HIMSS10: Investigator says EMRs can uncover fraud but sometimes put docs at risk

Fraud investigator Harry Markopolos blew the whistle on Bernie Madoff's record-breaking Ponzi scheme, but he's more proud of and excited about his work uncovering Medicare fraud. And he's excited about the prospect of EMRs helping to uncover wrongdoing. "I think as we get more data, we're going to...find the outlier frauds," Markopolos said Thursday morning during a keynote session at HIMSS10 in Atlanta.

However, Markopolous said EMRs that don't have a good auditing system could make it harder to catch fraud because there's no paper record of services actually rendered to match up against billing codes.

He also cautioned against some free, advertising-supported products, particularly standalone e-prescribing systems with embedded search functions, because pharmaceutical companies sometimes pay for top placement on the page. That could convey at least the appearance of being on the take from the pharma industry if physicians have uncommonly high prescribing rates for a particular drug, and create liability issues should a patient be harmed by the drug. "Put your own formulary in [the system instead of using the pre-installed list]," Markopolos recommended during an on-stage interview with CNN medical correspondent Dr. Sanjay Gupta. "That will go a long way toward preventing fraud."

He issued a similar warning against accepting payments from EMR vendors. "If the vendors are sending you money, that's a problem," Markopolous said.

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