A Recent Round-Up
“Feds push forward with controversial health rule – The Obama administration is moving ahead with controversial new rules that require doctors to switch to electronic health records or face fees, resisting calls from both parties to delay implementation.”
By Sarah Ferris for The Hill, October 6, 2015
“The Gag Clause is Killing Us – Doctors are barred from discussing safety glitches in software… And what if doctors — your doctor — is unable to make problems with EHR programs public, due to a so-called ‘gag clause’ written into the contract with the software company, which forbids sharing and publishing, in any form, of potentially dangerous flaws in the IT systems? This is already happening.”
By Deirdre Reilly for HealthZette, October 6, 2015
http://www.lifezette.com/healthzette/gag-clause-is-killing-us/
“Hackers target Australian health sector, selling records for A$1,000 – Hackers are targeting the Australian health sector, with fully populated digital health records sold on the black market for up to A$1,000 each [$720 US].”
By Beverley Head for ComputerWeekly.com, October 7, 2015
“Electronic health records software often written without doctors’ input – The reason why many doctors find electronic health records (EHR) difficult to use might be that the software wasn’t properly tested, researchers suggests.”
By Kathryn Doyle for Reuters, October 7, 2015
http://www.reuters.com/article/2015/10/07/us-health-software-ehr-idUSKCN0S11OY20151007
“EHRs provide long-term savings, convenience.”
(no byline), American Dental Association, ADA News, December 6, 2013
***
More:
- The Percentage of Office-Based Doctors with EHRs
- Do Nurses like EHRs?
- EHRs – Still Not Ready For Prime Time
- The “Price” of eHRs
Conclusion
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Filed under: Information Technology, Pruitt's Platform | Tagged: Darrell Pruitt DDS, EHRs, electronic medical records |
















Ransomware vs. EHRs
[Evil just won – Doc]
Not only has ransomware recently become capable of infecting backup files – the ultimate defense against malevolent encryption – but extortion threats now include publishing patients’ medical identities if the ransom is not paid (one or more times).
“Cryptowall 4.0: Update makes world’s worst ransomware worse still – Now you won’t even know what files are encrypted.” By Darren Pauli for The Register, November 9, 2015.
http://www.theregister.co.uk/2015/11/09/cryptowall_40/
“The fourth iteration of the world’s worst ransomware Cryptowall has surfaced with gnarlier encryption tactics and better evasion tricks that have fooled current antivirus platforms. Ransomware has ripped through scores of businesses and end-user machines in sporadic and targeted attacks that have cost victims millions of dollars in ransom payments made to criminals who have illegally encrypted valuable files.”
Pauli continues: “One of the most unique was a variant that silently encrypted and decrypted databases on the fly in a bid to avoid detection. That meant months of backups would contain encrypted data that could not be decrypted unless a ransom was paid for the respective key. Another [tactic] revealed last week threatened user data would be published online if a ransom was not paid. There is no indication the Chimera ransomware lived up to that capability according to analysis.”
How many medical identities will be posted on the internet before infuriated patients turn to providers with paper records? Starting a decade ago, I warned of this and was ignored by leaders who could have made a difference.
Solution: To protect patients’ welfare, dentists can either de-identify their primary electronic dental records, or return to paper.
…. Still too early?
D. Kellus Pruitt DDS
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Which offers ISIS a softer target – our southern border or HIPAA-covered entities?
Remember the 2013 data breach causing 9,000 dental patients’ PHI to appear indefinitely on the internet? See: “Pennsylvania dental patients’ stolen social security numbers posted online – EDR Data breach in Williamsport, Pennsylvania,” by D. Kellus Pruitt DDS for the Medical Executive-Post, November 29, 2013.
My article was followed 10 days later as “breaking” news in Williamsport: “Stolen: Data on Thousands of Williamsport Area Dental Patients,” by Dave Bohman for WNEP News, Williamsport, December 9, 2013.
http://wnep.com/2013/12/09/stolen-data-on-thousands-of-williamsport-area-dental-patients/
The breach was discovered and dutifully reported to authorities (and WNEP) by security expert Justin Shafer, and was hastily attributed to an unknown hacker before the case was closed. However, in the last few hours, Justin discovered otherwise, and followed the “torrent” to a computer in Baghdad which is hosting the sharing of the files on PirateBay. Shafer performed when the FBI was clueless and impatient.
http://justinshafer.blogspot.com/2015/11/williamsport-pa-databreach-update.html
Thanks, Justin.
Should we be concerned that ISIS might be collecting Americans’ medical identities? If I were a terrorist cell, that’s the soft spot I would hit – perhaps as a preemptive first blow in a coordinated cyber-attack.
EHRs – Soft Targets!
D. Kellus Pruitt DDS
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Providers Press for Delay, Flexibility in EHR Rule
The federal government’s $31.7 billion electronic health-record incentive payment program needs to be refocused on promoting interoperability of electronic health-record systems, improving their usability and enhancing outcomes instead of measuring processes, according to comments on the feds’ latest round of program rules.
Several groups, including the American College of Cardiology, asked CMS rulemakers to scrap full-year reporting periods for meaningful-use metrics, replacing them with 90-day periods.
The groups also asked the CMS to end the program’s pass-fail requirement, which has been in place since its inception. It requires hospitals, physicians, and other eligible professionals to meet all meaningful-use criteria to receive incentives payments and avoid program penalties.
Source: Joseph Conn, Modern Healthcare [12/16/15]
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Patients are also unhappy with doctors’ EHR use
Not surprising, but how do we fix this problem? Find out more here:
http://medicaleconomics.modernmedicine.com/medical-economics/news/patients-unhappy-doctors-ehr-use
Jeff
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CMS Makes it Easier to Opt Out of EHR Requirements
The CMS is making it easier for providers to waive out meaningful use requirements of electronic health records amid a series of proposed changes to the 6-year-old $31.8 billion EHR incentive payment program.
In December, President Barack Obama signed the Patient Access and Medicare Protection Act, which expanded providers’ eligibility for hardship exemptions to Stage 2 of the meaningful-use program.
Basically, the law provides the CMS with the authority to batch process hardship applications by categories instead of a case-by-case method used previously.
To comply with the law, the CMS posted a new streamlined hardship application, reducing the amount of information that providers must submit to apply for an exception. Eligible professionals will have until March 15 to apply for an exemption.
Source: Virgil Dickson, Modern Healthcare [1/22/16]
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Ransomware Wreaking Havoc in American Hospitals
In the past few weeks, ransomware viruses have placed three hospitals under siege.
Ransomware is a form of malicious code that blocks owners from their own data by encrypting them with a key solely belonging to the hackers and deleting its original copies
http://www.msn.com/en-us/news/us/ransomware-wreaking-havoc-in-american-hospitals/ar-BBqPur0?li=BBnb4R7&ocid=U348DHP
Hope Hetico RN MHA
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Why the AMA’s new president Dr. Andy Gurman doesn’t use an EHR
Andrew Gurman MD, is an orthopedic hand surgeon from Hollidaysburg, Pa., and the newly inaugurated president of the American Medical Association. Dr. Gurman also doesn’t use an EHR.
http://www.beckershospitalreview.com/healthcare-information-technology/why-the-ama-s-new-president-dr-andy-gurman-doesn-t-use-an-ehr.html
“I don’t have an EHR,” Dr. Gurman told MD Magazine. “I just take the penalties.”
Dr. David Marcinko MBA
http://www.BusinessofMedicalPractice.com
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IN THE NEWS
– “Congress says HHS has to step up efforts to secure nation’s medical records” By Joseph Conn for Modern Healthcare, September 28, 2016.
http://www.modernhealthcare.com/article/20160928/NEWS/160929887/congress-says-hhs-has-to-step-up-efforts-to-secure-nations-medical
Conn: “The Government Accountability Office, responding to an inquiry by Congress, made it ‘official’ this week: HHS has failed to protect the privacy and security of electronic patient records from hackers, data thieves and voyeurs.”
– “Doctors already burned out over policy requirements as MACRA rollout looms, survey finds” By Beth Jones Sanborn, Managing Editor, Healthcare Finance, September 28, 2016
http://www.healthcarefinancenews.com/news/doctors-already-burned-out-over-policy-requirements-macra-rollout-looms-survey-finds
Sanborn: “Physician morale is low, which is leading them to be less prepared for healthcare reforms like MACRA and value-based reimbursement, according to a new survey from The Physician’s Foundation and Merritt Hawkins. In fact, the pressures of the job has 48 percent of physicians planning to retire, cut back on patients or hours, or seek non-clinical, administrative roles.
– “Doctors: E-health records raise costs, don’t help patient outcomes” By Lucas Mearian for Computerworld, September 29, 2016.
http://www.computerworld.com/article/3125590/healthcare-it/doctors-e-health-records-raise-costs-dont-help-patient-outcomes.html
Mearian: “Three out of four U.S. physicians believe that electronic healthcare records (EHRs) increase practice costs — outweighing any efficiency savings — and seven out of 10 think they reduce productivity, according to a new survey.” He adds, “Physicians are less likely to think that EHR capabilities support clinical outcomes than they did in the 2014 survey.”
D. Kellus Pruitt DDS
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7 in 10 Physicians Say EHRs Reduce Their Productivity
Deloitte Consulting recently released results from their 2016 Survey of US Physicians regarding electronic health records. Here are some key findings from the report:
• 7 out of 10 physicians think that EHRs reduce their productivity.
• 78% of physicians believe that EHRs are useful for analytics and reporting.
• 3 in 4 physicians believe that EHRs increase costs, outweighing any savings.
• 47% of physicians believe that EHRs improve clinical outcomes vs. 55% in 2014.
• 3 out of 5 would keep the current EHR system they have and not replace it.
• 62% want improved interoperability from their EHRs.
Source: Deloitte Consulting, October 2016
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“Post-EHR era: Bunk buzzword or here before long?
CIOs from Healthcare IT News’ Best Hospital IT Departments 2016 share their take on the fate of electronic health records.
-November 7, 2016
http://www.healthcareitnews.com/news/post-ehr-era-bunk-buzzword-or-here-long
darrelldk2
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“Patients don’t trust health information technology,”
Gienna Shaw
FierceHealthcare
http://www.fiercehealthcare.com/it/patients-don-t-trust-health-information-technology
More than 50% of consumers are skeptical about the benefits of healthcare information technologies, including patient portals, mobile apps and electronic health records. And fully 70% of Americans distrust health technology, up sharply from just 10% in 2014.
“More than 50% of consumers are skeptical about the benefits of healthcare information technologies including patient portals, mobile apps and electronic health records. And fully 70% of Americans distrust health technology, up sharply from just 10% in 2014.”
Hello paper dental records!
(I warned about this a decade ago).
D. Kellus Pruitt DDS
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EHR article:
“EHRs, hectic work environment drive family doctors’ burnout: By Paige Minemyer for FierceHealthcare.com, May 12, 2017
http://www.fiercehealthcare.com/practices/ehrs-hectic-work-environment-drive-family-docs-burnout
EHR commentary:
“Death By A Thousand Clicks: Leading Boston Doctors Decry Electronic Medical Records” By Drs. John Levinson, Bruce H. Price and Vikas Saini for WBUR, May 12, 2017 http://www.wbur.org/commonhealth/2017/05/12/boston-electronic-medical-records
EHR ad:
“EHRs provide long-term savings and convenience” Anonymous, for the ADA News, December 6, 2013.
http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience
D. Kellus Pruitt DDS
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EHRs in the news – take cover now
“Global malware attack hits Wisconsin health care providers – New malware that has swept through computers in more than 60 countries has disrupted medical transcription services at some Wisconsin hospitals.” By Rick Barrett for the Milwaukee Journal Sentinel, July 1, 2017.
http://www.jsonline.com/story/news/local/wisconsin/2017/07/01/global-malware-attack-hits-wisconsin-health-care-providers/446133001/
“Ransomware Attacks: Half Of All Organizations Hit By Ransomware Suffer Multiple Attacks – Thirty-eight percent of respondents said they were hit by two to three ransomware attacks, while 12 percent reported falling victim to 4 or more attacks, indicating that recovering from a ransomware attack doesn’t guarantee an organization is prepared for or immune from another in the future.” By AJ Dellinger for IBTimes, June 30, 2017.
http://www.ibtimes.com/ransomware-attacks-half-all-organizations-hit-ransomware-suffer-multiple-attacks-2560086
“Ransomware attack is cover for something far more destructive – Using ransomware as a cover for national attacks has serious implications not just for governments. Innocent people end up in the crossfire of these massive cyberattacks. Whether it’s hospitals, universities, supermarkets, airports or even a chocolate factory in the firing line, the mess eventually trickles down to you. It could mean not being able to get your medicine because Merck’s data is compromised or having flights grounded at a hacked airport.” By Alfred Ng for cnet.com, July 1, 2017.
https://www.cnet.com/news/ransomware-attack-goldeneye-petya-cover-data-destroy-nation-state/
Nevertheless, the American Dental Association stands stoically behind their anonymous, incredible claim that “EHRs provide long-term savings and convenience.” No byline, ADA News, December 6, 2013.
http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience
Good News:
As of this afternoon, there have still been no reports of successful malware attacks on paper records stored in filing cabinets. What’s more, paper records can be read by flashlight.
D. Kellus Pruitt DDS
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CDI: Bottom 5 States for EHR Adoption
1. New Jersey
2. Rhode Island
3. Louisiana
4. Hawaii
5. Vermont
Source: Center for Data Innovation
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Practice Fusion
Employees at Practice Fusion expected IPO riches, but got nothing as execs pocketed millions.
https://www.msn.com/en-us/money/companies/employees-at-practice-fusion-expected-ipo-riches-but-got-nothing-as-execs-pocketed-millions/ar-AAv5aQv?ocid=spartandhp
Nancy
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EHRs: Evidence of a national scam
“Are Electronic Medical Records Ethical?”
By Jamie Wells, M.D. for American Council on Science and Health — April 17, 2018.
https://www.acsh.org/news/2018/04/17/are-electronic-medical-records-ethical-12848
Dr. Wells: “Electronic medical records (EMRs) were pitched as a long-sought concept of computerized universal personal health material that would mitigate issues with access and barriers to care. In reality, when I speak of EMRs, I am referring to what they actually delivered to physicians, billing platforms that marginalize meaningful patient data necessary to inform diagnosis and therapeutic interventions.”
My comment: Beautifully stated, Dr. Wells. In one-size-fits-all healthcare, electronic dental records are a poor fit. Dentistry is often an afterthought. A basic difference between dental and medical practices is due to the number of patients they can treat per day. Whereas a dentist might have two or three thousand active patients, physicians have tens of thousands. What’s more, dentists only bill for treatments related to the lower face.
Here are the facts about electronic dental records which dental industry leaders censor or otherwise ignore due to conflicts of interest – including coding: Dental EHRs are not only more expensive and less secure than paper dental records, but they require more training and offer patients NO TANGIBLE BENEFITS over paper to offset their cost and danger.
How is that not a scam?
D. Kellus Pruitt DDS
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CMS Proposed Rule on EHRs Seeks to Reduce Provider Burden
The Centers for Medicare and Medicaid Services just followed through on its promise to institute an overhaul of the Meaningful Use program designed to reduce the burdens on providers in terms of time and cost, while also increasing the program’s focus on interoperability. The policy changes to the Meaningful Use program—which has been renamed the “Promoting Interoperability” program includes the use of 90-day electronic health record reporting periods in 2019 and 2020.
Further, the proposed rule includes the requirement for providers to use the 2015 Edition certified EHR technology in 2019 to qualify for incentive payments and avoid reductions to Medicare payments. In announcing the proposed rule, CMS Administrator Seema Verma said the aim is to remove unnecessary, redundant, and process-driven quality measures from a number of reporting and pay-for-performance programs.
Source: Greg Slabodkin, Health Data Management [4/25/18]
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More bad news for EHRs
“Report: Cyber Attacks on the Rise and Evolving, as Ransomware Declines – Cyberthreats are continuing to increase and shift, and even though ransomware attacks are significantly declining, cyberattacks are on the rise, according to a new report from the global association ISACA.”
By Heather Landi
Healthcare Informatics
June 14, 2018.
https://www.healthcare-informatics.com/news-item/cybersecurity/report-cyber-attacks-rise-and-evolving-ransomware-declines
That’s one more worrisome development in EHRs that doesn’t affect dentists with paper dental records. Electronic dental records are a scam. They have always been a scam.
Darrell Pruitt DDS
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EHRs are #1 on a list of “crappy technologies.”
“10 Crappy Technologies – Hints as to why we should limit our faith in edtech.” By Joshua Kim for Inside Higher Ed, July 2, 2018.
Kim: “The reasons to be skeptical of educational technologies are the same reasons to be skeptical of any technological solution. Often, they just don’t work.”
#1 on his list of technology which has made life worse: Electronic Medical Records.
Kim: “If you think that technology has been bad for higher ed, you might feel better if you spent some time in healthcare. The electronic medical record (EMR) has been an unmitigated disaster in medicine.” Kim adds, “The EMR has completely failed to live up to its promise of better health through data collection and mining, and instead has been used as a tool to increase billing. The EMR has turned doctors into the world’s most highly trained data-entry clerks.”
See. It’s not just me, ADA officials. Get your damn head into the game! Quit sacrificing my profession for non-dues revenue gained through coding, electronic dental records and other ADA Business Resources™ conflicts of interest.
Darrell K. Pruitt DDS
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