Patients Resist Digital Doctoring

Modern Physician reports that "The pull-down menus, alerts and point-of-care information contained in computerized clinical decision-support systems [CDSS] can distract physicians from their face-to-face encounters and leave patients feeling ignored and dissatisfied with their care." This comes from a study at the University of Missouri at Columbia that evaluated patient perceptions of doctors using digital diagnostic tools.

"Get over it!" is the first thing that comes to mind. Would you begrudge your mechanic hooking up your car to the diagnostic computer and scrutinizing the bars and gauges and charts on the screen? The physician has to use tools, just like everyone else, to achieve peak performance in treating patients. Personally, I'd rather see the back of his head researching my complaint to take advantage of every inspiration and precaution, than to look at a smiling face telling me "Shucks, I don't know, let's try some drugs!"

The time has come for us as patients to embrace the new technology, just as we insist that our doctors do the best job possible in our behalf, and to get used to some changes in the doctor-patient relationship.

Surprise: You May Now Be Liable Under HIPAA

When the HIPAA privacy rule first went into effect, business associates of hospitals, physicians, etc. didn't have to worry about getting in trouble for releasing data in ways that violate patients' privacy.

No more.

In light of several years of clumsy handling of patient data by contractors and employees, it's perhaps not surprising that HHS is changing the rules to extend the strict HIPAA privacy rules -- and penalties for violations -- to external vendors and IT communities.

If you work in any way with patients' medical data -- whether as a data processor, consultant, IT contractor, EHR installer, whatever -- you'd better get familiar with the new rule that goes into effect March 26. It clarifies when breaches need to be reported to the Office for Civil Rights, scraps the old standards for the use of patient-identifiable data for marketing and fundraising purposes, and expands direct liability under the law to so-called “business associates” of HIPAA-covered entities.

Perhaps equally interesting is that patients once again will have the right to limit release of treatment records to insurance companies if they paid out-of-pocket on that treatment. Look out for problems and potential fines related to goof-ups related to granting access to the wrong business partners on the wrong data. Greatly increased penalties for privacy and security violations under the ARRA are explained in the new ruling.

Read the HHS news release.
Read the rule in the federal register (you've still got time to comment).

$1.25 Billion in December EHR Incentives

The Centers for Medicare and Medicaid Services announced that a record $1.25 billion was paid in December to hospitals, physicians and other professionals in electronic health-record (EHR) incentive payments. The program awards healthcare providers for adopting electronic health records systems.

The December pay out is three times the size of the previous largest one-month awards total. Medicare and Medicaid awarded $255 million to physicians and other professionals, and $1 billion to hospitals. So far, EHR incentive programs have paid out $10.3 billion to improve the quality of US healthcare information technology, which for decades has lagged behind other industries.