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1
THE REAL FACTS ABOUT EMR
Any fact that needs to be disclosed should be
put out now or as quickly as possible, because
otherwise the bleeding will not end. Henry
Kissinger
There are in fact two things, fact and opinion
the former begets knowledge, the later ignorance
Hippocrates
"Practical politics consists of ignoring facts."
Henry Adams
2
Terms and Acronyms
MRI - Medical Records Institute, which sets many
of the definitions frequently used today in
reference to information technology, as explained
below. CCHIT - stands for a voluntary,
private-sector organization to certify HIT
products. It was initially founded by three
leading HIT industry associations the American
Health Information Management Association
(AHIMA), the Healthcare Information and
Management Systems Society (HIMSS) and The
National Alliance for Health Information
Technology (Alliance). CPOE - computerized
physician order entry. C-EHR - stands for
certified electronic health record. EHR
electronic health record, which is a
computer-accessible, interoperable resource of
clinical and administrative information pertinent
to the health of an individual. The information,
drawn from multiple clinical and administrative
resources, is used by a broad spectrum of
clinical personnel. This enables them to
coordinate the patient's care and promote
wellness. EMR electronic medical record, which
is a computer-accessible resource of medical and
administrative information available on an
individual collected from and accessible by
health care professionals involved in the
patient's care within a single care setting. HHS
- Health and Human Services, currently chaired by
Secretary Michael Leavitt. HIMSS EHRVA is a trade
association of EHR vendors which functions as an
advocacy and lobbying group founded to fight for
the optimal use of healthcare information
technology (IT) and management systems for the
betterment of healthcare. Founded in 1961 it has
offices in Chicago, Washington D.C., Brussels,
and other locations across the United States and
Europe.
Slide 2
3
FACTS ABOUT CCHIT
4
(No Transcript)
5
On 7/2006 CCHIT began certifying EMR software
systems
  • And now the average cost of the typical
    certified EMR is about twice as expensive as
    those that arent certified.
  • The uptake of certified EMR software systems
    has stagnated while those that arent certified
    have seen the overall prevalence in the market
    grow to almost 30.
  • The failed installation rates are estimated at up
    to 50 in the c-EHR software systems industry
    the deinstallation rate is reported to be another
    8.
  • Only 10 of those that buy c-EHR software systems
  • actually use all the features that Medicare
    wants to
  • eventually force onto physicians.
  • The special features that government and
    Insurance
  • companies want to implement have more to do with
  • withholding payment to providers than in
    actually
  • improving patient care.
  • http//www.healthcare-informatics.com/ME2/dirmod.a
    sp?sid349DF6BB879446A1886B65F332AC487FnmtypeB
    logmodViewTopicmid67D6564029914AD3B204AD35D8F
    5F780tier7idEDE4B65E6FA344C286C02EFB2CD4D223
  • http//www.ihealthbeat.org/articles/2007/10/31/Sur
    vey-Finds-Health-Care-Providers-Often-Backtrack-on
    -EHRs.aspx?topicID54

6
Reason for the High Failed Installation Rates An
artistic depiction of what a typical CCHIT
certified enterprise EHR chaotic installation
could look like in real time.
Slide 6
7
In 2006 CCHIT began certifying EMR software
systems, offering assurance
  • Since 2006 approximately 100 EHR software systems
    have been CCHIT certified. Of these, 3 of which
    have declared bankruptcy, and at least 2 dozen
    other certified EMR software systems have seen
    their stocks fall in the past year alone over
    30. And these are just the ones that are
    publicly traded. Little is known of the majority
    of EHR software systems that are privately owned.
  • On several blog sites on the net there are
    several discussions of EHR software system
    vendors that leave their users angry, and on one
    occasion holding patient records hostage waiting
    for more fees. Here are the most recent
    discussions
  • eCW (https//md.sermo.com/medical/ticket/details?n
    avonid23060)
  • Cerner (https//md.sermo.com/medical/ticket/detail
    s?navonid18593)
  • NextGen- discussion still active after more than
    a
  • year! (http//www.emrupdate.com/forums/t/12000.as
    px?PageIndex1)

8
The Medicare P4P and e-prescribing rules show
that the government has conspired with HIMSS
enterprise EMR vendors to try to  force
physicians to purchase a CCHIT-certified EMR in
the future if they wish to be paid a fair wage
for services rendered when they see those
elderly patients in their practices. This could
be illegal, but
  • There exists a situation, "extortionate
    extensions of credit" which can apply to
    CCHIT-related activity
  • For vendors The purported CCHIT "buy-in"
    certification costs of 30000 if you wish to stay
    in business within the HIT industry.
  • Physicians The department of HHS P4P payout of
    money only if you purchase a CCHIT-certified EMR.
  • Legalese "By its very nature, however, extortion
    causes the victim to consent to the taking of
    property. Extortion does not necessarily involve
    the use of force or the threat of the use of
    force. For example, the victim storeowner
    voluntarily pays a Mafia enforcer 1000 per month
    because the Mafia enforcer said, pay us 1000
    per month of we'll break your legs.

http//www.emrupdate.com/forums/p/7953/60493.aspx
60493
9
The Medicare P4P and e-prescribing rules show
that the government has conspired with HIMSS
enterprise EMR vendors to try to  force
physicians to purchase a CCHIT-certified EMR in
the future if they wish to be paid a fair wage
for services rendered when they see those
elderly patients in their practices. This could
be illegal, but
  • In Summary "Governmental power, by its nature,
    is legalized extortion, i.e. unless you buy a
    CCHIT certified EMR you won't be able to make a
    decent living in the practice medicine in the USA
    anymore You only have 2 options-
  • Dont vote for elected officials that dont
    understand the implications of their
    representation.
  • Dont consent to forced HIT rules which may pay
    you an extra pittance for consent or
    participation which legitimizes the process
    further.

http//www.emrupdate.com/forums/p/7953/60493.aspx
60493
10
Occasionally a Physician May Claim It would
however be more positive and productive if
doctors as a profession would actually accept the
challenge and work with CCHIT to design
appropriately suitable standards.
  • If you try to work with CCHIT, all you end up
    doing is giving this politically contrived
    public/private company more validity. Its whole
    premise is wrong and flaunts the Clayton and
    Sherman antitrust acts simply because of the
    backing of the Department of Health and Human
    Services.
  • CCHIT functions not unlike the mafia, providing a
    method of racketeering in which if you didn't pay
    their 30000.00 a year, your business dies. This
    decreases competition, leading to increased
    prices that impacts every physician office in the
    USA. On top of this they through massive
    donations which are usually poorly known, they
    have been able to get bipartisan support to force
    doctors into purchasing their bloated, costly,
    difficult to use EMR software.

An Antitrust Primer- http//www.emrupdate.com/fo
rums/p/7196/56269.aspx56269
11
Occasionally a Physician May Claim It would
however be more positive and productive if
doctors as a profession would actually accept the
challenge and work with CCHIT to design
appropriately suitable standards. (continued)
  • When I first began looking into this, I found
    that CCHIT itself, a nonprofit organization,
    had planned on making a million dollars in the
    first 6 months of existence in 2006, then divide
    the profits at the end of the year. I exposed
    that, and subsequently they reorganized on
    11/2006. Subsequently, an article stated that
    Cerner spent 180,000 in its lobbying efforts in
    Q1 of 2008 in Congress to forward the agenda of
    the "enterprise" EHR.
  • So those that are contemplating on working with
    this process- dont!

URL for the CCHIT original charter and minutes
demonstrating how not-for-profit CCHIT was going
to make a profit in 2006 http//msofficeemrproje
ct.com/Page3.htm
12
CCHIT Facts According to Histalk
  • Incorporated as an LLC in 2004, reincorporated as
    a non-profit C-corporation in 2006.
  • CCHITs address on the tax form is 200 S. Wacker
    Drive, Chicago, IL 60606.
  • CCHIT took in 4.7 million in FY2007, spent 3.6
    million of that, and banked 1.1 million,
    bringing its fund balance up to 2.7 million and
    total assets of 3.4 million.
  • Of the 4.7 million in income, 2 million was
    from certification fees, 2.7 million was from
    government contracts.
  • CCHIT reported 866K transferred to AHIMA (the
    enterprise EHR vendor lobbying group) in a
    category that includes sharing of equipment,
    facilities, or employees. HIMSS
  • received 196K for a category that includes
  • performance of membership services.

http//histalk2.com/2009/02/21/monday-morning-upda
te-22309/
13
CCHIT Facts According to Histalk
  • The tax records indicate that CCHIT chair Mark
    Leavitt is still a HIMSS employee, "on leave from
    his position as HIMSS Chief Medical Officer
    while serving as Chair of CCHIT. CCHIT pays HIMSS
    an hourly rate for Dr. Leavitts services that is
    intended to cover the portion of his salary and
    benefits allocable to those hours." Thats at
    odds with both his CCHIT bio and his LinkedIn
    write-up, which say hes finished with HIMSS and
    working full-time for CCHIT (he put on LinkedIn
    that he left HIMSS in September 2005), although
    on tax forms he is shown as being paid 164K for
    40 hours a week at CCHIT, possibly more.

http//histalk2.com/2009/02/21/monday-morning-upda
te-22309/
14
FACTS THE ECONOMICS ABOUT BUYING A c-EMR
SOFTWARE SYSTEM
15
If you try to take advantage of the Stark Law
Relaxation to allow hospitals to buy you an EMR
  • First you have to find a hospital willing to
    donate money to your cause.
  • By law, the most that the hospital can buy is 85
    of the initial outlay of the EMR.
  • The hospital will not cover the training, which
    can cost as much as the EMR itself.
  • You still have to pay for-
  • The yearly ongoing fees, usually costing about
    15 of the initial cost.
  • The cost of the hardware which can handle an SQL
    server backend, plus the technical assistance to
    make it work.
  • You still have the loss of productivity
    associated with workflow disruption that in many
    cases does not improve with time.
  • The response to date has been lukewarm due to
    both hospital and physician reluctance to enter
    into binding agreements, costs, and problems
    related to patient confidentiality.

http//www.hschange.com/CONTENT/1015/
16
Multiple Vendors Claim Physicians need to
understand that this is an investment, so they
will not only make their initial costs back, but
in the next five years, they could make an extra
125,000!
  • As stated in the previous slide, the initial and
    ongoing costs provide a large hurdle to overcome
    before a provider begins to make money.
  • Just the 50 failed installation rate, the 8
    deinstallation rate, and for those that do
    install the EMR, the 90 less-than-full use, and
    lastly the loss of productive workflow, alone
    will kill any possible increased income using an
    expensive CCHIT-certified EHR.
  • In 2 case studies published at the www.aafp.com
    site, the total outlay just for the technology
    was reported to cost anywhere between 125,000.00
    to as much as a 250,000.00 for 2 doctors over
    the first 5 years (2002 dollars).
  • The two aafp website articles referenced above
    http//www.aafp.org/fpm/20020400/57howm.html
    and http//www.aafp.org/fpm/20030500/37impl.html)
  • http//www.emrupdate.com/blogs/ducknet/archive/200
    8/10/01/ehr-adoption-remains-off-in-the-distance-g
    etting-way-to-complicated.aspx

17
The 2/13/2009 stimulus bills 44,000.00
incentive payment for significant use of a
c-EHR may seem like a lot, but not really
  • The current (2009) estimated average cost of
    purchasing an EHR system is 33,000 for each
    physician, with an additional cost of 1,500 per
    doctor per month for maintenance. So if you do
    the math, 33000.00 plus 1500 x 60months
    123000.00 (http//blog.case.edu/case-news/2008/10
    /30/ehrregulation)
  • Add to that 1/3 of a full-time employee to follow
    the trail of the reporting and documentation, and
    it comes out to another 10000.00/year x 5 years
    50,000.00
  • Workflow losses The costs of P4P with the added
    extra data input needed to capture the granular
    data is an estimate, as the specifics havent
    been posted yet, but say it takes an extra 5
    minutes per encounter. An office grossing
    100,000.00 a year in Medicare funds, at 100.00
    per encounter, equals to 1000 encounters. Do the
    math again- 1000 x 5 min/encounter 5000
    minutes
  • 5000/20 min per encounter 250 lost
    encounters, or
  • another 25000.00/year x 5 years 125,000.00
  • Total losses over 5 years 298,000.00

http//www.hcplive.com/mdnglive/articles/PC_Medica
re_HIT_mandate
18
FACTS ABOUT E-EHR SOFTWARE SYSTEMS AND QUALITY
19
Big government, EHR vendors, health insurers, and
Presidents Bush Obama all believe that EHR
software systems improve quality save lives
  • But there is not one prospective study
    demonstrating this fact.
  • There are several showing the opposite, s.a.
  • In one study published in 2005 involved a
    pediatrics ICU using EHR and CPOE systems. The
    final result was that more children died using
    HIT- Univariate analysis revealed that mortality
    rate significantly increased from 2.80 (39 of
    1394) before CPOE implementation to 6.57 (36 of
    548) after CPOE implementation.
  • In another study, the CPOE system was so bad that
    physicians could not put in the orders in a
    timely manner, and after only 3 months the whole
    project was discontinued. See Cedars-Sinai
    Doctors Cling to Pen and Paper URL below.
  • Pediatrics, Vol. 116, No. 6. (December 2005), pp.
    1506-1512, http//www.citeulike.org/user/scheufele
    /article/505501
  • http//www.washingtonpost.com/wp-dyn/articles/A523
    84-2005Mar20.html?subAR

20
Big government, EHR vendors, health insurers, and
Presidents Bush Obama all believe that EHR
software systems improve quality save lives
(continued)
  • In 2007 one study, published in the Archives of
    Internal Medicine, showed that for 14 of the 17
    quality indicators, there was no significant
    difference in performance between visits with vs.
    without EHR use.
  • In 2008 a study performed at the Richmond, VA
    MCV/University of Richmond Medical Center they
    concluded that for 10 quality indicators,
    there is limited evidence of the relationship
    between hospital EMR use and quality.
  • http//archinte.ama-assn.org/cgi/content/abstract/
    167/13/1400
  • http//mcr.sagepub.com/cgi/content/abstract/65/4/4
    96

21
One study finally showed that EMR software
systems might lower malpractice risk
  • But this was a retrospective study which involved
    varied amounts of EMR use by practitioners.
  • The survey response rate was only 71.4 (1345 of
    1884), and only 1140 respondents of these had
    significant data on the presence of EHR.
  • The purported 40 reduction was not statistically
    significant In logistic regression analysis
    controlling for sex, race, year of medical school
    graduation, specialty, and practice size, the
    relationship between EHR adoption and paid
    malpractice settlements was of smaller magnitude
    and no longer statistically significant (adjusted
    odds ratio, 0.69 95 confidence interval,
    0.40-1.20 P .18).
  • A subgroup analysis revealed that although only
    5.7 of frequent EMR users had paid malpractice
    claims, compared to 10.8 of those not using an
    EMR, those that infrequently/partially used an
    EMR (s.a. "hybrid systems") faired WORSE than
    those using only paper records (12.1).
  • The facts remain that despite the cheerleading
    for EMR software systems theres still not a
    shred of evidence they have a significant impact
    on outcomes that matter.

http//archinte.ama-assn.org/cgi/content/abstract/
168/21/2362
22
On the contrary, another more recent study showed
the opposite- that EMR software systems pose new
legal risks
  • For one thing, an overarching concern is that
    Federal Rules of Civil Procedure, approved by the
    U.S. Supreme Court in December 2006, make any
    electronically-stored data discoverable in a
    trial--and those details can catch doctors off
    guard.
  • Doctors may run into problems if the EMR software
    systems metadata (the time stamp indicating who
    entered what and when) conflicts with his or her
    version of events.
  • Perhaps even more vexing, it's still not clear
    what the legal status of an EMR is. At present,
    it's still in question whether all EMR software
    systems meet the legal definition of being
    medical records, a concern that could become
    important in some forms of legal disputes over
    patient care.

http//www.fiercehealthit.com/story/emrs-pose-new-
legal-risks/2008-10-06
23
On 7/2008 Congress passed a bill forcing doctors
to use e-prescribing or suffer a cut in
reimbursement
  • This bill was pure politics at its worse.
  • For most practitioners, e-prescribing is a
    workflow slowing tedious procedure.
  • Allscripts claims that they offer a free
    system, but its a marketing ploy. Its database
    is not open source and no plans are in the
    works to make it accessible to most EMR software
    systems so as to prevent double entry. This
    "free" e-prescribing is what convinced Congress
    to put e-prescribing on their recent 7/2008 HR
    6331 bill.
  • Although on 7/2008 there were up to 10 of
    physicians capable of e-prescribing, only 2 of
    prescriptions actually were legitimately sent by
    e-prescribing as described by law.
  • It was meant to make a transition from
    handwritten prescriptions to a format that was
    more legible overall, but what is not known is
    why they prohibited the faxing or simple printing
    of prescriptions from an
  • EMR?

https//md.sermo.com/medical/ticket/details?navon
id21117
24
FACT C-EHR SOFTWARE SYSTEM AGENDAS HAVE MORE TO
DO WITH POWER, MONEY, AND GREED
25
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • You have to follow the money. The internet first
    mentions a relationship that Obama has had with a
    technology guy call Robert Blackwell who kept
    him, a newly minted lawyer, on retainer.
    Blackwell seemed to later get quid pro quo
    payments where his company, EKI (Electronic
    Knowledge Interchange) profited.
  • EKI is a business and technology consulting firm
    that specializes in delivering measurable
    business value to mid to large size corporate and
    government organizations, which is something that
    Obama wants to bring to health care through the
    use of c-EHR systems.
  • Obamas presidential campaign website reported
    that
  • Blackwell in 2008 committed to raise between
  • 100,000 and 200,000 for Obamas White House
  • run that year. I'm sure that eventually we'll be
    hearing
  • more of this Blackwell relationship. 
  • http//citizenwells.wordpress.com/2008/04/29/robe
    rt-blackwell-obama-money-laundering-eki-consulting
    -rod-blagojevich-illinois-tony-rezko/
  • http//news.lavenderliberal.com/2008/04/27/obama-
    supporters-how-do-you-justify-barrys-blackwell-eki
    -killerspin-wheeling-and-dealing/

26
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • TULLMAN Shortly after Obama gets elected, he
    makes Glen Tullman, CEO of Allscripts, his
    personal IT advisor.
  • Mr. Tullman personally gave President Obama at
    least 144300.00 in donations in the 2 years
    prior to his election. His employees gave 20662
    during the same period. His company,
    Allscripts/Misys also gave the possible future
    HHS Secretary Daschle 12000 speaking fees on
    8/2008 for a lecture.
  • This lobbying put him into the unusual position
    where he can influence legislation which can
    ultimately enrich himself by forcing the use of
    e-prescribing and c-EHR systems while the
    American taxpayer, and especially doctors have to
    foot the bill.
  • http//histalk2.com/2009/02/05/histalk-interviews-
    glen-tullman-ceo-of-allscripts-2509/
  • http//hotair.com/archives/2008/04/27/an-obama-pay
    off/
  • http//www.talkleft.com/story/2008/4/27/145012/15
    4
  • http//www.obamamustgo.com/
  • http//www.discoverthenetworks.org/Articles/black
    well5.html
  • http//www.campaignmoney.com/political/contributio
    ns/glen-tullman.asp?cycle08
  • http//fundrace.huffingtonpost.com/neighbors.php?t
    ypeempemployerALLSCRIPTS
  • http//www.democraticunderground.com/discuss/duboa
    rd.php?azview_alladdress389x4968435

27
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • On a more recent note, several of Obama's health
    information technology related appointees have
    been found to be "problematic" (I'm trying to be
    kind here)
  • DASCHLE Allscripts/Misys (CEO Glen Tullman's
    company) also gave the possible future HHS
    Secretary Daschle 12,000.00 speaking fees on
    8/2008 for a lecture. Fortunately "buy me out"
    Daschle failed to pay his taxes, so he had to
    resign.
  • KUNDRA  On 3/10/2009 the FBI raided the former
    office of one of President Obama's appointees,
    Vivek Kundra. An employee of the D.C. Office of
    the Chief Technology Officer and a private
    contractor were charged with corruption,
    including bribery of a public official, money
    laundering, wire fraud and conflict of interest. 
    As the raid took place, Obama's appointee,
    Kundra, was giving a speech at FOSE - an annual
    government technology expo - about changing the
    way the government purchases materials from
    vendors. Kundra is on leave from his White House
    job until further details of the case become
    known, a White House
  • source told the Associated Press. He was at the
    job only 7 days before this
  • occurred if he stays on, he would be an
    integral part of the push to c-EHRs.
  • http//www.democraticunderground.com/discuss/duboa
    rd.php?azview_alladdress389x4968435
  • http//voices.washingtonpost.com/posttech/2009/03/
    vivek_kundra_to_be_obamas_chie.html 
  • http//www.huffingtonpost.com/2009/03/12/fbi-raids
    -obama-technolog_n_174265.html 
  • http//groups.google.com/group/alt.politics.democr
    ats.d/browse_thread/thread/6c3ddc4a3f4bee10 

28
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • Other lobbyists include
  • DEPARLE President Obama's health technology
    "czar", Nancy-Ann DeParle, has some deep
    financial ties to the healthcare industry shes
    supposed to reform. Among them is the fact that
    she served as a Cerner board member since 2001
    and that she was paid 195K in stock and cash and
    held around 1 million of CERN shares at the end
    of 2007.  She donated 39,400.00 to various
    Democratic party officials. On 3/6/2009 she
    resigned from Cerner's board.
  • BLUMENTHAL President Obama recently selected
    David Blumenthal M.D., to serve as national
    coordinator within the U.S. Department of Health
    and Human Services. Blumenthal was director of
    the Institute for Health Policy at Massachusetts
    General Hospital in Boston, part of Partners. An
    interesting disclosure he is receiving grant
    support from GE Healthcare.
  • http//content.nejm.org/cgi/content/full/NEJMp0901
    592
  • http//www.chicagotribune.com/news/nationworld/chi
    -deparlemar29,0,7090806.story
  • http//www.histalkpractice.com/2009/03/02/news-330
    9/ 
  • http//www.campaignmoney.com/finance.asp?typeinc
    ycle08criteriaDeParle

29
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • An editor from the Chicago Tribune questions how
    DeParle and others in this administration can
    avoid conflicts of interest, particularly given
    the size and market share of some of the firms
    they have served.
  • "What the administration is going to have to
    guard against is this perception that there is
    some benefit given to companies who know people
    in the administration."

http//www.chicagotribune.com/news/nationworld/chi
-deparlemar29,0,7090806.story
30
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • FRIEDEN Dr. Thomas Frieden, M.D., an infectious
    disease specialist, who worked at the CDC from
    1990 to 2002 as an Epidemiologic Intelligence
    Service Officer investigating a range of issues
    include the spread of multidrug-resistant
    tuberculosis, who served as the former Chairman
    of the New York City Department of Health and
    Mental Hygiene since January 2002, has been named
    by President Obama as the director of the Centers
    for Disease Control and Prevention.
  • Frieden has been a strong advocate of
    electronic health records, and as such his
    department two years ago signed a 19.8 million
    contract to fund deployment in underserved areas
    of integrated practice management/electronic
    records software from eClinicalWorks Inc. (eCW),
    Westborough, Mass.
  • I suspect that he will be the the fourth c-EHR
    system
  • lobbyist surrounding Obama, representing eCW. To
    date
  • I was not able to find the exact behind the
    scenes reason
  • for his strong patronage of this particular EMR
    but Im
  • still looking.

http//www.healthdatamanagement.com/news/CDC-28210
-1.html?EThealthdatamanagemente872555astemai
lchanneldisease_management
31
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • GLASER Mr. John Glaser, VP CIO Partners
    Healthcare in Boston was appointed to a 6 month
    stint as an adviser to David Blumenthal, the
    recently appointed national coordinator for HIT.
    Glaser will spend 4 days/week for 6 months
    working with ONC.
  • Blumenthal, a practicing physician and Harvard
    Medical School professor most recently worked for
    Partners HealthCare as director of the Institute
    for Health Policy at Massachusetts General
    Hospital.
  • Glaser is a fellow of HIMSS, CHIME and the
    American College of Medical Informatics. He also
    serves on the editorial board of Healthcare IT
    News and is a regular columnist at
    www.histalk.com.

http//www.healthcareitnews.com/news/glaser-advise
-onc-chief-hitech
32
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States
  • PARK On 8/3/2009 Mr. Todd Park, co-founder and
    board member of Athenahealth, has been named CTO
    of the US Department of Health and Human
    Services. He resigned from Athenahealths board
    on 8/10/2009 and had promised to divest his
    Athenahealth stock position. Park will report to
    Deputy HHS Secretary William.
  • Athenahealth (Nasdaq ATHN), another
    enterprise level EHR vendor is a leading
    provider of internet based business services for
    physician practices, and received the 2008
    Certification Commission for Healthcare
    Information Technology (CCHIT) for its
    AthenaClinicalsSM Version 9.15.1.

http//histalk2.com/2009/08/03/todd-park-athenahea
lth-co-founder-named-cto-of-hhs/
33
SUMMARY FACT STATEMENTS
34
EMR FACT SUMMARY
List of quick facts about EMR
  • Physicians do NOT like c-EHR systems.
  • EMR does NOT save time.
  • EMR does NOT improve workflow, and most likely
    will make it worse.
  • EMR does NOT save money, especially for the
    doctor.
  • EMR does NOT make a physician money and will
    NOT offer a ROI.
  • EMR has NOT been demonstrated to improve
    quality of care over paper in prospective studies
    when looking at the same quality measures.
  • EMR does NOT prevent redundant testing.
  • EMR does NOT lessen your risk of malpractice
    litigation.
  • https//md.sermo.com/medical/ticket/details?navon
    id24242
  • https//md.sermo.com/medical/ticket/details?navon
    id31562

Slide 34
35
EMR FACT SUMMARY
More of the list of quick facts about EMR
  • EMR does NOT save paper.
  • EMR CAN bring organization to an office.
  • EMR WILL print out a hell of a 3 page
    consultation on an OV for a sore throat, whether
    or not the patient was seen.
  • EMR WILL erode the patient privacy and make
    everyone's file available to government,
    insurance companies, and anyone else who wants to
    see it.
  • The c-EHR agenda has more to do with power,
    money, and greed than with issues of quality,
    errors, and ROI.

Slide 35
https//md.sermo.com/medical/ticket/details?navon
id31562
36
EMR FACT SUMMARY
Finally, quotes from David C. Kibbe
  • "One has to question whether or not a
    vendor-founded, vendor-funded and vendor-driven
    organization should have the exclusive right to
    determine what software will be bought by federal
    taxpayer dollars.
  • "It's important that the people who
    determine how this money is spent are
    disinterested and unbiased . . . Even the
    appearance of a conflict of interest could poison
    the whole process."

Dr. Borges in his organized office using his EMR!
http//www.washingtonpost.com/wp-dyn/content/artic
le/2009/05/20/AR2009052003600.html
Slide 36
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