Vendors, privacy activists speak out on report

The RTI International recommendations got split reviews from Don Schoen, president and chief executive officer of MediNotes, a West Des Moines, Iowa, developer of EHR systems for ambulatory care, and chairman of the Electronic Health Record Vendors Association, a trade group affiliated with the Chicago-based Healthcare Information and Management Systems Society.
Schoen said that he supported some of the recommendations, particularly one that calls for vendors to not build into their systems prompts that suggest physicians could add more documentation to the record of a patient encounter to obtain a higher-paying evaluation and management code.
“I can’t speak for every product that’s out on the market today, (but) most members don’t have products that prompt docs at a certain level,” Schoen said. “Most measure what doctors have reported in their note and tell them this is the code that qualifies. The last thing the doctors want as well as the companies themselves is to stand under scrutiny to commit any kind of fraud. We’re out there to help our clients get paid for what they honestly and justifiably should.” But he also took issue with some of the procedures of the RTI work group that produced the report, including a lack of vendor participation and the short public comment period, both of which compared unfavorably with practices by CCHIT, he said.
“Not one of our vendors that we know of has been on that panel,” he said, adding that during the two-week comment period, on average only about 63 respondents voted in favor of the 14 recommendations, a response rate he called “ludicrous.”
{“The federal government (HHS) proposes to open up all our electronic health records to insurers and others to detect fraud. Guess what the cause of fraud is? Access to medical records by people we would never want to see them. Congress must restore our longstanding rights to control access to our personal health records that HHS eliminated in 2002. HHS has been out-of-control for years—–first it eliminated Americans’ rights to control who can see and use their medical records, now it wants insurers and others to have open access to our entire health records to stop fraud. Allowing even MORE unwanted users to have access will not stop fraud, it will increase fraud. The RTI report commissioned by HHS concludes that fraud will be greatly enhanced by today’s electronic records systems. It certainly will—unless patients once again control access to personal health records. HHS doesn’t want the exponential increase in fraud that will result from building a digital health system with no privacy rights to dampen enthusiasm for electronic health records. But who pays when the wrong people have open access our medical records for fraud, for identity theft, and for medical identity theft? We do—taxpayers and patients. We will pay the costs and suffer from the thefts—-yet we could easily PREVENT the wrong people from seeing our medical records and PREVENT fraud, if Congress restores the right to give consent before anyone can access our personal health information. The irony is ‘smart’ technology exists today that can easily give us the power to control all access to personal health information, no matter where it is stored. We have to demand that this ‘smart’ technology—called independent consent management tools—-be required throughout the electronic healthcare system. ~ Dr. Deborah Peel, Patient Privacy Rights”}

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