September 30, 2010
Experts Rip Obamacare's REC Foul-ups
Houston Neal, Director of Marketing for Software Advice, emailed me a link to an article on his company's medical blog, explaining what his company feels that electronic health records and the Regional Extension Centers (RECs) created to support them in Obamacare are a huge mistake.
The entity spearheading this effort, the Office of the National Coordinator for Health IT (ONC), is specifically charged with helping 100,000 priority primary care providers become "meaningful users" of EHRs in 24 months. Eight months have passed since the ONC began funding RECs, and we're skeptical that they will deliver.Don’t get us wrong. We're big advocates of EHRs. We're glad to see such an energized EHR market. We're just skeptical that throwing money at the problem will lead to efficient and successful adoption of this important technology.
In our opinion, there are five fundamental flaws with RECs:
1. Doctors aren't moving as fast as the money is flowing
2. The market already delivers on what RECs promise
3. "Preferred vendor lists" limit choice and free markets
4. RECs won't get doctors to "meaningful use" fast enough
5. The REC model leads to under-staffed, ephemeral entities
The article goes on the detail each of the five flaws in detail.
Obamacare—like everything else MR. ESPN has touched—is a mindlessly expensive disaster that costs billions and makes things worse for all Americans, and serves primarily to strangle private business and grow government.
Let's get this thing repealed
STAT.
EHRs are one of those things that is great as a concept, but often horrible in real world use. The devil is in the details, and it requires a total commitment from the practitioner otherwise it is all but guaranteed to fail.
No system is off-the-shelf perfect, and no existing practice can perfectly interface with one either. So implementation requires adaptation of the software and adaptation of the practice to the new systems(that's the element many are loathe to swallow.) As the Medical Blog noted, this is something that will require a very free market for innovation and later standardization.
In the broadest sense EHR is much like facsimile machines, or other labor saving technologies - they are only of real practical and financial benefit once most everyone is using them. Getting the majority of potential users over the hump is essential, but needs to be done in a palatable manner.
By attempting to force widespread adoption in this manner the implementations are practically doomed to fail. The greatest downside will be the creation of a large class of practitioners who are thus embittered to the entire concept. It is possible that this core of negativity will have the net of effect of delaying widespread acceptance and use longer than might have happened otherwise.
Posted by: ThomasD at September 30, 2010 09:51 PMEHRs are a massive invasion in the personal space by government agents.
Everyone's medical history (all of it, every prescription, procedure, visit to your doctors) will be available to government agencies across the board, crosslinked to medical and tax records, employment records, etc. etc.
Still think it's a good idea? Now try having all that information available to a government flunky who has to decide if you're to be allowed treatment for say cancer.
You're 50, have a decent job which pays the government $30.000 a year in taxes, but the treatment will cost $200.000.
The flunky has a guideline to only allow treatment if the cost is recovered by incoming taxes from the patient in under 5 years. You're denied treatment, offered assisted suicide instead.
