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Another View of the Coming Physician EHR Revolt

Posted on February 15, 2013 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a LinkedIn response to my post on The Coming Physician EHR Revolt, Barry Schechter offered the following candid comments:

First off I feel bad for the Drs. Then as we had in another thread the big red flag is the medical billing aspect of EMR and who benefits from that billing data. Then we have the difficulties in sharing the pertinent data allowing patients to get comprehensive care, sometimes in the same building. Then we have HIPAA which has become a greater boondoggle and less effective than TSA at airports or Homeland Security. Small wonder that Drs want to revolt. Then we can add the singleness of opinions about what an ICD really means and whether it is or isn’t ethical to copy and paste. The billing engine drives this bus and the EMR is nothing more than an auditor’s or payer’s window in to being able to justify rejections. It’s also a way for payers to eliminate the errors that come up through paper billing and given that make it easier for payers to “check up” on billing practices when auditing EMR. The bigger backlash will be from the patients as they realize that EMR is not being used to provide better medical care and that all the data is being zealously protected and not shared among their care providers. Patients will have even more cause to scream when insurers use the billing engines to eliminate CPT and ICD that are below a threshhold of service (I see that coming).

I think Barry is right that many doctors fear that EHR is just a way to track their billing and screw them over in the end. Whether this fear is founded or not, I’ve heard it expressed by a number of doctors.

ONC Encourages Emergence Of E-Patients

Posted on I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Throughout the Meaningful Use rollout, there’s been discussion of how to best use all of these new health IT toys to get patients more engaged in their care.  But as far as I know, the following is the first time ONC has officially launched an initiative to cultivate the emergence of health IT-smart e-patients.

In a new article in Health Affairs, ONC national coordinator for  health IT Farzad Mostashari has shared plans to use health IT to reach patients and encourage their involvement with their care. The ONC is already working with 17 Beacon communities to test ideas such as text-messaging for diabetes risk assessment, but the idea now is to expand things to much higher level.

ONC now hopes to encourage patients to participate in e-patient activities such as secure e-mail messaging with doctors, use of EMRs that patients can add to and transmit, as well as use of mobile health apps for chronic disease monitoring and wellness promotion, reports

I’m excited to see ONC jump on this bandwagon enthusiastically. While there is an e-patient movement afoot, and a growing list of doctors interested in “participatory medicine,” it’s unlikely that the run-of-the-mill patient with few self-advocacy or technical skills would get involved on their own.

And the truth is, if ONC truly wants to build a nation of engaged patients, Meaningful Use requirements are too modest by far. Sure, there’s new requirements afoot that will make it easier for patients to e-mail doctors and transmit their health information, and that’s fine. But the truth is that few patients will take advantage of these features without a great degree of encouragement.

As something of an e-patient myself, I’m eager to see the movement blossom, as I believe it’s good for both the clinician and ordinary citizens receiving medical care. Let’s see how much effort Dr. Mostashari and his team put into cultivating patient engagement.