Don’t for­get Oba­macare’s elec­tronic med­i­cal records wreck

The Washington Times Weekly - - Commentary - By Michelle Malkin

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.” Dr. 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.

Michelle Malkin is the au­thor of “Cul­ture of Cor­rup­tion: Obama and his Team of Tax Cheats, Crooks and Cronies.” Her e-mail ad­dress is malk­in­blog@gmail.com.

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