The latest, just released today, is entitled "Growth of electronic medical records eases path to inflated bills" by Fred Schulte at the Center for Public Integrity.
Mr. Schulte and colleagues wrote extensively for the Huffington Post Investigative Fund on health IT and safety dating to 2009, as written about at this blog here (query link) and at NPR here.
The new article focuses on the role of electronic medical records systems and associated software in promoting upcoding - billing at higher rates - through features such as documentation cloning, templates, facility of making it look like work not done was actually performed, and deliberate algorithmic prompting of users to "do more" to "get more."
I wrote about these issues at my Feb. 2011 posts "Does EHR-Incited Upcoding (Also Known as 'Fraud') Need Investigation by CMS, And Could it Explain HIT Irrational Exuberance?" and "Dr. Ross Koppel: Another Angle on EMR-Incited Upcoding".
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| "Cracking the Codes", a series by the Center for Public Integrity on medical billing fraud |
The latest article is part of a series, recently started, on medical bill "upcoding" and billing fraud - largely of Medicare - called "Cracking the Codes" at this link.
I will have more commentary, but one quote in the latest article really stood out as emblematic of an extremist-based, anti-science view from our nation's health IT leadership.
This from Robert Kolodner, former head of the Office of the National Coordinator for Health IT (ONC) at HHS:
Dr. Robert Kolodner, a physician who headed the federal push for electronic medical records in 2007, acknowledged that billing abuse took a backseat to steps likely to entice the medical community to embrace the new technology.
Kolodner said officials were certain the savings achieved by computerizing medicine would be so great that billing abuse, “while needing to be monitored, was not something that should be put as the primary issue at that time.”
In other words, sideline (ignore) health IT-based billing fraud (and safety risks to the live patients subjected to this experimental technology without informed consent) because "we believe" the savings will be greater based on "our faith in the technology."
What math book were they using in this calculation? What book of fables were they reading? What ethics were they adhering to?
Incredible.
Considering that the evidence for such gains was anecdotal at best - and that studies refuting it existed - and especially in face of the Sept. 18, 2012 (yesterday's) Wall Street Journal Op Ed "A Major Glitch for Digitized Health-Care Records" by Stephen Soumerai and Ross Koppel that savings promised by the government and vendors of healthcare IT are unsupportable and little more than hype - this statement is remarkable. I wrote about the WSJ Op Ed here.
The levels of delusion suffered by Dr. Kolodner and other "officials" is especially remarkable to me. The beliefs are leading to up to $1 trillion (per the WSJ) being diverted from the healthcare to the IT sector in some illusory, clearly hysterical, extreme, faith-based (at best) belief that there would be a large net savings.
This is the Ddulite phenomenon ("Luddite" with the first four letters reversed) in the extreme, resulting in what can be called social policy malpractice:
A Ddulite is a 'hyper-enthusiastic technophile who either deliberately ignores or is blinded to technology's downsides, ethical issues, and repeated local and mass failures.'
The other possibility is that the "officials" pushing this meme were simply willingly blind to the scientifically-unsupported nonsense they were proffering by way of their pockets being stuffed, by the makers of that technology and other opportunists, with the very money they claimed the technology would save.
I think that angle needs to be investigated, and investigated very seriously.
-- SS
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