Healthcare Legislation to "Control the People?"

At "<span style="font-weight: bold;"><span style="text-decoration: underline;"></span></span><a href="http://hcrenewal.blogspot.com/2010/03/ama-and-nearly-100-other-physician.html">AMA And Almost 100 Physician Societies Sound Off To CMS On Health IT</a>" I referred to concern held by AMA and ~94 other medical specialty societies about comments overheard from senior government officials that:<br /><br /><span style="font-size:100%;"><span style="font-weight: bold;"></span></span><blockquote><span style="font-size:100%;"><span style="font-weight: bold;">complex measures and high reporting thresholds</span> are needed to discourage EP's - Eligible Professionals <span style="font-style: italic; color: rgb(255, 0, 0); font-weight: bold;">(i.e., eligible for government EHR subsidies)</span> from switching back to the use of paper during this transition to EHRs</span>.</blockquote><br />Such reporting requirements could not only 'discourage' a switch back to paper even if these 'government-approved' EHR's turned out to be a <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/?loc=cases&sloc=2009">clinical and/or operational nightmare</a> (which I feel is likely if not unavoidable based on numerous writings at this blog and <a href="http://www.tinyurl.com/healthITfailure">here</a>), but also could force event those planning to stay with paper and endure the "penalty" for doing so to move to computer systems. The human resources required to satisfy truly ominous reporting requirements via paper records might simply be too burdensome.<br /><br />This could be perceived as an ingenious and devious plan to establish control of healthcare providers via IT and data. (He who controls the data, controls the playing field.)<br /><br />Privacy activist Dr. Deborah Peel shares related concerns as expressed in a Wall Street Journal article yesterday "<a href="http://online.wsj.com/article/SB10001424052748703580904575132111888664060.html">Your Medical Records Aren't Secure</a>."<br /><br />Along the lines of control, now there's this, recently posted on <a href="http://www.drudgereport.com/">the Drudge Report</a>:<br /><br /><span style="font-weight: bold;"></span><blockquote><span style="font-weight: bold;font-size:100%;" >Shocking Audio: Rep. Dingell Says ObamaCare Will Eventually ‘Control the People’</span><span style="font-size:100%;"> (<a href="http://www.breitbart.tv/shocking-audio-rep-dingell-says-obamacare-will-eventually-control-the-people">link</a>)</span></blockquote><br />I don't care which "people" Dingell's referring to - 300 [sic] Americans (he left out "million"), physicians, insurers, etc. <span style="font-style: italic;">Our government has no business discussing "controlling" anyone.</span><br /><br />Ideology aside, the control mentality of government over medicine, facilitated by healthcare IT, is starting to rear an ugly head. I'm afraid this phenomenon might get really out of hand in the very near future.<br /><br />-- SS<br /><br />Addendum: there appears to be a <a href="http://hcrenewal.blogspot.com/2010/01/more-on-perversity-in-hit-world.html">healthcare IT industry sockpuppet</a> writing in the comments thread at the <a href="http://online.wsj.com/article/SB10001424052748703580904575132111888664060.html">aforementioned WSJ article</a> by Dr. Peel, under the especially inappropriate <span style="font-style: italic;">nom de blog</span> "Hank Dagny." The usual dismissal of physician concerns about HIT, unqualified statements, ad hominem attacks, and other games typical of an industry shill occur throughout that comment thread.<br /><br />See my reply <a href="http://online.wsj.com/article/SB10001424052748703580904575132111888664060.html#articleTabs_comments%3D%26articleTabs%3Dcomments%26commentId%3D1031862">at this link</a>. (It takes a moment to load the WSJ comment thread.)<br /><br />Also see this summary of a <a href="http://www.schneier.com/blog/archives/2010/03/electronic_heal.html">Canadian analysis of electronic health record security</a> at the blog of security technologist <a href="http://www.schneier.com/about.html">Bruce Schneier</a>. Hat tip to <span dir="ltr">Joseph Arpaia, MD</span>.

Healthcare Legislation to "Control the People?"

At "AMA And Almost 100 Physician Societies Sound Off To CMS On Health IT" I referred to concern held by AMA and ~94 other medical specialty societies about comments overheard from senior government o…

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On HIT Vendor Nondisclosure of Nondisclosure Agreements

Seen at the HIStalk blog in <a href="http://histalk2.com/2009/08/18/news-81909/">News of 8/19/09</a>:<br /><blockquote><br />A couple of readers wisely suggested that I not consider running nondisclosure language from vendor contracts. Reasons: (a) it might identify the client since terms are often customized; (b) it might violate vendor privacy requirements and get a client or me in trouble; (c) clients might not want to share anyway since they may like the idea of being prohibited from sharing patient safety information. A couple of vendors e-mailed to say they don’t include such terms. I’d be very surprised if Cerner and Epic don’t based on my limited history with them.<br /><br /></blockquote>My response to the HISTalk blog owner, Tim, and other interested parties:<br /><br /><blockquote><br /><table class="w100" cellpadding="0" cellspacing="0"><tbody><tr><td><table class="msgHd" cellpadding="0" cellspacing="0"><tbody><tr><td class="hdtxt">Sent: </td> <td class="hdtxnr"> Thursday, August 20, 2009 7:32 AM </td> </tr> <tr> <td class="hdtxt"> To: </td> <td class="hdtxnr"> <div id="divTo" class="rwWRO"><span class="rwRO"><a href="https://exchangeweb.drexel.edu/owa/?ae=Item&t=IPM.Note&a=New&to=mr_histalk%40yahoo.com&nm=mr_histalk%40yahoo.com" class="emadr">mr_histalk@yahoo.com</a></span></div> </td> </tr> <tr> <td class="hdtxt"> Cc: </td> <td class="hdtxnr"> <div id="divCc" class="rwWRO"><span class="rwRO"><a href="https://exchangeweb.drexel.edu/owa/?ae=Item&t=IPM.Note&a=New&to=david.kreda%40gmail.com&nm=david.kreda%40gmail.com" class="emadr">david.kreda@gmail.com</a></span>; <span class="rwRO"><a href="https://exchangeweb.drexel.edu/owa/?ae=Item&t=IPM.Note&a=New&to=rkoppel%40sas.upenn.edu&nm=rkoppel%40sas.upenn.edu" class="emadr">rkoppel@sas.upenn.edu</a></span>; <span class="rwRO"><a href="https://exchangeweb.drexel.edu/owa/?ae=Item&t=IPM.Note&a=New&to=Emilia_DiSanto%40finance-rep.senate.gov&nm=Emilia_DiSanto%40finance-rep.senate.gov" class="emadr">Emilia_DiSanto@finance-rep.senate.gov</a></span>; <span class="rwRO"><a href="https://exchangeweb.drexel.edu/owa/?ae=Item&t=IPM.Note&a=New&to=MChassin%40jointcommission.org&nm=MChassin%40jointcommission.org" class="emadr">MChassin@jointcommission.org</a></span>; <span class="rwRO"><a href="https://exchangeweb.drexel.edu/owa/?ae=Item&t=IPM.Note&a=New&to=pschyve%40jointcommission.org&nm=pschyve%40jointcommission.org" class="emadr">pschyve@jointcommission.org</a></span></div> </td> </tr> <tr style="display: none;" id="trAtt"> <td class="hdtxt"> Attachments: </td> <td id="tdAtt" style="display: none;" class="hdtxnr"></td> </tr> </tbody></table> </td> </tr> <tr> <td class="clp"><table class="w100" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><br /></td></tr></tbody></table></td> </tr> <tr> <td class="bdy"> <div class="bdy"> <div class="BodyFragment"> <span style="font-size:85%;"><div class="PlainText">To: HISTalk blog<br /><br /> Re: nondisclosure of nondisclosure agreements by HIT vendors<br /><br />Tim,<br /><br />Those who've written advising you *not* to post the language of HIT nondisclosure agreements <span style="font-weight: bold;">are in fact correct:</span><br /><br />As per Koppel and Kreda's March 2009 <a href="http://jama.ama-assn.org/cgi/content/extract/301/12/1276">"Hold Harmless" article</a> in JAMA and my <a href="http://hcrenewal.blogspot.com/2009/07/health-care-information-technology.html">July 21 JAMA letter</a> to the editor commenting on it, nondisclosure and hold harmless agreements stifle HIT innovation, put patients at risk, and cause healthcare executives to violate their Joint Commission and fiduciary responsibilities to protect patients and workers from undue physical or legal jeopardy.<br /><br />You and other bloggers should *not* be the ones to clandestinely obtain and post such language. The HIT vendors themselves, in an atmosphere of transparency and in deference to patients safety and to hospital governance, should gladly and transparently do so if such language exists in their contracts.<br /><br />This assumes, of course, that HIT vendors hold patient safety and practitioners' rights as a high priority.<br /><br />S.S.<br /></div></span></div></div></td></tr></tbody></table></blockquote><table class="w100" cellpadding="0" cellspacing="0"><tbody><tr><td class="bdy"><div class="bdy"><div class="BodyFragment"><span style="font-size:85%;"><div class="PlainText"></div></span></div></div><br /></td></tr></tbody></table>I think that says what needs to be said.<br /><br />-- SS

On HIT Vendor Nondisclosure of Nondisclosure Agreements

Seen at the HIStalk blog in News of 8/19/09:A couple of readers wisely suggested that I not consider running nondisclosure language from vendor contracts. Reasons: (a) it might identify the client sin…

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