RTI report includes controversial EHR requirement

he Bush administration has signed off on 14 recommendations in a federally funded report by RTI International on how to use electronic health-record systems to detect healthcare fraud and to gather evidence for fraud prosecutions.
The 115-page report, enigmatically titled Recommended Requirements for Enhancing Data Quality in Electronic Health Record Systems, is posted on the RTI Web site. It includes a controversial call for requirements that EHRs be designed to provide payers, acting as fraud auditors, remote access to patient records, including the records of a patient over a period of time and not just to verify care for a specific claim.
The work was funded by a $488,000 contract awarded in October by the Office of the National Coordinator for Health Information Technology at HHS, which reviewed and approved the recommendations. The report carries a May 2007 date, but was released by RTI last week.
While the stated objectives of the RTI study were to identify certification requirements for EHR systems that would help increase data validity, accuracy and integrity, overwhelmingly, the focus of the report was on fraud detection and prevention. Specifically, it laid out a series of proposed requirements for EHRs to be picked up and incorporated into the activities of two separate, federally funded IT promotional organizations, the Healthcare Information Technology Standards Panel, and the Certification Commission for Healthcare Information Technology.
{Fraud prevention is not the purpose of the initiative. More likely, it’s meant to cajole a resistant public and worried policymakers. Who can argue against fraud prevention? The focus on fraud prevention is meant to impede public resistance to broad data collection and access. There’s a burgeoning health data industry dependent on access to everyone’s information.
Data provides profits and power over patient care, sometimes both at the same time. If the NHIN succeeds, or if electronic medical records are mandated (as in Minnesota), except for intrepid doctors who will not bend, succumb to pressure or be compromised, there will be nowhere to get medical treatment outside the watchful eyes of ‘the system.’ EHR system data will be used to ration care. The decisions will be called ‘data-based.’ ~ Twalia Brase, president of the Citizens’ Council on Health Care, as quoted in the article}
Download RTI Report

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