I read the article twice and still don't get it. He seems to be saying that the EHR only needs to contain the information that the patient wants in there - which is fine with me. However, if people choose not to disclose that info to the govt., what's the friggin point?
So true.
I may dig a little deeper on this. I still feel people should not disclose any info to the govt. that they don't need to . Especially those that are paying their own way.
First, note that there's a
thread on the meaningful use regulations directly below this one (well, before I bump this one by responding to it). It has additional information on this topic.
That said, it sounds like you're proceeding here on the assumption that the goal of EHR adoption is to give the government access to your information. It's not. The government (whether you're defining that as the federal government or state) doesn't see this information. An electronic record is subject to the same privacy rules as a paper record--partly those are set by federal law, though state law supercedes the federal privacy laws if the state law is stricter.
The point is to get providers using electronic records and exchanging information to improve quality of care and cut costs (e.g. by better coordinating care, reducing medical errors, substantially reducing time and transaction costs, etc).
What about smoking? BMI's? High cholesterol? If insurers are going to do risk assessments and charge accordingly, wouldn't unprotected sex - abortions; STD's, etc. be considered risky behavior?
That kind of rating won't be happening anymore starting in 2014 (with the exception of tobacco use, in which case your premiums for a given plan can be up to 50% higher than those of a non-smoker buying the plan).
I'm confused. It says the info in the EHR is between the patient and doctor, that they decide what is or isn't included. It says the EHR program is voluntary, no specific info is required to be included in the records and the doctor needs the patients permission. If the doctor chooses not to participate, they get penalized by less than 100% of Medicare/aid payments. Ok. But then it says that the EHR must include a patient's 'problem list'. No specific info is required . . . except for the specific info that is required? What if the doctor wants to list this but the patient doesn't?
Yes, the EHR incentive program is voluntary. It's a system of incentive payments to Medicare and Medicaid doctors and hospitals who start using high-functioning EHRs, it's not a mandate (the state of Minnesota, on the other hand, passed a law in 2008 requiring universal use of EHRs in the state by 2015). No doctor has to participate, though as you noted Medicare doctors will see small reductions in the physician fee schedule if they're still using paper in a few years.
The Stage 1 requirement for the problem list is: "More than 80% of all unique patients seen by the EP or admitted to the eligible hospitalÂ’s or CAHÂ’s inpatient or emergency department (POS 21 or 23) have at least one entry or an indication that no problems are known for the patient recorded as structured data."
It doesn't require a problem list for every patient seen by a provider (though I don't know why you'd want an incomplete or inaccurate medical record), nor does it explicitly require comprehensiveness since it merely requires one item. Things like HIV status are generally have a special status as sensitive information in state law that grants them extra privacy protections.
Exactly zoom. I don't know if this is a poorly written article or the EHR component of the HC bill was poorly explained. I'm going to side with the latter.
Just as a sidenote, the EHR incentives aren't part of the health care bill. They're from the HITECH Act, which passed in February of 2009.
And Samson - of course insurers (or the eventual govt. UHC) is going to use this info to set premiums. Why else would anyone need it except the doctor who already has it?
Other doctors. One of the primary aims of health information exchange is to get your information to the person who needs it when they need it--be that in emergency situations or if you happen to go to someone other than your usual provider, if you're out of state, etc.
I know they'll be covered, but shouldn't their insurance cost more if that's the way they do it? In fact, doesn't it work that way now with "high risk policies" for people with HIV and cancer and what not?
Starting in 2014, insurers won't be able to price for risk, except in a very limited way based on age and tobacco use (with other rate variations allowed for family size and geography). What will happen instead is risk adjustment, administered by the states. Risk pools that have high-than-average risks will get a payment to offset the additional financial strain they're taking on.
