October 23, 2013

Don’t Forget O’care’s Electronic Medical Records Wreck

Dr. Nicholas DiNubile, a Philadelphia orthopedic surgeon, has a timely reminder for everyone encountering the federal health care exchange meltdown: “If you think signing up for Obamacare is a nightmare, ask your doctor how the EMR mandate is going.” Bingo.

Dr. Nicholas DiNubile, a Philadelphia orthopedic surgeon, has a timely reminder for everyone encountering the federal health care exchange meltdown: “If you think signing up for Obamacare is a nightmare, ask your doctor how the EMR mandate is going.”

Bingo.

The White House finally acknowledged the spectacular public disaster of Obamacare’s Internet exchange infrastructure during Monday’s Rose Garden infomercial. But President Shamwow and his sales team are AWOL on the bureaucratic ravages of the federal electronic medical records mandate. Modernized data collection is a worthy goal, of course. But distracted doctors are seeing “more pixels than patients,” Dr. DiNubile observes, and the EMR edict is foisting “dangerous user-unfriendly technology” on physicians and patients.

Instead of concentrating on care, doctors face exhausting regulatory battles over the definition of “meaningful use” of technology, skyrocketing costs and unwarranted Big Brother intrusions on the practice of medicine.

As I reported last year, Obamacare’s top-down, tax-subsidized, job-killing, privacy-undermining electronic record-sharing scheme has been a big fat bust. More than $4 billion in “incentives” has been doled out to force doctors and hospitals to convert and upgrade by 2015. But favored EMR vendors, including Obama bundler Judy Faulkner’s Epic Systems, have undermined rather than enhanced interoperability. Oversight remains lax. And after hyping the alleged benefits for nearly a decade, the RAND Corporation finally ‘fessed up that its cost-savings predictions of $81 billion a year – used repeatedly to support the Obama EMR mandate – were (like every other Obamacare promise) vastly overstated.

In June, the Annals of Emergency Medicine published a study warning that the “rush to capitalize on the huge federal investment of $30 billion for the adoption of electronic medical records led to some unfortunate and unintended consequences” tied to “communication failure, poor data display, wrong order/wrong patient errors and alert fatigue.” Also this summer, Massachusetts reported that 60 percent of doctors could not meet the EMR mandate and face potential loss of their licenses in 2015. And a few weeks ago, the American College of Physicians pleaded with the feds to delay the mandate’s data collection, certification and reporting requirements.

Dr. Hayward K. Zwerling, an internal medicine physician in Massachusetts who is also president of ComChart Medical Software, blasted the Obamacare EMR mandate in a recent open letter: “As the developer of an EMR, I sincerely believe that a well-designed EMR is a useful tool for many practices. However, the federal and state government’s misguided obsession to stipulate which features must be in the EMRs, and how the physician should use the EMRs in the exam room places the politicians in the middle of the exam room between the patient and the physician, and seriously disrupts the physician-patient relationship.” Zwerling’s call to arms appealed to fellow doctors to pressure the feds to repeal the mandate. “It is past time that physicians reclaim control of their offices, if not the practice of medicine.”

As I’ve mentioned previously, my own primary care physician in Colorado Springs quit her regular practice and converted to “concierge care” because of the EMR imposition. Dr. Henry Smith, a Pennsylvania pulmonary doctor, also walked away. “Faced with the implementation costs and skyrocketing overhead in general,” he told me, “I finally threw in the towel and closed my practice.” He said, “As EMRs proliferate, and increased Medicare scrutiny looms, medical documentation is evolving from its original goal of recording what actually was going on with a patient, and what the provider was actually thinking, to sterile boilerplate documents designed to justify the highest billing codes.”

Dr. Michael Laidlaw of Rocklin, Calif., told EHR Practice Consultants that he abandoned the Obamacare EMR “incentive” program “when I realized that I spent the first two to five minutes of each visit endlessly clicking a bunch of garbage to make all the green lights show up on the (meaningful use) meter. I said to myself: 'I’m not wasting precious seconds of my life and my patients’ time to ensure some database gets filled with data. I didn’t go into medicine for this. It is not benefiting my patients or me. I hate it.‘ I actually refused to take the $10K-plus this year. I have even accepted that I would rather be penalized in the future. What is worth the most to me is AUTONOMY.”

Let me underscore that again: Doctors face steep penalties if they can’t meet the radical technology goals imposed by the very same glitch-plagued Obamacare bureaucrats who now need an emergency “tech surge” to fix their own failed info-tech Titanic. The Obamacare wrecking ball has only just begun.

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