Sunday, January 31, 2010

As Records Go Digital, Cultures Clash - Part 2

At "As Records Go Digital, Cultures Clash, Bringing to Life Secrets the Health IT Companies Don't Want You to Know" I wrote of the used-car nature of the healthcare IT market, where lemon laws do not seem to exist and "physician buyer beware" seems a defining characteristic.

The Huffington Post Investigative Fund now has a report of their own on this phenomenon:

Shopping for Health Software, Some Doctors Get Buyer’s Remorse

By Emma Schwartz
Huffington Post Investigative Fund
Jan. 29, 2010

Computerizing American medical records within five years is a key goal of federal health policymakers, but disputes between some doctors and their technology vendors highlight the many challenges for individual medical practices making the conversion.

Bankrupt vendors leaving orphan software and inaccessible data, vendors misappropriating others' software for their own products, fights over source code, and "doctors left holding the bag" are just a few of the factors that clinicians have to face.

A nightmare scenario:

Robert Cameron wasn’t much of a technology buff, but the orthopedic surgeon knew he wanted to get rid of all the paper in his nine-physician practice in Pensacola, Fla. So he bought an electronic medical records system from a California-based company called Acermed.

Cameron’s group spent more than $400,000 on the software, but the system still never fully worked and even confused patients’ scheduled visits, according to a lawsuit the doctors filed against the technology company in 2006. Acermed filed for bankruptcy in September 2007, complicating the doctors’ attempts to recover their expenses.

The effort to go digital “was a disaster,” Cameron says now.

... Cameron’s Florida doctors group, Gulf Coast Orthopaedic Specialists, looked at half a dozen companies before signing with Acermed in April 2005. After installing the first part of the system, they alleged in their lawsuit, the scheduling software “malfunctioned causing patient appointment[s] to disappear.” Also, the billing system was not feeding claims back to insurers, which over the next six months nearly ran the practice into bankruptcy itself, the complaint alleged.

[Perhaps an ancient TRS-80 programmed by a medical student in Microsoft BASIC would have done better? - ed.]

Gulf Coast doctors continued to alert Acermed to the problems, but the company was unable to fix them, the lawsuit stated. They weren’t the only ones having trouble. Two other doctor groups—one in Florida, another in Tennessee—had also filed suit against Acermed, alleging similar problems. Gulf Coast filed its suit in October 2006. Acermed stated in court documents that the doctors had no basis for their claim.

[In other words, disappearing appointments and failed billing never happened and it was all in the doctors' imagination - ed.]

As it turned out, Acermed had been dealing with problems of its own. In July 2006, a federal judge ordered Acermed to pay more than $750,000 for using some of the source code from another vendor it had once worked with to develop its own electronic medical record software in 2004.

[In other words, the company misappropriated part of its computer program from elsewhere - ed.]

Gulf Coast’s lawsuit was still pending when, in September 2007, Acermed filed for bankruptcy. Company officials at the time said that the reason for their bankruptcy was the financial impact of legal bills, not problems with their software.

In January 2008, Ophthalmic Imaging Systems of Sacramento, Calif., bought Acermed and renamed it Abraxas Medical Solutions with Acermed’s former chief executive Michael Bina as president.

In an email, Bina said he does not “represent AcerMed any more and would not like to comment on its behalf.” He said that one of his conditions for joining Abraxas had been that it continued to service Acermed customers, and that “many clients” of AcerMed have stayed with the new company.

[A musical chairs question - who, then, does represent the old company if not the president of the company that now supports the old company's products? - ed.]

One of those clients, Tony Cattone, general manager of a 70-doctor medical practice in New Jersey, said in an interview, “they have lived up to their commitments and it’s working fine.”

[Until the new company does the same as the old, that is - ed.]

Several other doctors said they were left with loan payments for a system they never received.

And today, the Gulf Coast group still hasn’t entirely gotten rid of paper. In December 2008, the doctors settled their lawsuit with Acermed for an undisclosed amount. They invested in a different electronic system, but the doctors aren’t entirely happy with the new one either, said Alan Trest, the group’s technology manager. With the current system, doctors have to type rather than dictate notes. Some aren’t willing to make that transition because they say it takes them more time. So the group still pays for transcriptions.

“They haven’t really completely bought into the idea,” Trest said.

See the full story at the above link.

I note that "revolutionizing medicine" via IT still seems somewhat unlikely when the IT industry conducts itself more poorly than the used car industry.

-- SS


Anonymous said...

Very Interesting Article and commentary, however the hyperlinks lead to private documents. Is it possible to get the source for all this information?

Thank you

Anonymous said...

Buying this HIT stuff seems worse than buying a used car. When you buy a used car, your patients are not at risk. Interesting, when you buy a used Toyota, at least there is someone around who might know how to fix it.

If you are into gambling, spend your hard earned thousands on HIT, knowing that you may lose all or part of it, with little or no benefit.

Best advice: stay out of the casino until the odds of success are better and there is proof of safety and efficacy.

InformaticsMD said...

The anonymous documents apparently were public at the time the Huffington Post published. I am not sure why they were turned private.

-- SS