ONC on healthcare IT and patient rights: These systems "have to be rolled out to know where the problems lie"

An anonymous commenter to my blog post about the USA Today article on bad health IT (http://hcrenewal.blogspot.com/2015/02/former-onc-director-david-blumenthal.html) noted this, that I myself missed:

Anonymous said...

Gettinger's comment is stunning, especially coming from a director of safety and quality for HHS' Office of the National Commissioner for Health Information Technology:

 "You don't just plunk down EHRs and everyone's happy. You use an incremental kind of approach (and) that takes time, that takes energy and that takes effort," he says, adding that they have to be rolled out to know where the problems lie.

February 1, 2015 at 9:17:00 PM EST

(Writing of ONC's Acting Director Andrew Gettinger MD, Office of Clinical Quality and Safety, http://www.healthit.gov/newsroom/andrew-gettinger-md.)

If quoted accurately, that's likely the end of the line for me regarding ONC and any concerns about patients' rights.  Patients are to be used as live subjects to debug software.

That is advocating human subjects experimentation without informed consent with a technology known to cause increased risk, harm and death, and there's nothing to debate there.  This statement would be perhaps appropriate for someone writing about animal experimentation. 

My own mother's dead, in fact, from that type of attitude.

Gettinger's statement will serve as the cover slide to my upcoming legal presentations to American Association for Justice state chapters and at the AAJ national meeting later this year, as well as to the Association of Health Care Journalists (AHCJ), to which I've been invited to speak.

-- SS

Healthcare Legislation to "Control the People?"

At "AMA And Almost 100 Physician Societies Sound Off To CMS On Health IT" I referred to concern held by AMA and ~94 other medical specialty societies about comments overheard from senior government officials that:

complex measures and high reporting thresholds are needed to discourage EP's - Eligible Professionals (i.e., eligible for government EHR subsidies) from switching back to the use of paper during this transition to EHRs.

Such reporting requirements could not only 'discourage' a switch back to paper even if these 'government-approved' EHR's turned out to be a clinical and/or operational nightmare (which I feel is likely if not unavoidable based on numerous writings at this blog and here), but also could force event those planning to stay with paper and endure the "penalty" for doing so to move to computer systems. The human resources required to satisfy truly ominous reporting requirements via paper records might simply be too burdensome.

This could be perceived as an ingenious and devious plan to establish control of healthcare providers via IT and data. (He who controls the data, controls the playing field.)

Privacy activist Dr. Deborah Peel shares related concerns as expressed in a Wall Street Journal article yesterday "Your Medical Records Aren't Secure."

Along the lines of control, now there's this, recently posted on the Drudge Report:

Shocking Audio: Rep. Dingell Says ObamaCare Will Eventually ‘Control the People’ (link)

I don't care which "people" Dingell's referring to - 300 [sic] Americans (he left out "million"), physicians, insurers, etc. Our government has no business discussing "controlling" anyone.

Ideology aside, the control mentality of government over medicine, facilitated by healthcare IT, is starting to rear an ugly head. I'm afraid this phenomenon might get really out of hand in the very near future.

-- SS

Addendum: there appears to be a healthcare IT industry sockpuppet writing in the comments thread at the aforementioned WSJ article by Dr. Peel, under the especially inappropriate nom de blog "Hank Dagny." The usual dismissal of physician concerns about HIT, unqualified statements, ad hominem attacks, and other games typical of an industry shill occur throughout that comment thread.

See my reply at this link. (It takes a moment to load the WSJ comment thread.)

Also see this summary of a Canadian analysis of electronic health record security at the blog of security technologist Bruce Schneier. Hat tip to Joseph Arpaia, MD.

On HIT Vendor Nondisclosure of Nondisclosure Agreements

Seen at the HIStalk blog in News of 8/19/09:

A couple of readers wisely suggested that I not consider running nondisclosure language from vendor contracts. Reasons: (a) it might identify the client since terms are often customized; (b) it might violate vendor privacy requirements and get a client or me in trouble; (c) clients might not want to share anyway since they may like the idea of being prohibited from sharing patient safety information. A couple of vendors e-mailed to say they don’t include such terms. I’d be very surprised if Cerner and Epic don’t based on my limited history with them.

My response to the HISTalk blog owner, Tim, and other interested parties:

Sent: Thursday, August 20, 2009 7:32 AM To: mr_histalk@yahoo.com Cc: david.kreda@gmail.com; rkoppel@sas.upenn.edu; Emilia_DiSanto@finance-rep.senate.gov; MChassin@jointcommission.org; pschyve@jointcommission.org Attachments:

To: HISTalk blog Re: nondisclosure of nondisclosure agreements by HIT vendors Tim, Those who've written advising you *not* to post the language of HIT nondisclosure agreements are in fact correct: As per Koppel and Kreda's March 2009 "Hold Harmless" article in JAMA and my July 21 JAMA letter to the editor commenting on it, nondisclosure and hold harmless agreements stifle HIT innovation, put patients at risk, and cause healthcare executives to violate their Joint Commission and fiduciary responsibilities to protect patients and workers from undue physical or legal jeopardy. You and other bloggers should *not* be the ones to clandestinely obtain and post such language. The HIT vendors themselves, in an atmosphere of transparency and in deference to patients safety and to hospital governance, should gladly and transparently do so if such language exists in their contracts. This assumes, of course, that HIT vendors hold patient safety and practitioners' rights as a high priority. S.S.

I think that says what needs to be said.

-- SS