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.
