Friday, June 20, 2008

House of Representatives Hearing on HIT: an Action Alert from the Assoc. of American Physicians and Surgeons

Received this from the Association of American Physicians and Surgeons, a conservative group. I largely agree with their points (my comments in red italic):

Action Alert - House Hearing on HIT

The Health Subcommittee of the House Committee on Energy and Commerce will be holding a hearing on Health Information Technology legislation next week. If your member of Congress is listed below, please contact his office by Tuesday morning of next week. Ask to speak to the health LA (legislative assistant). Tell him you are a doctor and explain briefly why the federal government should not be promoting, mandating, or funding Health Information Technology. This needs to develop in the free market; the congressman should oppose all HIT legislation.

AAPS Talking Points:

1. It is an unconstitutional intrusion into private affairs. Congress has no constitutional authority to dictate how private medical records should be kept. The only nexus for the exercise of such power is the filing of a claim for federal payment. Thus, any records related to services for which no federal claim is made must be exempt.

[Not only do they have no authority, they have no expertise in the complexities of EMR, complexities the Health IT industry conceals as they rip off physicians and medical centers with overpriced, substandard crap. One should only read the lawsuit my university, Drexel, filed against its EMR supplier, Allscripts, for example. This document is public - ed.]

2. The bill is really a form of corporate welfare. The cost of acquiring a compliant medical records system is an unfunded mandate on private practitioners, and hence an unlegislated and unconstitutional tax. The benefits primarily accrue to the private partner [e.g., payors - ed.] in the public-private partnership, not to the general welfare.

[That is what the latest evidence points to - ed.]

3. There is no evidence that the bill will work as intended. It is assumed that HIT will improve quality or reduce costs, but there is much evidence to suggest that the opposite will occur.

[see my website and my many posts on HCRENEWAL for substantiation of that - ed.]

4. Mandating HIT amounts to regulating the practice of medicine. “Quality monitoring” of practitioners effectively dictates how medicine must be practiced to obtain a government-approval rating. Congress has neither the expertise nor the constitutional authority to direct the practice of medicine. It cannot delegate to government agencies or private organizations authority that it does not have.

[indeed, although businesspeople, IT personnel, and others don't have the expertise, either, but that doesn't seem to stop them from trying - ed.]

5. HIT is vulnerable to terrorism and disaster. Congress should make no law regarding the use of computerized medical records that does not require that all such records systems are EMP-hardened and have adequate backup electrical generating facilities (and stored fuel for same) to keep the system up (including air conditioning) for 60-90 days in the event of disruption of the electrical grid. Has there even been a study of the effect of a prolonged blackout on a hospital that is solely dependent on electronic records?

[yes - one I'm aware of - a few days - and it wasn't pretty - "
Computer Crash — Lessons from a System Failure", NEJM, Volume 348:881-882, March 6, 2003. The Bay Pines, Florida VA Hospital's $450 million dollar CoreFLS debacle, while not an EMR system or blackout due to power failure per se, is another useful example, as chronic system issues disrupted the hospital's supply chain and prevented performance of surgery as a result - ed.]

-- SS

1 comment:

Kevin said...

What of Hardcopy Reocrd vulnerabilities?

I note the valid points about the vulnerabilities of electronic based health records.

For a balanced discussion of the matter though, the counter point about the vulnerabilities of hard copy records must be raised. At least with electronic records, there is the scope for multiple backups off site from the affected area(s), something quite impractical for hard copy records. What of the potential for permanent loss of records secondary to fire/flooding etc. when you can't do such back ups?

It would be interesting to see the actuarial data with regards to the likelihood of such more mundane but equally important events compared to a prolonged power-outage or an EMP strike.