Home Forums Discussions General Discussion SCHIT- New requirements for EMR to spy on doctors

You’re Not Paranoid When Someone Really Is After You

A very troubling report on how to use EHR to detect healthcare fraud and to gather evidence for fraud prosecutions and gain legal evidence to prosecute perpetrators has just been released.

The report, from RTI International (Research Triangle Institute) and commissioned by the federal Office of the National Coordinator of Health Information Technology (ONCHIT) includes a recommendation that vendors build portals into their systems that would allow payers to access physicians’ and patients’ EHRs for purposes of fraud detection, so-called “electronic peepholes”.

The authors recommended that fraud management requirements also be developed for health information exchanges and the proposed national health information network, and that those criteria be implemented into EHR testing criteria used by the Certification Commission for Health Information Technology (CCHIT).

The ONCHIT reportedly has already signed off on RTI’s recommendations, and the proposed new CCHIT criteria, will be put out September 13 for a 30-day public comment period, during which time, on September 19, CCHIT will host several "town calls" to explain the criteria and get public input.

Sort of on the same topic. I was watching Lance Armstrong and Chris Matthews doing this thing where they are asking the candidates stuff about cancer. Yesterday was Senator Clinton's turn. Lance threw her a softball by asking her if she supported Electronic Medical Records? He used the Katrina trouble as a good example of medical records now sinking and rotting at the bottom of the gulf. And of course she said she did and that she sponsored a bill for them and so on and so forth.

The first question that came to my mind is the "unfunded mandate" issue of all these healthcare laws. I was yelling at the TV, "And who is gonna pay for it you fools? Are you really ready to pay for what you ask for?" Sure perhaps these folks have decent intent when the pass such things (maybe...) but who is willing to stand up and be counted as to how to pay for them? As we all know who use AC, a traditional CHITT approved and certified system takes 25-50 thousand dollars to impliment and support. Whose really willing to pay PCP's and even specailists enough to be able to afford that kind of regular big system price tag. Especially since most of us are not Vinny and Bert when it comes to these things. Most of us are Automatic transmission drives. We need to be able to put in the key and go. Most of us would need half an IT team (and not the Geek Squad either) and their related costs to keep and maintain such a system. At $56 Medicare for a level 3 sick visit in upstate NY (that is info that is readily available on the CMS webiste and so I did not committ a Free Trade infraction just now) who could afford such a thing? Not us, that's for such.
Who here remembers setting the choke and letting the poor thing warm up, and kicking it down, even in the summer??? Sorry.

But Vinny and I have spoken on this important issue you raise here Roy and you are absolutely correct in being concerned. This is the "Gonzo" illegal wire tapping of doctors to then use against doctors and patients. Pre-exsisting conditions, did you really chart a level 4 here, too many templates and not enough personalized entries. They can't wait to get their hands on all that data. We need to resist this as much as possible.

Just how did the carriers get such a choice seat at the table as to be able to control and manipulate the CHITT process??? It seems like Dick Cheney's way of setting up the energy commissions. If your not a part of big energy, you can't have a seat at the table. How do Roy or Vinny who would represent my interests, our interests well on such a committee, get a choice seat on it??? They are probably using our money to sponsor such stuff just so they can get their grubby little paws on this data. There is a carrier here in NY that likes to come across as well intended because this is where they are going, CDPHP. They can't wait to have a direct hook-up to our EMR's, so they can pick our bones clean. They are one of Vinny's favorite boogymen. He and I wonder the same thing about supposedly well intended "Vaccine Registries" too. If you want the data then we'll send it to you and only after a properly filled out HIPAA release form from the patient.

This is big brother at it's worst. But again as in my other thread, if there was some organized voice for all these things, then I do think we could get the public to understand just how "Dangerous" this really is. Letting private for profit insurance companies and the gov't have full and un-restrained access to anyone and everyone's medical records really is very 1984 and Orwellian to say the least. If this doesn't scare each an everyone of you, it certainly should. It's nobody's business about your family Hx of cancer, ADD, whether or not you are taking SSRI's or mode stabilizers no less the thousands of other little peices of private information that is in someone's chart.

This is another silent "Gonzo Gate" and someone needs to make this public. "Hey let's go to the Attorney General's bedside while he is half asleep, sedated, and ill, and see if we can't get him to sign off on this Unwarrented Wiretapping thing, OK?" This is really no different. This data is the patient's and the doctor's joint intellictual property that we as the providers maintain for both sides so as to provider a high level of care. This is not the government's or some private corporations property to go blasting thru at will. I do feel if it was presented to the public as another Gonzo Gate, they would "get it" and hopefully get mad enough against it. These are the types of issues that could bind and unite doctors and patients together, if presented well. But who speaks for these two important groups? Only the entire population of the country here, nothing that big... The set of balls on these people....

Good Night and Good Luck
Paul

You might check this out. It's not too far-fetched.
http://www.flixxy.com/data-privacy.htm

AmazingDave,
That is one hilarious YouTube!!!! Thanks for bringing it to my attention. Sounds like it came from Canada (with their Canadian Health Care and intrusive government), eh?

Hi Gang,

It's very simple - I don't give a rats sorry behind if my EMR is "certified" by some random organization of idiots. I've spent over 30 years designing computer/human systems, and frequently advising clients NOT to computerize something that doesn't need computerizing. (Talking people out of giving me money - since 1974!) I keep my own counsel, thank you very much. The CCHIT is full of something that has at least the same last three letters.

This data is the PRIVATE medical record of my patient, and the PRIVATE record of the services I render them. You want to look for fraud? Fine. Audit the claims data. Not good enough? Great. Send me a list of charts to pull and send a warm body into MY office to read them.

If the requirement is that my EMR needs a "back door" in order to accept someone's insurance, then I guess I'm not accepting their insurance. If the government decides to require it, I'm outa here. I made a lot more money as an engineer than I'm making now.

My partner and I lost about $4000 each of "incentive" money from CDPHP, our largest carrier, because Amazing Charts doesn't give them the connectivity they want. Oh well.. keep your money, I'll keep my patient's privacy, thank you very much.

It will be over MY DEAD BODY that software with a "back door" will be allowed into my office.

Does it get any more clear than that???

Oh, and Ms Clinton has been our Senator for 1 1/2 terms now, and hasn't done JACK for New York State. When she LAST tried to reform healthcare, she had over 300 lawyers and bean counters there, but not one physician. Yeah, she's gonna fix health care REAL GOOD now, you betcha.

V.

Vincent Meyer for Senator, New York State.
If you run, I'll support you.

So, I was in Canada last week gaining skills in procedures and practice management skills of physicians who have found alternative lifestyle than their government controlled colleagues. Are there any Canadian physician using Amazingcharts? I brought up my EMR, Amazingcharts. The owner of the practice was very interested but stated that they must choose one of five vendors approved by the Canadian government. They complained that although they are not mainstream government owned physicians, they are not allowed to use other "non-approved softwear."

We must stop the trend towards giving away access to our medical records before the CCHIT hits the fan!

You know.... why isn't CCHIT on the censored list? It's a lot more obscene that [censored].

The government approved EMR/practice management is apparently very expensive (surprise!!!). The independent physicians are doing travel medicine, cosmetic procedures, non-covered by government procedures (which is increasing), and immunizations. They appear to be doing financially better than their bretheren down South.

When crossing the border into Canada, the custom agent gave me a difficult time after finding out I was there to meet other physicians. They particularly wanted to make sure that I wasn't going to be working there. I had to produce a letter showing that I was going there to observe and was paying them $4000 (US) for the opportunity to observe--- and that they were not going to get $4000 if customs turned me away.

Roy,
Where have you been my friend. We miss you. I just had to tell you and the gang what I did today at our IPO Practice Manager's meeting. You would have been so proud of me. Our PO and the Hospital that we are affiliated with, Crouse, has been looking for and testing out an ASP Style EMR/PM program. At some point it is looking all too cozy and even I am a bit concerned that our PO may not always have the average small physician's interests at heart, although they probably do more than most others.

So Maud White the Director of the PO was talking again about this product vendor, "Waiting Room Solutions", as always "designed by a doctor"; seems to be the catch marketing phrase these days. But when so over used it looses it's meaning. See what you started Jon, now they all want to copy you...Take a bow. Who came first AC and Jon or Chartware and Dr David Tully-Smith? Anyway She wanted to know how many folks wanted to have a Dr and PM meeting and demo on the product. Now I had emailed her and cc'ed a number of other folks about this warrent-less wire-taps, and funny how many Americans are just simply willing to give up their civil liberties these days, and nobody got back to me on it. Not one out of about a dozen or more intelligent (I thought) people in this business. I was asking her to use the group memos she sends out to warn people about this, to speak up, and to pester any vendor that says they are CHITT certified whether or not the plan to design and install the portal. She didn't....

So when she brought up this product today I just stood up and addressed the entire meeting of about 50 practice managers, and told them about the committee's recommendations and how what they recommend will almost certainly be adopted, and that there were but 2 or 3 days left to comment on this before it goes to the next level. I also told the meeting that we were still awaiting an answer about this dangerous subject from our own vendor. And to whether or not they were going to design one and if so would they at least include an option in the admin section to allow those of us of good conscience to choose whether or not to turn the darn thing on or off. At least one small practice's PM is probably downloading a free copy of AC tonight on my say so. She is a retired doc herself, now her husband's PM. And you're welcome Jon. I appealed to everyone's sense of constitutional defense and patriotic duty to fight and resist this at any and all levels. And told them that the day this is mandated, is the day we take our system off the net and go back to a closed loop or print out all the charts and return to paper. Over my dead body.

And then Maud tried to sort of water this all down with the fact that this is being proposed based on the idea of reducing fraud. At that point I reminded the group that our own state (MSSNY) and county medical society wants us to fight and resist requests for records, and has educated those of us who attended (not nearly enough) how and when to not turn over requests for records when ever possible. It is the opinion of the NY Medical society and it's council that ever chart request is really a chart review and audit of some sort. It is a reason to get into your medical records and see what you are doing. And that anyone would be extremely nieve if they think that these carriers are not using these opportunities as such. I finished with telling them that it is our opinion (my fellow user friends here) that there will come a day when no doctor can claim that they haven't been audited, had money grabbed back by these greed SOB's and possibly even prosecuted for fraud. Can You imagine having the Gov't or these carriers reviewing each and every note you write? Can you imagine the idea of a security breach at any major carrier and the ID fraud and the loss of HIPAA compliance that can and will happen from just one simple breach?

Hey folks! Doesn't this big brother, Alberto G. type invassion stuff bother any of you out there???? Please speak up and get involved. This is your civil rights just flushing down the toilet here. Or are we all just sheep bound for slaughter???? BAAAAA, BAAAAAA. I remember a great jewish folk song, that sort of was about being a passive victim.

"On a wagon bound for market, there's calf with a mournful eye; high above him, there's a swallow, winging swiftly thru the sky... How the winds are laughing, they laugh with all their might, laugh and laugh the whole day thru and half the summer's night...."

Speaking of jewish wisdom, there is an old saying from the holocaust that sort of goes like this: "When they came for the Jews and the Gypsies I said nothing; when they came for the gays and othe subversives again I said nothing, by the time they came for me, it was too late...." Folks whether it's this present administration, CHITT or anyone else that wants to impose on and take away your rights of privacy and free speech you must always be aware and speak up. This is one of those times when those of good conscience must stand up, together and be counted or we are all in a lot of trouble.

Good Night and Good Luck,
Paul

What a difference an "S" makes.

If you type CHITT and EMR in Google and click on "I'm Feeling Lucky," it brings you immediately to Clinicare, an Electronic Medical Record from Alberta, Canada.

If, on the other hand, you add an "S" to the end of EMR and type:

CHITT and EMRS and click on "I'm Feeling Lucky," you will be brought to....wait why ruin the fun? Put CHITT and EMRS in Google and do the I'm Feeling Lucky thing, and see what comes up. So, it does prove that one must use good spelling and punctuation and none of the [censored] words.

OK. So I guess that was too confusing.

Google CHITT and EMRs and it brings you to this thread. Very nice Roy.

Bert,
Are you talking about CHITTA CHITTA bang bang??? The Canadian version of CHITT??? With all this CHITT floating around someone's bound to get it good. Sorry I just couldn't resist...