Home Forums Discussions General Discussion Down with CCHIT

Great anti-CCHIT post by Al Borges over at emrupdate.com. Check it out.

http://www.emrupdate.com/forums/t/11150.aspx

Brian,
I love this guy! I just signed up and waiting for my temp password. How can we help this guy out? But many of them are stilling missing half the points like the back door spying portal and that these state grants are but corporate wellfare for those rich companies that they properly rail against.

But if you read a little further down the thread you'll notice that I think that is our Joseph there linking back to us here at AC. Way to go Joe!

CCHIT on a Shingle anyone???
Good Night and Good Luck,
Paul

Paul:

Good luck with that. I have tried to create an account there several different times using different handles, different email addresses, etc. without success. I even tried to contact Al Borges directly once and got no reply. I finally decided it must be an "invitation only" forum, for EMR high muckety-mucks or something. Tell me how you make out.

I'm sure you're right. Well, Dr. Borges will find plenty of kindred spirits on this forum. I'd like to welcome any emrupdaters to our little anti-CCHIT splinter cell.

I'm Nick the Administrator with emrupdate.com -- EMRupdate is an open board -- everyone is welcome to register at emrupdate.com. What may be a problem is that some providers list our mail-server as spam, meaning that your confirmation email never reaches you because this is rejected by your mail server; alternatively we have other mail issues which I don't know of.

Send a Private Message to this account at Amazing Charts, or email amazingcharts@ambay.com and I'll guarantee you membership within 24-hours.

Nick Harrington

Hi there:

This is a pretty neat forum. Thanks, Joseph for recommending it! Although I programmed my own EMR over the past 17 years in a similar manner as AC (MS Access, Jet backend), I use AC as a sample of the ideal inexpensive, yet powerful EMR on the market to which other vendors need to compare their EMRs to both in price and functionality.

>>> But if you read a little further down the thread you'll notice that I think that is our Joseph there linking back to us here at AC. Way to go Joe!

Joseph is one of the most powerful anti-CCHIT posters going back to when "the movement" started back in August, 2006.

>>> "invitation only" forum

Heck no! They let me post... ;^)

I see that Nick, the webmaster, has already chimed in and personally invited all you guys.

BTW, we do need more discussion there on AC. Whenever there is the rare discussion by one of the other vendors attacking AC (to try to prop up their offering, of course), I'm usually alone in defending AC.

>>> I even tried to contact Al Borges directly once and got no reply.

Don't know what happened... I usually check my email several times during the day. It could have been that your message got placed in the spam bucket- be sure to make your title meaningful, never leave blank or simply something "spambottish" like "a special message for alborg" or "looking for you online".

Anyhow, thanks for the welcoming message.

CCHIT is on the defensive, but if you hear these guys, they swear that in 5 years we'll all become CCHIT robots documenting on CCHIT EMRs, emptying our pockets of our little earned cash for the priviledge of working of almost nothing.

It all hinges on physicians and their acceptance of this albatross... I've been bouyed by the numerous articles and other evidence of CCHIT failure.

Cheers,
Al

Al and Nick.... "How the Hell are Ya???" Welcome aboard my friends! Very glad to make your aquaintance.

I've got to go play Daddy and get to a meeting at my kids school a bit, but I just wanted to say a quick "Hello". We need to swap notes and plan stratagies. Here in NYS there are some of those "state grants" and I tried to apply for them and of course it is full of "BullCCHIT". We like to make plays on words like this around here you will notice. The childish humor factor helps to keep our spirits up.

Even our county and state medical societies are in on this. For a number of reasons we have not renewed for either AAFP or MSSNY (Med society) for my wife. Finanical is one, but to take the hit for two organizations that we feel are totally out of touch with the reality of the situation is the other. They do not properly represent us and our perspective on a number of issues and this is certainly one of them.

We here like Roy, Vinny and myself are very upset about regional medical information hubs, state vaccine regisitries, no less the new backdoor spy portal for the carriers to watch each and every note you docs write. Now that is really BullCCHIT.

Wasn't Orwells "1984" required reading for anyone who got thru english 101 or 201 back in undergraduate school??? I certainly don't want to put my children with their names, date of birth, and the like in some centralize gov't based server. One for their own protection against an ever growing invasive gov't (Can you GonzoGate and Warrentless Wiretaps???) and two simply to protect their ID from regular criminal fraud. As a true defender of civil rights, I got a twinge and felt a chill go down my back the day I regisitered my kids for the SS#'s just so we could claim them on our taxes. Centralized databases about citizens and their health is total BullCCHIT. Not in my America while I'm still breathing.

How many doctors are willing to go to jail to protect their patients civil rights, help keep them out of these centralized databases, much like a reporter might to protect his or her sources??? As I've posted here before, that day is just about upon us, so one and all might as well start doing the gut check now, look deep into your own soul and in your own eyes the next time you see yourself in the mirror ("and I raise my head and Stare, into the eyes of a stranger....I've always know that the mirror never lies" "QueensRiech; Operation MindCrime".)

Anyway, it is a true pleasure to make your aquaintance. Keep up the good fight....In the words of Edward R and Keith Olberman;
"Good Night and Good Luck"
Paul

Welcome, Al and Nick!

Thanks for your kind words.

I am fairly new to Amazing Charts, and have found it ideal for a solo practitioner like myself. CCHIT can only make it worse, for my purposes.

Jon Bertman wants to make doctors lives suck a little less. His program is geared toward "getting doctors home for supper at night." The little instructional movies for the program generally end with the phrase, "and that's how simple it is!".

CCHIT, by contrast, cares nothing for simplicity or getting doctors home to supper at night, and the more influence they have over Amazing Charts, the more it will suck. In my opinion.

Hail and well met, brave stalwarts!

I cannot help but believe our government is purely and simply trying to oust any small, independent business no matter what it is. Take the American farmer. The push for a National Animal Identification Number program for each and every animal in this country, whether used for food or not, will without a doubt put the small farmers out of business simply because of the idiotic paper work. This CHITT "CHITT" is nothing but an evil, cloaked plan drummed up by third party payers to put us non-compliers out of business (Play our way or don't play at all). The proposed mandate that we must use "approved" software is bad enough but the hidden, costumed intent to invade my patients' medical information is simply communistic in its purest form. We need to get practicing docs organized somehow and even more importantly we need to get to those in training. Most of them have no idea what waits out there for them. Just like when Managed Care first began. Those of us who tried hard to thwart it were outdone by the younger docs who, because of their need to build a practice, embraced it in toto. We all need to look around right now and see what we do on a daily basis to aid and abet the third party payers and STOP DOING IT!!!
(Geeze, is there a full moon or something? I'm sounding really paranoid.)
Anyway, welcome aboard, fellows. I hope you will continue to join in and stir the pot.

Leslie
Dying a slow death

Al and Nick,
My confirmation email never came back to me and I've done a check of my filtered out spam too. I regisitered as hockeyref with you just like I did here and elsewhere. If you could check into this, that would be great. Thanks....

Leslie,
It's not the economic set up of a country that effects such invassions of privacy, it's a lack of protections of civil rights and how totalitarian it is. We have been slipping down that slippery slope that legal scholars warn about for quite some time.

First it was the FISA courts (did I get that right or did I butcher that one? ADD, sorry) secret courts that don't have to answer to anyone publicly. Then it was the destruction of even that little bit of a check on uncontrolled power via the Patriot Act which allows for no over-sight what so ever. We are setting up some very bad legal standing here and we citizens of good conscience need to really get mad and stand up to this CCHIT where ever it may be. It is like a bad sneaky infection, we must weed it out and bring it to the cleasning forces of sunlight for all to see.

Everyone, as many of you know I used to work in the media as a tech in theater and TV. We really need to think in terms of public awareness thru TV and newspapers. The carriers don't give two CCHIT's about what we think. I believe they actually get a sick sadistic pleasure from making our lives miserable. It's the public at large and a political will that scares the CCHIT out of them. Remember Harry and Louise???

How much money did they spend making sure that they didn't get their hands smacked for raiding the cookie jar??? Our money, all of our money, money the collected with a promise to provide quality healthcare via taking good care of a quality network of providers...I'm not the type to let them off the hook so easily. They spent our money to just to keep more of our money for themselves and to continue to hurt providers and patients via crumby policies and even worse reimbursements. We need to show these people for the robber barrons and carpet baggers that they really are. They use the media everyday to try and paint a feel good image of themselves, consumer psych, I know they taught it in my psych dept. Now there is some manipulative BullCCHIT. As we used to say (probably still do, but I don't live there anymore) in the beautiful Green Mountain state of Vermont...There were these teeshirts with a Yosemite Sam like character on them with a shotgun and the shirts read; "Off of my land, flatlander!" We need to escort these selfish, greedy SOB's off of our land. They have abused the public trust for their own gain at the expense of the greater good. Good-bye, plain and simple.

Question, what is the most correct spelling, CHITT or CCHIT??? Be well everyone.
Paul

Leslie, Just because you're paranoid doesn't mean that they're NOT out to get you.

V.

Has anybody been able to successfully register for EMRupdate.com yet?

The correct spelling of the dying-on-the-vine organization started by HIMSS is "CCHIT"!

I started a new thread about another CCHIT-certified "EHR" that's in trouble: QuadraMed. The debate got kind of heated, and in fact inploaded, leading Robert, the moderator to delete about 10 postings- a first.

The most important thing about the thread, though, was not that QuadraMed was in financial trouble, but that sales had dropped by 20% for the year 2007. This number is most likely being seen throughout the industry, a byproduct of CCHIT interference with the usual EMR competition leading to overall higher EHR pricing. This was documented also by the CDC report, stating that the growth of the EHR industry was essentially flat, unlike the modest growth seen in the less expensive, smaller, more usable EMRs like AC.

URL: http://www.emrupdate.com/forums/t/11290.aspx

Folks,
Here is a reply I sent Al in a PM. I felt it was important to share... Have great Holiday one and all and we'll catch ya on the other side....
Paul

Al,
Yes please find out what all of us can do to get signed up and signed on. Thanks. I think your observations are correct, but also include the carriers and the govt Medicare and Medicaid as well. The reasons for this is obvious, as we who know already know, "Follow the Money", right? The vendors want to squash competition from small competitive companies like AC and a hand full of others. Why should we be able to buy a "QuickBooks" EMR at a reasonable price that works for us, when they want their corporate wellfare and all our money. As I like to remind people, Nancy and I can't barely get any money for ourselves from her own practice, our business is but a conduit for "other peoples' money". These folks are all greedy vultures who can't keep their hands out of our cookie jar. Really. It is sad.

The carriers and the gov't ones, want to use P4P as a means of controlling you guys and reducing your payments, to complete your enslavement. There are larger issues at work here, and I see this EMR, invasion of privacy and P4P simply as "symptoms" of the bigger picture, the actual illness at work here. We need to see the forest from the trees here. There really is a movement converging from both sides, the greedy medicial industrial complex "freemarket" side and the open access to all citizens' side, that want to control and even exclude you providers from this discussion and debate of how to deal with this coming storm.

Both sides want you to work for cheap, as slaves to their system, and to have their theories dominate the conversation. Neither side has really asked PCP's in particular or providers in general to join in the debate or conversation. It almost seems to me that you folks have been very intentionally not invited to the table. Now I think that docs have made some very bad choices in what issues they fight for especially in the media, mainly tort reform, which only comes across as cover your own butts, and the wall of silence to the average guy on the street.

But seriously where is the AMA in all of this??? MIA from what I can see. Even the American Cancer Society has done a better job bringing their perspective to the public on all of this CCHIT. I believe that the AMA still cares more about their highly paid specialists and protecting the old way of doing things, than really getting involved with a change that will benefit all and empower patients and PCP's, and salvage the doctor patient trust and relationship.

Why is the AMA not having a real press conference every day to move the discussion forward for doctors and patients??? Rallies at state capitals and in DC??? Grab headlines for goodness sake and take back control of the conversation. Why are they not building alligances with pro-healthcare groups so docs and patients can be allies and the the citizens of this country feel good about docs? That what is good for them is good for providers and visa versa??? I can remember just 3 years ago still reading article after article and editorial after editorial about how docs don't need and shouldn't get involved in union activites. And how PCP's would write back how out of touch these organizations are. They just don't get it. If you guys don't act collectively and soon you are all doomed, it may already be too late. It just amazes me how such a group of smart people can be so short sighted and dumb at times. The gravy train has left the station years ago and you guys need to overhaul your way of dealing with eachother no less these powerful forces that have taken control of your profession and your lives.

If you don't mind I'm gonna post these reply on a thread for all to see.... I think it is important to talk about such change and insight. Please let us know how we can all get on-board your board. Thanks for your help and your support. Keep up the good fight....
Paul

>>> our business is but a conduit for "other peoples' money". These folks are all greedy vultures who can't keep their hands out of our cookie jar.

I've never seen this sentiment expressed in this manner- well said!

>>> But seriously where is the AMA in all of this??? MIA from what I can see.

Follow this link for my discussion on medical societys (including the AMA) and CCHIT: http://www.emrupdate.com/forums/p/11322/74462.aspx#74462. I discuss how the AMA has been castrated over the past 10 years due to an exodus of its "in the trench" members.

I quit my 20 year membership in the AMA 3 years ago. It just wasn't representing my most important issues- decreased reimbursements, tort reform, progressively worsening Board certification requirements, and simply continuing to have a very expensive, unaffordable membership fee for those of us in "the trenches" while having about half its membership paying little to nothing for membership (students, residents, and retired). This AMA endorsement of CCHIT will be a deal breaker for many.

>>> Both sides want you to work for cheap, as slaves to their system, and to have their theories dominate the conversation. Neither side has really asked PCP's in particular or providers in general to join in the debate or conversation. It almost seems to me that you folks have been very intentionally not invited to the table.

Fortunately we now have the blogosphere to help us out. They insurance companies can consolidate and otherwise manipulate the market in ways physicians can't, and have millions of dollars to use in lobbying Congress, but we can continue to attack/inform/influence physicians so that we can act as a group. I feel that so far this year we've been able to do just that, resulting in a drop of the EHR market by 20% in 2007 placing many of the "big boy" vendors who started CCHIT in financial difficulties. It will be interesting how this Medicare P4P experiment with 1200 clinics works out; I wish that physicians would opt out totally, but I'm sure that they will find 1200 fools willing to let it test out its cost cutting P4P schemes.

I'll check with Nick to see what problems still remain on sign-ups to emrupdate.com. I tried to set up a new account with a different email, but I never got the return email with the new password. Hmmm... that's a problem. I'm sure that Nick will fix this STAT!

Cheers,
Al

Letter from Nick:

I believe I have a useless mail-server – or one that is now listed as spam by Comcast...

Should have one sorted by Next Week!

Once again, I think we have to continue to educate our PATIENTS as to how their insurance company stacks up. As I mentioned earlier, we have a big Humana base here in "Kentuckiana". For years they refused to pay an additional fee for Paps done at the time of general exams. Because of this I quit doing them and made my patients come back 6 months later to have their GYN exam done. I figured, if the patient went to a Gynecologist, the insurance company would have to pay them and the patient would have to pay another Co-Pay so, what's the difference? I was willing to do the procedure the same day (which would save the patient another Co-Pay) but THEIR insurance company would not allow this. I told the patient other insurance companies (most anyway)paid for the added procedure. When the largest school system in the area changed to Humana, my policy stood and I had a bunch of unhappy patients. I directed this swarm of teachers to contact their insurance carrier, their HR person (who by the way was/is a patient of mine) and their school board and complain. They did and they told their co-workers who were having similar problems in other offices to do the same. Now, I cannot really say if this was the straw that broke the camel's back but, as of this year, Humana will now pay for the Pap as the separate procedure that it is.
The medical community here is now ignoring United Health Care. Many have stopped taking it completely, many will take no new patients and many of us simply refuse to do routine, in-office things if they have this insurance. And, every patient I see who has UHC is sternly reminded that, because of THEIR insurance, we will not give injections, do EKG's, Bone Density scans, clean ears, do urines, take cultures, or any other convient-for-them procedure because their insurance reimburses below our cost. "So sorry, you will have to go to the lab or to the hospital or to the ENT specialist or to anywhere but here because your insurance company will not pay me to do it." I make a very special point of telling them they are getting service below even which Medicare gives. The usual response is, "But I have no choice...it is what my employer offers". I then tell them they do have a choice and their first step is to en mass, complain to their union or to the employer and fight for their right to at least be offered a CHOICE of health care coverage and level of care.
Until we put the burden of poor coverage on the consumer and, bring to their attention and pocketbook the carpet-bagging which is going on, the insurance companies will continue to suck us and them dry. I am beginning to see some heads come up. I am beginning to see patients fighting more for their medical care. Previously they would argue with me and get mad with me when, for example, I refused to put a diabetic, who for several years now has been very stable on an ARB, on a different GENERIC one. Even after I explained there IS NO GENERIC and they coughed on the ACEIs they continued to picture me as the bad guy. More and more I see them turning now to the insurance company and writing letters and complaining to their employers. Will this make a difference? Who the heck knows. But we simply HAVE to involve our patients in this battle. IMO, the first thing we need to do to fix our health care crisis is to completely remove the burden of health care insurance from the hands of our employers who don't really give a hoot about our health unless it affects their bottom line. Let's give the decision-making back to the people who use it. Let them decide what level of care they desire and what risks they are willing to take. Our employers do not choose our auto insurance, make our grocery choices for us or pick out who we will marry. Why in the heck do we allow them to make our health care decisions for us?

Sorry for the rant...having turkey withdrawals

Leslie

Leslie, we too are seeing issues with UHC. Not just the usual bundling, but denial of cliams. Sometimes it only affects us through the irate phone call from the patient: "Why did the lab bill me? Did you file the claim wrong? You did unnecesary tests!!" Seems UHC is now rejecting what we consider standard screening tests on preventive visits (Yes, the do pay for physicals here). Like, uh, std screening? Hepatitis screening? We won't even discuss mental health screening. Only 2 companies pay for that-- Aetna and HIP.

Guys,
I just put together a handout for our waiting room that speaks to the govt gathering data on all of us thru the vaccine registries, CCHIT and the like. I just showed it to the last patient of the day and her husband is a lawyer (ya, ya I know...). Well one of his partners is a local state representative that might actual have some influence on this thing. Both the right to organize as well as the vaccine stuff. This mom was really upset, let me tell ya. "Why haven't we heard of any of this stuff before?"

I'm telling ya people we have got to spread the word on this stuff, notices in the waiting rooms, talk to your patients, hand-outs. You'll all come off smelling like roses because you were the only one to tell them the ugly truth and make them aware of all this awful stuff. They'll love ya for it, trust me. Only we can do this, nobody else will. Anybody ready to take up the cause???

Generally when the patients start yelling at me that we filed the claim wrong or ask me why they got a bill, etc, I usually tell them why I did the tests I did, and tell them to take it up with their insurance company. One actually had the nerve to come in and throw his bill on the front desk and tell my office manager to get on the phone and "fix this". He was politely told that it's HIS health and that it's between him, the hospital's billing department, and his insurance company - it was not our job to insure that he would never get billed.

So far we're not seeing a whole lot in the denials area from them yet.

Regards,

V.

So post the darn thing already!! (since it's going to need to be an attachement, post it in the templates area, and I'll approve the post and attachment)

V.

Vinny,
I will try but I'm not very good at all this stuff so I might need your help. If I simply posted it as is (cut and paste seems to work) could you then get it posted the right way if I am too lame??? Lastly I did this in Word and not AC, so I'm not at all sure how this will or will not effect things. Thanks...

Also, Vinny and any other NYS'ers I was wondering could or should we all start taking consent, refusal of consent for these vaccine things so at least we have some cover for why we did or did not post them to the new "system"? Also does any NYS'er know what the penalties and enforcement is behind this new invasion of your patients and children's privacy???

This vaccine reggie really scares me because I see it as a "slippery slope" kind of thing that would then establish case law to allow the govt more power to gather other health data much like CCHIT wants to. I came up with a fairly frightening scenario...

So the use of the vaccine reggie now allows the govt to not just to get involved when there is a real public health issue, like a possible or actually occurring outbreak like with VD, STD's and TB, but now they can collect data just because there may be an issue later, for our supposed protections, right? The health dept is allowed to get involved only when there is a real case of TB or an STD to be concerned about, not because there might be an incident some time in the future, this is plain wrong. Like traffic cams that claim cars commit crimes, not individual drivers... Pull me over and get my license or go fish.

So what is to stop them from requiring pediatric patients from giving up a DNA sample to protect such a patient in the event that he or she was snatched by some weirdo? What parent wouldn't want to get their kid back if such a horrible set of circumstances were to occur? So sometime in the future my son is now a teenager lets say and after going to a school dance him and his friends went to hangout and party under one of the bridges in our local county park and left a few cigarette butts or beer and soda can with their DNA on them. A day later, some poor soul's body gets dumped there under that same bridge... Guess who's DNA they are going to find at the scene of the crime??? That's right my son's and his friends and now they are in the fight of their life to defend themselves against charges that they had nothing what so ever to do with. This really is the begining of something very bad. Our govt has no right being in the business of collecting assorted data on free citizens and the establishment of this first step on the slippery slope is very frightening and concerning. As we all know; "The road to hell is paved with good intent...."

FYI, Barnes and Noble has a fairly inexpensive paperback copy of "1984". I bought a copy for the waiting room and I am going to leave on our little table with the "Warning" notice to sort of help drive the point home. As Nancy said to me this weekend when I caught he reading it in her lounge chair, I ask, "So you reading about the coming brave new world?" and she reply, "No I'm just catching up on current events." Smart women...

Paul

Hey gang,
I have posted my anti vaccine reggie and CCHIT letter for all to see and use as they see fit as Vinny requested. I would greatly apperciate any factual editing anyone might care to add so as to keep this as absolutely accurate as possible so the discussion doesn't get side tracked by nit-picking at the perimeter to allow for a gang jumping on the guy who finally said, "Hey he really has no clothes!!!" Commom tactic these days and I would like to avoid it.
Vinny,
I believe it was you who told me that the vaccine reggie only had a compliance rate of about 5%, correct? Again, keeping this accurate for the sake of the greater point I feel is very important so please feel free to pipe in here folks. Have a great night... I've got stupid insurance billing to do, as always.... PIFATOS, that's the ticket. Food Stamps and Vets, Food Stamps and Vets....
Paul

Hi Folks,

I'm going to try to post it as a download in the other topic later this week.

V.

You may wish to check this article- http://www.emrupdate.com/forums/t/11023.aspx. It came out last month and doesn't discuss compliance rates, but actually goes into the percent of "EHR" owners UNINSTALLING their EHR systems for less expensive EMRs or to go back to paper based systems.

If you download my updated lecture found here ( http://www.emrupdate.com/blogs/emr1...sing-your-electronic-medical-record.aspx ) there is a slide that discusses a report that states that 40% of EHR users have unsuccessful installations, another 40% use their EHRs only partially, and about 20% use their EHRs fully, including all the bloat.

Folks-

I just tested the emrupdate login successfully! It sent a confirmation to a test email URL ("alborgTEST")... so now you can log in again. Nick was having problems with his ftp email server and had to switch to a new one.

Cheers,
Al

Great, Al!

Thanks for posting; I enjoy your posts on emrupdate.com, and we appreciate you keeping us up-to-date on emr issues.

I will give the login another try.

It's official:

It is now simple to sign up as a member of emrupdate.com, which seems to be a great clearing-house for news of interest to those of us on this User Board, including EMR news, speech recognition, and billing software. There is lots of discussion on CCHIT and related topics.

Login here: http://www.emrupdate.com/login.aspx

Or go here if you would like to browse the forums first, before joining:

http://www.emrupdate.com/forums/

To one and all thanks much and keep up the good fight. I just told my kids' doc that we want her to keep them out of the state vaccine reggie here in NYS. Of course she was spouting the company line as is was written and presented as though she had never given it a second thought... And this is one of the smartest PCP's in this part of the state. She has personally taught more docs, that have gone thru the med school or the family or peds residencies here than just about any other doc in this area. She really is any aware and intelligent women. So when someone like her is just sucked in hook line and sinker this really worries me.

Question: Whether it's HMO's from the 70's thru the 90's, P4P, CCHIT, State and federal databases of patients and medical records and all the other CCHIT that the govt and the carriers throw at you guys; Why the hell does such an intelligent group of people like doctors have so much trouble thinking for themselves, seeing thru the BullCCHIT and questioning the pablum that is fed to them by all these A-Holes???

Now I think I have one of the main reasons and sorry if I offend most of you guys here but here it goes none the less. The entire process of becoming a doctor is a process of beating the individuality out of you and weeding and screening out those that voice their displeasure with the present status quo. It starts at pre-med, continues thru Med-school, so by the time you get to residency you are ready to have the last of your personality beaten down in that insane system of servitude where you totally accept fellow docs peeing on you and having you do their garbage runs and "scut" work.

You are basically the programs unprotected slave, surf for the period of your training and you have been taught to be ready for and accept it no less. It is an "old boys, hazing ritual" really. And like such hazing rituals it bonds the victim to their victimizers and endoctrinates them to sustaining the insane process to repeat the torture over and over again, much like sex and child abuse. "I went thru it, you'll be OK. What you can't handle it?" Do you know why the labor dept finally got involved in trying to regulate residence and their hours? Not because they are a great defender of the American worker, but because their were over worked tired docs driving off the road and over highway dividers killing other people and destroying private property, that's why. If you guys would just die quietly on the side of the road or passout standing up and not involve someone else, they wouldn't even give a darn. Amazing.

I've always thought that if real change was going to happen, then it needs to start with how you guys pick and train the next generation so you start getting some more creative thinkers who have some bigger you know what's (be they the male or female verse there of). So are you guys totally P.O.'ed at me now???

Time to speak up before it's too late folks....

Hi guys:

I have a new Powerpoint presentation that I've uploaded today:

"What Has Gone Wrong with the Direction of the HIT in the USA?"

URL- http://www.emrupdate.com/files/folders/al_borges/entry75428.aspx

It has all the arguments that I've posted/others have posted about CCHIT, P4P, government intrusion into HIT, with all the URLs. It should make for a good read and files neatly all the issues and argument points for lobbying purposes. It includes the 2007 financially challenged CCHIT EMR vendors list and what issues have plagued them, including stock graphs and analysis. So much for "assurance"!

Cheers,
Al

Al,
I tried to register earlier and was one of the people that never got a reply email with my password and sign on info. So I went to do it again and now it tells me that someone with my profile and screen name already exsists. Is there some way to have the you just joined emails resent or something? How should I proceed? Thanks..
Paul

Paul:

The same thing happened to me. All you have to do is get their website to email you a password to the email account that you registered from.

Apparently, we actually succeeded in registering when we tried earlier, but it only went partway through. All you have to do is get your password.

Hi guys:

If you don't get the confirmatory email, send Nick Harrington a note (nharrington@ambay.com) and he'll send one manually.

I need for you to log on and help out in the occasional "war with the vendors" that occur. In fact, on Wednesday, Bob Larson, of NextGen got royally miffed when I compared the "big boy" HIMSS CCHIT certified "EHR" vendors to Mattel- i.e. one tries to poison children and the other the HIT market.

From there it went downhill with me explaining how CCHIT really is breaking the RICO laws, through racketeering, extortion of fees etc. He of course got even more pissed off. Then I told him that he was obviously uninformed since he didn't read my slide presentation on the direction of HIT.

URL: http://www.emrupdate.com/forums/p/11551/75575.aspx#75575

Folks,
I have put my handout in the waiting room and I make sure that patients and the parents of our young peds patients at least really know that it is there. Most of them are very upset when they see it and read it. I'm telling you, it is worth a few bucks in paper and ink to make up a nice batch and get it into people's hands. Most people in today's over threatened, post 911, gov't out of control to invade our privacies really are getting it. I really can not state strong enough just how upset people are when they read it. Use the power that we have, meeting and schmoozing with patients and families in our own communities to get folks up in a lather over these aweful things. This is the best way to defeat CCHIT and the nasty folks at the helm of these things.

Just Do It!!! Trust me you'll feel much better when you do.
Paul

Guys, say goodbye to AC if this goes through! Today it came out that Bush wants to force a CCHIT certified EHR on us all, but tagging the 10% pay cut reimbursement to ownership of a CCHIT certified EHR. I don't know how successful he will be, as I would be the first to quit Medicare if it goes through:

ALERT!! Bush to tie in CCHIT-certified EHR to the Rollback of the 2008Medicare Fee Cuts

http://www.emrupdate.com/forums/t/11804.aspx

Here is the location of a Powerpoint slideshow that I just put out that you can use to send to your Congressmen:


"What Has Gone Wrong with the Direction of the HIT in the United States?"
URL: http://www.emrupdate.com/files/folders/al_borges/entry75428.aspx

The sad thing is that HMOs/PPOs may later follow this lead and we'll be forced to cave in or go with pure cash patients.

Paul- do you have a link to your handout?

Bush is a numbskull. Hey, get this. I overheard a conversation on the commuter train the other day. The guys were talking about how some of the voters in the next presidential election were only 10 years old when Dubya was elected and had no concept of a President that was "articulate."

Sorry, I don't want to get into a political debate here, just thought that was funny.

Anyway Al, I read the exchange between you and Mr. NextGen and was ROFLMAO! As I recall, there are one or two FORMER NEXTGEN CLIENTS that subscribe to AC. Because of BAD SERVICE AND OVERPROMISSING. I wonder if there are any former AC clients that are happy with Nextgen due to AC promissing things that they couldn't deliver? NOT! (well I don't really have any data but I suspect not.) So much for the great god of EMRs CCHITT.

Does anybody find this HHS letter as upsetting as I do? I was home this evening watching TV after putting the kiddies down and my stomach was turning. This is really happening here in our America, gov't and large for profit companies spying on and violating the sactity of the examroom and the doctor/patient relationship. How many patients tell you that they smoke dope, had an abortion years ago (perhaps even before they were legal...) or what have you? Depression, SSRI's or mood stablilizers you folks write for. Who's f'ing business is it but that of the treating doc and the patient? This is just unreal.

The real problem with CCHIT like this is that they tend to brew for months or years under the surface like this has been with only a few of us who are in the industry, on the inside, getting all bent out of shape while most of the sheep just get in line for their blood letting. By the time the thing reaches the public's attention it is already way too late. I can not stress too much that each and every one of us as an ethical obligation to spread the word "Outside of Medicine" to the public at large. Especially those of you who have friends or patients that are ethical (oxymoron here?) lawyers, politically connected, journalists, activists and the like. This needs to get out into the cleansing sunlight before it is too late. And the privacy issue is the key because that affects each and every citizen in this country and folks just instinctually know that this is wrong.

So I ask each and every one of you: "Who have you told about CCHIT today?" I know I have told at least a dozen regular and medical business people; have you???

Good Night and Good Luck,
Paul

The following letter will be posted (hopefully) in Secretary Leavitt's blog tomorrow, "pending moderation":(http://secretarysblog.hhs.gov/my_weblog/2007/11/health-it.html?cid=93215954#comments). I ask that those interested in fighting e-prescribing please post too...

Dear Secretary Leavitt:

I disagree with your stance to tie the needed physician pay fix for 2008 to the ownership of a CCHIT certified EHR. It is wrong and misguided to suggest to Congress that they take that course of action. You don't know how many physicians "in the trenches" you're continued push to cram HIT down the throats of physicians as another unfunded mandate.

Problems that I see with e-Prescribing from what I've read include:

--Physicians are made to again pay for a good deal of the technology together with pharmacists. Patients and insurance companies, those entities that benefit most, pay NOTHING.
--You want to replace the current PAPER and FAXING of prescriptions both of which still work well and are FREE with a $300 to $500 a year per license cost (not including the EHR cost), making it another unfunded mandate.
--30% of retail pharmacies do not have e-prescribing capabilities.
--The DEA has a ban on e-prescribing for controlled substances, which account for 11-13% of all prescriptions. In addition, some states have paper-based requirements for narcotics prescriptions.
--It takes approximately 6-12 months for a vendor to become certified in SureScripts, the most prominent company associated with e-prescribing. This expensive developmental cost, with is part of the CCHIT certification process, invariably is passed on to the physician consumer in the higher EMR prices.
--Many of my fellow docs lament the problem of having to carry a tablet PC or laptop with them to prescribe.
--Lastly, many patients, especially the elderly, prefer paper prescriptions which in the current bills before Congress may signify penalties to the provider.

I truly hope that Congress ignores your request, which is misguided.

If you wish, you can download my 65 page Powerpoint report on HIT called: "What Has Gone Wrong with the Direction of the Health Information Technology in the United States?" from here: http://www.emrupdate.com/files/folders/al_borges/default.aspx?PageIndex=2.

It makes for a good read. It covers CCHIT, P4P, and e-Prescribing from a physician's point of view and it offers suggestions on how to improve the HIT by taking a different path.

Sincerely,
Al Borges MD
Oncologist, Virginia

Thanks, Al,

Thanks for the link, which I'll re-post in working form.

http://secretarysblog.hhs.gov/my_weblog/2007/11/health-it.html?cid=93215954#comments

I appreciate you providing an official outlet for us to express our concerns about these kinds of issues. I would appreciate more of this kind of information.

I will ask for action through the Washington State Medical Association and the AAFP. AAFP is now having a campaign for "STRONG MEDICINE" in which their emphasis is towards helping family physicians market and survive trends in medicine. I have been at odds with the AAFP as they are one of the chief CCHIT supporter and their vision does not include solo-practice and small practices. It almost seems to me that many of these physician organizations are there to help large institution at the expense of the hard working self sufficient physicians.

Please consider telling AAFP that we welcome the changes but we need "STRONG and IMMEDIATE ACTION" to stop this CCHIT now! They need to change course as CCHIT is out of control. CCHIT may be OK for ivory tower physician/executive types but is hazardous for the majority of those on this user board.

Well, here's my contribution. Let's see if this gets on his blog!

Dear Secretary Leavitt,

I have always pictured the role of government to protect the rights and liberties of its citizens. In the case of pushing for unfunded mandates such as e-prescribing, and CCHIT, the government is using its power to eliminate small solo-physician practices like mine.
In our community, large entities such as corporate owned hospital and FQHCs have virtually decimated the private practice of medicine. E-prescribing companies by virtue of technological and marketing resources required are limited to a few companies (Allscript and Surescript). This is basically government endorsement of these companies. These entities will continue to suck whatever revenue that we hard working independent physicians are able to make with the restrictive anti-competitive policies that the US government has placed on small practices.
CCHIT will force limitation of choice of EMR to a few high priced (unaffordable to small practices running on thin margin).