Once again, the Meaningful Use program is suffering from a disconnect between aspiration and reality. This time it's patient engagement.
There's a well-known adage in business that 10 percent of people will never steal, embezzle or commit fraud; 10 percent will always steal, embezzle or commit fraud when they can; and 80 percent will do it under certain circumstances when given the opportunity.
That might finally explain what's occurring with electronic health records and billing fraud.
The Centers for Medicare & Medicaid Services' 2015 provider payment rules, many of which have been released this month, are receiving a lot of attention. But I'm surprised that one of the most consistent themes throughout them--"EHR creep"--has received very little publicity.
I fear the security of patient information in electronic health records has gone from bad to worse. First we learn that more people are withholding information from their providers who use EHRs because they fear the systems won't keep their information confidential. Now we learn that they're right.
I hope I'm not the only person who finds the results of a study recently published in the Journal of the American Medical Informatics Association on patient perceptions of electronic health record users troubling.
The Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT's proposed rule offering some flexibility for attesting to Meaningful Use in 2014 may be one of the few occasions where a rule relating to the program has been met with open arms. But deeper dive reveals a detail that I find particularly interesting: the Medical Group Management Association's suggestion that CMS has overstepped its regulatory authority in Stage 2.
Why is there disconnect between laboratories and electronic health records?
It turns out that the providers may have been right all along: Simply using an EHR does not lead to fraudulent billing.
The lack of interoperability among electronic health records, no doubt, is a major impediment to improved healthcare and lower costs. But now we have a much more granular understanding of why the industry is having so much trouble achieving it.
Providers have been lashing out against subpar electronic health record design for years. They gripe that not only do poorly designed systems impede workflow and cost too much, they also create new patient safety problems and don't share data with other systems to coordinate care, as promised. Still, the industry hasn't done much to address these concerns.
However, maybe now they'll have to. New evidence released this week bolsters what the providers have been saying all along: EHRs, as currently designed, adversely impact patient safety.