Learn and listen to our podcast about health care reform and reasons why the HITECH act wasted money to physicians.

This blog is from a podiatrist, physician, and small business entrepreneur’s point-of-view in St. Louis, MO.

First of all, this is completely my professional opinion about why I feel the government actually wasted $19.2 billion for health care reform, specifically on the HITECH act (health information technology for economic and clinical health act) which is a small part of health care reform.  Here is some of my background to prove that I have accurate evidence to support my opinion.  I’m a podiatrist (specialist doctor in the foot and ankle), in solo practice whom has used 4 different EMR systems, provided medical billing for 10 years (8.5 of the 10 years were all on my own), and run an established small business all by myself in the state of Missouri.  I am not saying that healthcare reform is bad, I just want to help educate the general public on a topic that will effect all hard working Americans and a topic that I feel is kept quiet by our government for various reasons.

Some information and facts about the EHR incentive program from the government:

• The HITECH act goals are to reduce cost of health care by integrating all electronic health records.
• Make treatments standardized for different medical conditions.
• To help exchange information between doctors. It will save money by stopping the use of multiple tests for same patient.
• Eligible professionals (doctors that are not hospital based) can receive up to $44,000 over five years under the Medicare EHR Incentive Program.
• Eligible professionals (doctors that are not hospital based) can receive up to $63,750 over the six years that they choose to participate in the Medicaid program
• The program was signed by President Obama on February 17, 2009 and is called the HITECH Act (health information technology for economic and clinical health act)

Now here are my reasons why this doctor incentive program is flawed:

1. The major point of having doctors use EMR was to connect all doctors into one system to be able to share information so that test and exams don’t get overused and to help reduce cost of healthcare.  However, EMR systems are all different and every doctor has different likes and dislikes.  For example, I like apple products and the IOS system but others may like windows or android type programs.

2. There are too many EMR systems (over 300 to be exact of paid and free versions) that are available today and how will the government be able to connect all of them to share information is nearly impossible, although the hospital systems (because most of them us epic systems)  may have a better chance.

3. Why should some specialists that don’t involve blood pressure issues, vaccination issues, smoking issues,  need to supply information that may or may not be relevant to the patient’s history.

4. What if you have a geriatric practice or nursing home practice (older folks) and they don’t have internet/email access for a doctor to remind them of their office visit or send them access of there medical records (two of the criteria that a doctor has to meet to qualify for the financial incentive).

5. There are many more criteria, that is mandated to be “meaningful use” that a provider will need to provide that will COST him/her more time and effort.  The time and effort that it takes to provide this information takes away from the time with the patients.  Have you ever visited a doctor recently and the whole time they were looking down at their laptop or their tablet and not really listening to you???  I’m sure some of you have and it will get worse.  I’m not saying technology is bad (I’m the last person that would say that for those that know me) but there’s a limit on physician-patient relationship that needs to go back to the old-fashion way.

Example, the most decent, current paid EMR systems cost providers $250-$400/month, that means that with the $44,000 (paid over 6 years) incentive that the government gives the provider to use EMR it will take 8-10 years for that money to run out (if they are solely putting that money toward their EMR) then it would start costing the provider.  However, there are free EMRs available that won’t cost the provider anything, but that’s another issue that I will get to later.  I’m just talking about the cost not about the time it takes to learn the system, pay your staff to learn the system, education and adding special templates and notes to each system, and time to use the system versus talking to your patients face to face.

Should doctors take advantage of free EHR systems?

Practice fusion is one example of a free EHR system. They are considered the “Facebook of EHR”. However, can you deal with the banner ads?  Very similar to Pandora or Skype that are free and supported by other means.  Free systems are paid for by advertisements.  Would a doctor want there large practice supported by a system that is dependent on ads?  What if the companies decide to stop advertising?  Will the system go down?  Then transferring to another system is very tricky and time consuming and costly, trust me, I’ve done it twice now.  Why would a doctor even look at those ads, and if he or she was, then they are wasting time in the treatment of the patient!

They are also supported by private investors, software companies and pharmaceutical companies selling drugs that I feel are overused in the USA.  Pharmaceuticals are expensive and cost the healthcare industry a ton of money.  I’m not saying get rid of all drugs, but I believe that most physicians overuse oral medications and need to find a way to prevent diseases or treat with natural or other less expensive means.  In 2012, the cost of prescription drugs were $325.8 billion!  (Approximately $67.1 billion of that was Medicare Part D and $17 billion from Medicaid.)  That’s a whole other issue that I don’t have time for in this discussion.

Lastly, about free EHRs, the owners of the free systems won’t tell you the other ways it gets revenue but we think from data it’s collecting and selling to other companies, mostly pharmaceuticals, like Facebook does.  They collect information that will tell other companies where you “like” things.  They are stealing your information for their benefit.  Every time you hit “like” on a social media page, every time you search for something, you are essentially giving that company free information that helps them target you for future ads and income!  They should be paying you for that information!

This is basically the reason for the HITECH act.  Really? Your going to pay doctors and penalize them if they don’t support the HITECH act (doctors have until 7/1/2014 to attest with an EHR system or they will be penalized)?  That doesn’t seem to American like and supposedly a free country.  The reason the government wants doctors on board is that the data they receive from our EMR systems (demographics, blood pressures, smoking issues, weight, height, chronic diseases, etc).  Why do we need this data?  They could’ve easily got it through the billing and coding system that we already use and the update that will be ICD 10 next year.  In my opinion, it’s called the drug world!  The pharmaceutical world will be paying for this information to help them provide medications to patients.  They will be able to target exact areas of the country that doctors have helped them find for THEIR profit.  Of course we all know that the FDA gets their financial share of all drugs!  So think about it, the HITECH act is a small investment for the government that will get them billions more.  Lets just hope that they use that investment to improve healthcare.

What the government should’ve done?

• Send out letters to every non-hospital based physician to see if they would be interested in participating in forming committees for each specialty to represent all the physicians in the White house.  I would’ve been the first one to sign up!
• Hire well trained IT specialists and have them communicate with technological inclined physicians in each specialty to help develop a universal EMR product that all physicians could use for free (a lot cheaper than paying each doctor $44,000).  There would be 3 types of software products to choose from that would satisfy each type of operating system (IOS, Windows, Android) in the computer world and be able to share data between all 3 systems.
• Tax the pharmaceutical companies and any medical device makers that has been making billions at the expense of doctors and hospitals.

If you want to complete details on the EHR incentive program please see the website here.

Why I feel the government actually wasted $19.2 billion on the HITECH act (health information technology for economic and clinical health act) which is a small part of healthcare reform.