Confusion About “Meaningful Use” Reigns

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Are Doctors Embracing or Ignoring ARRA?

By D. Kellus Pruitt DDS

pruittAre physicians embracing ARRA Meaningful Use cash incentives or ignoring them? That depends on whom one asks.

Doctors versus the Feds

National progress towards Meaningful Use of expensive EHRs depends on whether one talks to federal employees whose jobs depend on the stimulus mandate, or doctors who purchase EHRs to improve care rather than to use them … Meaningfully.

The Feds

Today, Joseph Conn, writing for ModernHealthcare, posted a rosy outlook for MU adoption according to researchers working for HHS’ Office of the National Coordinator (ONC). They base their optimism for job security on a recent National Center for Health Statistics (NCHS) survey:

“A growing number of office-based physicians are using more-robust EHRs that have higher-level functions needed to help the doctors qualify for federal EHR incentive payments [for Meaningful Use] and assist them in providing better, safer care for patients, the researchers reported.” (See “Researchers: More doctors using more-sophisticated EHRs”).

eMR and HIT Security

The Doctors

However, yesterday, in an InformationWeek article by Ken Terry titled, “Meaningful Use Doesn’t Drive Doctors’ EHR Selection,” doctors suggested a more depressing future for MU sophistication based on the same NCHS survey:

“Jason Mitchell, MD, assistant director of the Center for Health IT at the American Academy of Family Physicians (AAFP), told InformationWeek Healthcare that he found [the lagging adoption of MU-capable EHRs] puzzling. While there’s no doubt that Meaningful Use has driven much of the increase in EHR use, he said, it seems strange that so many physicians would buy and implement EHRs that could not be used to show Meaningful Use.”


Whom should doctors believe – HHS employees who give away billions of stimulus dollars for Meaningful Use, or family physicians who have determined that the subsidy isn’t worth the cost and effort?


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Product Details

Is JAMA Censoring Physician Dissent?

Allegedly Stoops to “Name-Calling”

By Dr. David Edward Marcinko; MBA, CMP™dem24

According to the Wall Street Journal Health Blog, Jonathan Leo, a professor of neuro-anatomy from a small university in Tennessee, critiqued a study published in the Journal of the America Medical Association [JAMA], and pointed out an association between the study’s author and a pharmaceutical company. He posted his thoughts on the website of the British Medical Journal [BMJ].

JAMA Responds

According to the report, a none-too-happy Leo then received calls from JAMA’s executive deputy editor, one Mr. Phil Fontanarosa. And surprisingly, Editor-in-Chief Dr. Catherine DeAngelis, MD got involved by asking Leo’s superiors to retract his post from the BMJ’s site. Sound familiar ME-P readers? According to Keven Pho MD, the WSJ called Dr. DeAngelis for comment, and this is how the interview allegedly went:

“This guy is a nobody and a nothing.”

She said of Leo.

“He is trying to make a name for himself. Please call me about something important.”

She added that Leo

“Should be spending time with his students instead of doing this.”

When asked if she called his superiors and what she said to them, DeAngelis supposedly said,

“It is none of your business.”

Environmental Scanning

One can only wonder if the AMA has adopted the strategy of former CDC Director Julie Gerberding, of Atlanta, GA. Local gossip suggests that one initiative under her noxious leadership was her so-called policy on “environment-scanning” or, monitoring the news-media, internet space, blogs, wikis and other venues to identify “emerging threats to the agencies” reputation.” WOWSA!


An Alternative Theory

My alternative opinion is the AMA might be taking censorship lessons from Blue Cross and Blue Shield of New Mexico [BCBSNM], and its’ public-relations representative and former reporter, Ross Blackstone of the Health Care Service Corporation [Blue Cross and Blue Shield of Illinois, New Mexico, Oklahoma and Texas].

Monitoring the ME-P?

Or, perhaps they are reading [Think: monitoring] this Medical Executive-Post itself? They may even be teaming up with Becky Kenny [media relations specialist with Blue Cross and Blue Shield of New Mexico] who goaded [threatened?] the trade magazine ModernHealthcare. As ME-P readers know, ModernHealthcare is an advertiser-driven media outlet that removed a perfectly acceptable post of diverging eHR opinion from its blogsite?

Industry Shame

Such acquiescence is both a sign of shameful health insurance industry [BCBSNM] heavy-handedness, and poor journalistic ethos from ModernHealthcare’s leadership. The BCBSNM public relations hacks, and media representatives, also appear as clueless shills who are no-doubt glad they are employed in these troubling economic times.

In other words, do they do what they are told? Jump Rover! Fetch Fido; etc! Or; are they more like the innocent child who spills grape juice on a white carpet? Let’s simply forgive them for their brainless duplicity. Yet, MH capitulated; how unfortunate!


Doctors Censoring Patients [The Retro-Evolution]

By the way:

“What’s up with all this censoring?

The Internet has been publically available to the masses since 1995, and I was using electronic bulletin boards [eBBs] years before then. The next thing you know, doctors will start trying to censor the opinion of their patients, much like customers rate restaurants.

Ops! My bad! This has already occurred. Sorry!

The ironic thing here is that patients don’t know about quality care. But, they do know if they’ve been kept too long in the waiting room; or, if the doctor’s office staff was surly; or, if the doctor had a miserable bedside manner. So, the doctors are really being rated on their personality; not their medical acumen. I pity the fools. These medical guys, and healthcare guru gals, just don’t seem to realize that “perception is reality.”  But, they sure feign outrage at poor patient reviews.



From my perspective, this is another public-relations disaster for JAMA, and especially Dr. DeAngelis, who must have known she was on the record with a national newspaper. After all, she is the editor of JAMA. Maybe not however, as we have previously opined that professional experts are not necessarily professional journalists.


Of Cover-Ups and Crimes

“But, one must still wonder aloud; is this cover-up becoming worse than the proverbial crime?”

Resorting to personal attacks is somewhat unbecoming of the editor-in-chief of a prestigious medical journal, and reflects poorly on JAMA; don’t you think? Then again, JAMA and the AMA itself, is not as prestigious as it once was; is it?

In fact, when I asked ME-P managing-editor and Professor of Health Administration, Hope Rachel Hetico; RN, MHA, CMP™ to opine on admitted third-party limited information; she graciously replied with the utmost gentleness:

“With less than 25% of the nation’s MDs in the AMA; JAMA is probably still somewhat prestigious to those who don’t know any better; but many of us do know better. The older generation just needs some-time to catch up to modernity, and transparency – or resign. The top-down and command-control model of leadership is long gone – please be patient with them.”




And so, your thoughts and comments on this Medical Executive-Post are appreciated. Should Catherine DeAngelis MD resign over this incident? Please criticize or defend her actions. Is healthcare industry censorship on the rise – or is the industry just following-the-money? What do you think of ModernHealthcare or BCBSNM?

Is personal integrity – or scrutiny – the reason Joseph Biederman MD [Harvard’s controversial chief of pediatric psychopharmacology] ended his ties to the pharmaceutical industry recently for diagnosing bipolar disorder in children [as well as for the nature of big-pharma’s support behind his research]? Please opine.

Industry Indignation Index: 63

Disclaimer: I am not a member of the AMA. But, for a decade I was on the editorial staff of both a leading national medical, and surgical journal, back-in-the-day. I am currently the Editor-in-Chief of Healthcare Organizations [Financial Management Strategies] a 1,200 page, quarterly premium print-journal, available on a subscription basis.


Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact:  or Bio:

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Don’t Rush Into eHRs

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Address Medical ID Theft


[By Darrell Pruitt; DDS]

Yesterday, an important message titled “Don’t Rush eHRs Without Addressing Medical ID Theft” was posted on by Martin Ethridgehill, a provider training specialist with Blue Cross and Blue Shield of New Mexico.


Mr. Ethridgehill points out that if a patient’s electronic medical identity is stolen by someone for health insurance benefits, critical information about the patient can be imperceptibly altered, leading to accidental death in an emergency room for any number of reasons.  Furthermore, he points out that even if the real patient is aware that his or her record is tainted by a false patient’s data, it is very difficult to get the comingled record cleared up.

I have also read elsewhere that HIPAA actually impedes resolution of the nightmare because the Rule also protects the privacy of the false patient – prohibiting the real patient from examining his or her own health record.

Reasons to Go Slow 

Ethridgehill is particularly critical of the EHR industry which lately has downplayed the importance of patient privacy in order to sell dangerous products.  He gives these reasons for the need to slow down in the rush for interoperability:

  • “Adding safety and records mitigation protocols ensures patient safety as an ongoing concept and practice.”
  • “No industry would be allowed to operate, where the officials in charge of it stated that the market or other bodies would be responsible for creating safety procedures. Can you imagine if the auto industry stated, “We make cars, let the market figure out how to regulate safety”? I doubt that Congress or any other body would consider these people as remotely credible, yet I hear time and time again these statements being made in public and private forums by executives, lobbyists, and even so-called healthcare leaders.”
  • “For the public and providers to embrace a product that has no regulation, no built-in safeguards and obviously no importance to safety from the makers of these products, why would Congress expect the American public or healthcare providers to embrace a product or concept that involves the unregulated risk of injury, death, or staggering liability opportunities, let alone without any hope of remedy or proper relief?”


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact:


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