This blog has long noted the painful consequences of the federal government’s intervention in health information technology (HIT). Last February, NCPA published an Issue Brief recommending that the federal government’s ambitions in HIT be rolled back. The major problem is the government’s undue influence in Electronic Health Records (EHRs).
Last month, the Administration published the regulations for stage 3 of the Meaningful Use incentives, which both pay and fine doctors for their use of EHRs in accordance with the rules. Margalit Gur-Arie describes the new rules:
Meaningful use stage 3 is adding a host of structured and codified data elements that you will need to collect and record. To that end, you should consider updating your policies as follows:
- Require each patient to provide an updated resume at least once a year, because you need to continuously collect and update work history, including positions held, and financial information.
- In collaboration with your attorney, create a crosswalk based on State laws and meaningful use regulations regarding what you must ask or are barred from asking your patients. For example, in some states you are not allowed to ask about guns in the domicile, and for meaningful use you must inquire how often your patient goes to church, and whether he or she is a homosexual (regardless of your specialty). It’s a fine balance, and you don’t want to break any laws.
It look EHRs are going to create a whole new level of conflict between patients and doctors, doesn’t it. And if you are an entrepreneur, Ms. Gur-Arie continues:
If you are a brilliant young entrepreneur thinking of putting together a small team of dedicated and knowledgeable buddies to build a really good and useful software product for doctors, forget about it. The 431 pages published by ONC are the highest barrier ever erected to entry into a market, with the possible exception of the market for weapons of mass destruction.
And don’t forget that the EHR momentum is given more force by the flawed Medicare doc fix being considered by the Senate this week.