Article – AMA: EHRs create ‘appalling Catch-22’

I enjoyed this article.

Often, policymakers and executives debate the merits of an initiative. What is often lost in the shuffle are the important lessons and optimizations that make the program a success.

In the article, a number of folks discuss the implications of an EMR after implementation, including the possibility of fraud, or the incorrect perception that it has occurred.

My thoughts…

  • Fraud is easier to detect the more the information is electronic and coded. In fact, any pattern is easier to detect if extensive, well-structured data is available. Algorithms that detect possible fraud patterns will emerge, just as they did for credit card transactions. I recall a investigative news show on Medicare fraud where the agent stated that the move to electronic transactions and ‘smarter and smarter’ alogrithms have made their job easier. False positives will be a problem for a while until they get it right.
  • Coding of records is about to become a huge push. Beyond regulations for coding of data, there are several initiatives to provide codes for orderable procedures, lab/clinical observations, medical terms, diseases, medical/surgical/diagnostic services, and even imaging workflow concepts. Other groups are working to provide practical guidance on how to best use these codes in different contexts. This article talks about the need for better and more coding.

And here is an article on a Web site where EMR users can rate their EMR. There are some interesting comments in the article.

Also, an Accenture survey finds a significant increase in the use of EMR and HIE technology by physicians.

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