Has the HIT Bubble Already Popped?

Long Before Reaching … Dentistry

[By Darrell K. Pruitt DDS]

HCPlexus recently partnered with Thompson Reuters to conduct a nationwide survey of almost 3,000 physicians about their opinions of the quality of health care in the near future considering the Patient Protection and Affordable Care Act (PPACA), Electronic Medical Records, and their effects on physicians and their patients. (See “5-page Executive Summary”)

http://www.hcplexus.com/PDFs/Summary—2011-Thomson-Reuters-HCPlexus-National-P

Results:

“Sixty-five percent of respondents believe that the quality of health care in the country will deteriorate in the near term. Many cited political reasons, anger directed at insurance companies, and critiques of the reform act – some articulating the strong feelings they have regarding the negative effects they expect from the PPACA.”

What’s more, one in four physicians think eHRs will cause more harm than help. So what’s the accepted threshold for the Hippocratic Oath to come into play?

Do you also find excitement in healthcare reform’s surprises? Experiencing the sudden, last minute turns healthcare reform has taken lately is like riding shotgun with Mayhem behind the wheel, texting. Here’s other discouraging news from the same HCPlexus-Thompston Reuters survey: “A surprising 45% of all respondents indicated they did not know what an ACO is, exposing a much lower awareness of ACOs versus the broader implications of PPACA. It appears there has been a lack of physician education in this area.”

ACOs Defined 

Since I also had no idea what an ACO is, I searched the term and came across a timely article that was posted on NPR only days ago titled, “Accountable Care Organizations, Explained.”

http://www.npr.org/2011/01/18/132937232/accountable-care-organizations-explained

Author Jenny Gold writes: “ACOs are a new model for delivering health services that offers doctors and hospitals financial incentives to provide good quality care to Medicare beneficiaries while keeping down costs.” Does that remind anyone of insurance HMO promises just before the bad idea collided with surprisingly intelligent consumers in the early 1990s? Kelly Devers, a senior fellow at the nonprofit Urban Institute, is quoted: “Some people say ACOs are HMOs in drag,” There’s a sharp turn nobody warned us about.

HMO Differentiation 

Further blurring the difference between ACOs and HMOs, Gold adds “An ACO is a network of doctors and hospitals that shares responsibility for providing care to patients. Under the new law, ACOs would agree to manage all of the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years.” I wonder if we’ll see a resurrection of HMO gag orders preventing physicians from discussing effective but expensive treatment alternatives not offered by the ACO.

As expected, not only are hospitals and doctors competing for the opportunity to run ACOs, but so are former HMO insurance agents. Devers explains, “Insurers say they can play an important role in ACOs because they track and collect data on patients, which is critical for coordinating care and reporting on the results.” As a provider, do you trust UnitedHealth’s Ingenix data mining tendencies? A few years ago, NY State Attorney General Andrew Cuomo spanked the company for selling insurers pseudo-scientific excuses to cheat out-of-network physicians.

Just like Health Maintenance Organizations don’t maintain health, insurer-based Accountable Care Organizations will not bring accountability to care any more than the Patient Protection and Affordable Care Act provides patient protection and affordable care. And since I’m exposing blatant bi-partisan deceptions, there is no privacy or accountability in the Health Insurance Portability and Accountability Act, and the “HIPAA Administrative Simplification Statute and Rules Act” doesn’t.

HITECH Funding

Gold suggests that because HITECH rules were written intentionally vague in order to push the envelope of stakeholders’ imaginations, similar to HIPAA’s ineffective security rules I suppose, the doctors’ predictable ignorance of ACOs is understandable.

But then again, all this may not even matter in a few months. According to Howard Anderson, Executive Editor of HealthcareInfoSecurity.com, HITECH funding itself is threatened. He recently posted “GOP Bill Would Gut HITECH Funding – Unobligated HITECH Act Funds Would be Eliminated.”

http://www.govinfosecurity.com/articles.php?art_id=3306

Assessment

While Obama’s healthcare reform teeters between two houses, I encourage consumers to plead with their lawmakers to stop being suckered in by cheap, meaningless buzzwords sprinkled in the titles of bills. I’m hoping we can at least get them to read a little deeper. Be on your toes. Mayhem is “recalculating.”

Conclusion

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3 Responses

  1. HIT savings myth
    I’m not wrong. I’m just early

    “The e-record cost-saving myth” by Sally C. Pipes was posted on the Open Forum of SFGate this morning.

    http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/05/02/EDDH1OC38A.DTL

    “Researchers from Harvard University and the City University of New York have cautioned that the federal government’s multibillion-dollar investments in health information technology might not be the boon their proponents claim.

    In fact, replacing the racks of manila folders at doctors’ offices across the country with electronic medical records might actually drive up the cost of health care without improving it.”

    Imagine that.

    Sally C. Pipes is president, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is “The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare,” (Regnery 2012).

    “Of course, hospitals and doctors’ offices should be free to adopt useful and cost-effective technological innovations. But government mandates that they do so distort incentives – and could end up doing more harm than good. By trying to speed the adoption of HIT, the government might slow it down – and cost taxpayers a lot of money in the process.” I call that another I told you so.

    I’ve also discovered that distorted incentives causes a few HIT stakeholders to be rude to customers.

    If our grandchildren are lucky, even more Americans will start to question the wisdom of mandating healthcare technology – along with HIPAA/HITECH and its inestimable cost. I say the sooner the better.

    D. Kellus Pruitt DDS

    Like

  2. HIT stakeholder responds

    Larry Lewis, Director Social Media and Digital Marketing at Smart Training in the DFW area, responded to my ME-P and Linkedin posts concerning the cost of HIPAA compliance. His company is actually under contract to the Texas Dental Association to promote the TDA’s “effective and efficient” online compliance training for the new TX-HB-300 privacy law. Sweet. He says HB 300 is even more stringent than HIPAA. (Special for frightened TDA members: only $27.50 from TDA Perks!)

    http://tda.org/displaycommon.cfm?an=1&subarticlenbr=2196

    Thanks, Larry. I like your tone.

    However, even though for some reason you think those who have responded have done a good job of giving me parameters of the cost, perhaps you should look again, but closer this time. You’ll notice that they’ve given me nothing – unless you count the snappy response that the cost of compliance is an (unknown) fraction of the fines for non-compliance. That’s not an estimate. That’s a hateful, but clever response that seemed OK this HIT group. But I sense that you’re different.

    Hell, Larry. I can’t persuade a single consultant to commit to an estimate of their cost! Where’s the parameter for that? You could help by asking consultants you know to simply share their average billings for small practices – including their list of services. Why do they resist, Larry?

    I still don’t how much non-productive staff time I’m expected to dedicate to not only fulfilling tedious HIPAA requirements, but to also document their fulfillment, year after year. If I’ve been provided “parameters” (wherever you found them), please show me how they can be used to estimate the necessary staff hours.

    You suggested that my concerns about HIPAA hinges on the Phoenix Cardiac clinic’s data breach. You might not have known me long enough to recognize the humor. Phoenix is just the latest in the increasing frequency of data breaches and the first small practice that has drawn HIPAA fines.

    Let me bring you up to speed: Over 96% of healthcare organizations have experienced reportable data breaches of patients PHI in the last 2 years. The frequency of data breaches doubled between 2010 and 2011 and is expected to double by the end of 2012. Identity thieves are increasingly targeting medical identities over financial, and will pay ten times more for medical IDs than social security numbers. Data breaches added $6.4 billion to the cost of healthcare last year. And finally, HHS Office of Civil Rights director Leon Rodriguez only days ago sent out word that he is targeting small practices for audits… And you think my concerns hinge on the Phoenix Cardiac clinic? That’s rich, Larry.

    But wait. There’s more, you say.

    As if $100,000 HIPAA fines aren’t enough to scare dentists from EHRs, you are telling me that Texas’ new TX-HB-300 state privacy and breach notification law is even more stringent?

    “The law expands the requirements for training, definitions of Covered Entities and breach notification requirements and harsher penalties.” Oh you sweet talker!

    I’ve discovered that HIPAA stakeholders don’t generally disapprove of obscene fines levied for HIPAA violations. I suspect that raising providers’ fear actually drives business their way. Am I right? How much do you expect TX-HB-300 to raise the cost of healthcare in Texas? Or do you think it will make Texans’ medical bills cheaper?

    Since it appears that you support the Phoenix clinic fine, would you say the doctors who own the clinic deserve to face bankruptcy – including ruined reputations for the remainder of their careers because of their admittedly careless mistake? Would you feel the same about me if someone in my office accidentally made a similar mistake, Larry?

    Last of all, you mentioned that the “TDA (Texas Dental Association) has taken a leadership role in providing HIPAA and TX-HB-300 compliance training online and at a very low cost. (27.50 for members) This will at least provide you a cost effective and efficient way of training your staff without it being terribly time consuming. I also believe that you can obtain a basic BA agreement template from TDA as well. ( Our office is contracted by TDA) If you need further info feel free to contact me.”

    So are you of the opinion that HIPAA consultants aren’t really necessary for effective training of staff like others have led me to believe? I think you can understand how confusing this can be.

    D. Kellus Pruitt DDS

    Like

  3. HIT

    “Will we leverage the power of digital technology to expand student’s minds and open up choices about how to live, or will we use it to monitor students’ behavior and tell them how to live?

    For example, much of the health-related technology that we are seeing involves asking children to count the calories they consume or expend when they are exercising.

    Is this this what we want students to be doing at school?”

    Michael Gard – Associate Professor
    [University of Queensland]

    Like

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