1 of Meaningful Use. Stage 1 was meant to get systems installed. Stage 2, which has barely started for the early adopters among hospitals and won’t start for 2 1/2 months for physicians, is about interoperability. That’s where the savings and efficiencies are supposed to come from.
6. We’re years away from knowing whether Meaningful Use program did its job, though I don’t fault members of Congress such as Sen. John Thune (R-S.D.) for putting pressure on the administration to demand more for the big taxpayer outlay.
5. “‘The electronic medical records system has been funded to hospitals at more than $1 billion per month. Apparently little or none of that money went to the enrollment process which is where the bottle neck for signing up to ObamaCare’s insurance exchanges appears to be,’ Robert Lorsch, a Los Angeles-based IT entrepreneur and chief executive of online medical records provider MMRGlobal, told Fox News.”
The money wasn’t supposed to go to the insurance enrollment process. The Meaningful Use incentive program was from the HITECH Act, part of the 2009 American Recovery and Reinvestment Act. The Patient Protection and Affordable Care Act, a.k.a. Obamacare, came a year later. Again, someone is confusing insurance and care. They are not the same thing.
4. “Lorsch, at MMRGlobal, offered the U.S. government what it describes as a user-friendly personal health record system for one dollar per month per family – a fraction of what it has cost the taxpayer so far.”
MMRGlobal’s product is an untethered personal health record. No untethered PHR anywhere is “user-friendly,” which is why adoption has been anemic. Without data from organizational EHRs, PHRs are worthless. Besides, the direct-to-consumer approach in healthcare has failed over and over, since people are used to having someone else — usually an insurance company — pick up the tab.
3. For that matter, MMRGlobal is a bad example to use as an alternative to EHRs. (The Fox story is correct in saying that other vendors do have close ties to the Obama administration, though the former Cerner executive’s name is Nancy-Ann DeParle, not “Nance.”) I could be wrong, but I haven’t seen a whole lot of evidence that MMRGlobal isn’t much more than a patent troll.
2. “But this process could have been easier if a nine-year, government-backed effort to set up a system of electronic medical records had gotten off the ground. Instead of setting up their medical ID for the first time, would-be customers would have their records already on file.”
Actually, as I wrote in a story just published in Healthcare IT News, we could have had national patient identifiers 15 years ago, as called for by the 1996 HIPAA statute. But Congress voted in 1998 not to fund implementation of a national patient ID and President Bill Clinton signed that into law. Since then, interoperability and patient matching have been mighty struggles.
1. “‘Plus, unlike under ObamaCare, the patient would be in control of their health information and, most importantly, their privacy,’ Lorsch said.”
Where in Obamacare does the patient lose control of health information? Less than a month ago, I was in Washington listening to HHS Office for Civil Rights Director Leon Rodriguez say, ““There is a clear right [in the HIPAA privacy rule] not only of patient access, but patient control over everything in their records.” This may come as news to some people, but patients own and control the information. They might not know it, but the language is pretty clear.
Already, the Fox story has been reposted in a number of blogs shared all over the Internet, so it’s being accepted as fact in some quarters. If you want the truth, you sometimes have to do the work yourself.