Author Topic: PATIENT's CAN OPT OUT OF MANDATORY EHR!  (Read 4856 times)

PMRNC

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PATIENT's CAN OPT OUT OF MANDATORY EHR!
« on: November 27, 2011, 09:02:47 PM »
This is something I have been looking into for a while. Because of some really BAD experiences with doctors (personally, not professionally) and EMR already, I wanted to look into "opting out" and every expert I talked to was telling me I couldn't. Well of course that's not an answer I was going to accept.  This will come up because our clients will be asking us.. "Patient so and so does not want an EHR..what do we do"   


http://cnsnews.com/news/article/hhs-everyone-can-opt-out-government-mandated-electronic-health-records-system

HHS: Everyone Can Opt Out of Government-Mandated Electronic Health Records System

The U.S. Department of Health and Human Services (HHS) says that everyone can opt out of having an electronic health record included in the federally mandated national electronic-health-record system created by the stimulus law enacted in February


(CNSNews.com) – The U.S. Department of Health and Human Services (HHS) says that everyone can opt out of having an electronic health record included in the federally mandated national electronic-health-record system created by the stimulus law enacted in February.

The $787 billion economic stimulus bill, the “American Recovery and Reinvestment Act” signed into law by President Obama in February, calls for “the utilization of an electronic health record for each person in the United States by 2014.” The law says the records should include a person’s “medical history and problems list.”

The law also says the electronic health record (EHR) will become part of a “nationwide health information technology infrastructure,” accessible with authorization by health-care providers and the government.

To make certain this happens, the law provides for doctors, hospitals, and other health care providers to be given financial incentives to begin participating in the EHR system by 2014. Doctors, hospitals and health care providers that fail to make “meaningful use” of the system by 2015, the law says, will be penalized with reductions in their Medicare payments.

But individual Americans can opt to never have an EHR entered in the system, according to Dr. David Blumenthal, who is overseeing the development of the system as HHS's national coordinator for health-care information technology.
 
“We want to make it clear that no one will ever have to use an electronic health record, if they don’t want to, and that when you do have electronic health records, they’ll have every conceivable privacy protection that is compatible with a useful health care system,” Blumenthal told CNSNews.com during a telephone news conference last Tuesday on EHRs with Secretary of Health and Human Services Kathleen Sebelius. (Transcript below.)
 
Rep. Patrick Kennedy (D.-R.I.) recently told CNSNews.com that it would “totally be up to the individual” whether a doctor could list an abortion or an STD on their EHR. CNSNews.com asked Sebelius if that was the case, and whether patients could also prevent a mental illness or drug or alcohol abuse from being included on their EHR.

Blumenthal spoke up to respond to the question, saying that EHRs will be privacy-protected, that a committee is studying how to arrange the privacy protections, and that people will be able to completely opt out of having one.

“We are extremely sensitive to the need for privacy and security of information,” said Blumenthal. “It is one of our very top priorities. And we have, actually have a health-information technology policy committee of national experts. We held a hearing on this topic just 10 days ago. This very question came up. We’ve charged that committee with studying how to protect patient information and they’re going to be reporting back to us.

“We want to make it clear that no one will ever have to use an electronic health record, if they don’t want to, and that when you do have electronic health records, they’ll have every conceivable privacy protection that is compatible with a useful health-care system,” Blumenthal continued. “So, we’re going to wait to see what this panel reports back to us on in terms of the exact protections that we’re going to build in.”

Blumenthal was asked in a follow-up question to clarify if the EHRs were mandatory or voluntary.

“Let me say this again: No one will ever be forced to use an electronic health record if they don’t want to,” said Blumenthal. “This is always going to be between doctors and patients. Now--so, that’s a given and so that, by definition, makes them voluntary.”
 
Blumenthal did not say when the committee studying the privacy issue would complete its work, but indicated that the financial incentives for health-care providers to begin using EHRs do not begin for another year and a half. “We have a little bit of time,” he said.

As of Monday, Blumenthal’s office had not answered follow-up questions that CNSNews.com submitted last week. A spokesman for the press office indicated that it could take “up to two weeks” for the request to be considered by the agency’s press secretary.

When CNSNews.com asked White House Press Secretary Robert Gibbs last week whether the White House agreed with Rep. Kennedy that patients could opt out of having an abortion or certain diseases excluded from the ENR, the president’s spokesman said he had “no idea.”
 
“I’m not a health IT expert. I would direct you to somebody -- I have no idea,” he said.
When CNSNews.com followed up, asking whether just the concept of allowing omissions from the EHR was a good idea.
 
“I’m not a health IT expert, so I apologize,” Gibbs asserted.

Transcript:
 
CNSNews.com: Our outlet spoke last week with Rep. Patrick Kennedy. And he told us that patients will actually be able to stop a doctor from including abortions or STDS in their medical history that will be part of the government-mandated electronic health record in the national record system.  I am just wondering is that Secretary Sebelius’ understanding, that a patient would be able to stop such things from being recorded, and if that’s the case, could patients also prevent things like mental illness or drug and alcohol abuse from being recorded if they so desired?”

Blumenthal: “This is Dr. Blumenthal again. I think I will take I’ll take that question. We are extremely sensitive to the need for privacy and security of information. It is one of our very top priorities. And we have, actually have a health-information technology policy committee of national experts. We held a hearing on this topic just ten days ago. This very question came up. We’ve charged that committee with studying how to protect patient information and they’re going to be reporting back to us. We want to make it clear that no one will ever have to use an electronic health record, if they don’t want to, and that when you do have electronic health records, they’ll have every conceivable privacy protection that is compatible with a useful health-care system. So, we’re going to wait to see what this panel reports back to us on in terms of the exact protections that we’re going to build in.
 
CNSNews.com: Are electronic health records mandatory, or as you indicated, voluntary? Help me understand here.
 
Blumenthal: “Let me say this again: No one will ever be forced to use an electronic health record if they don’t want to. This is always going to be between doctors and patients. Now--So that’s a given and so that, by definition, makes them voluntary.”
 
CNSNews.com: And you talked about this panel. When will this privacy committee conclude with its work?
 
Blumenthal: We’re going to let them do a little bit of work and report back to us on how long it is going to take them. To be clear, the incentives that are associated with the adoption of electronic health records don’t go out for another year and a half. We have a little bit of time.

 :o ;D ;)

THIS Gal is OPTING OUT :)
Linda Walker
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www.billerswebsite.com

DMK

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #1 on: November 28, 2011, 10:19:32 AM »
I agree completely!  I am curious though, if you're using your insurance to pay for the visit, will they be able to require EHR? 

It has felt like complete blackmail to me all along offering "financial incentives" to use EHR, and then threatening to cut reimbursement if you choose not to participate in EHR.

And the doctors I've been to, so far, who are using EHR are so bad at the technology that they're failing at the doctoring as well!

The interesting thing is that if you were running for president, and they were vetting you, your health history will be vetted too!  That's probably why Kennedy was so adamant about the abortion, STD, alcohol addiction aspect!  The general public doesn't think information will be used against them (what?  Facebook isn't private?) so they keep inputting information everywhere!  (Uh oh, they'll be knocking down my door when they find out I don't agree!)       ;)
 

PMRNC

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #2 on: November 28, 2011, 12:01:06 PM »
Quote
I agree completely!  I am curious though, if you're using your insurance to pay for the visit, will they be able to require EHR?

It has felt like complete blackmail to me all along offering "financial incentives" to use EHR, and then threatening to cut reimbursement if you choose not to participate in EHR.

And the doctors I've been to, so far, who are using EHR are so bad at the technology that they're failing at the doctoring as well!

The interesting thing is that if you were running for president, and they were vetting you, your health history will be vetted too!  That's probably why Kennedy was so adamant about the abortion, STD, alcohol addiction aspect!  The general public doesn't think information will be used against them (what?  Facebook isn't private?) so they keep inputting information everywhere!  (Uh oh, they'll be knocking down my door when they find out I don't agree!)

The funny thing is that before I put this out there, I wanted to run it by attorney with the same question!  He just responded this morning and said that they will not be able to deny payment so long as the carrier is given all they need to "bill" the claim. The insurance companies are not the ones requiring EHR first of all, and secondly, patients cannot be forced to have an electronic record. He told me this isn't even unclear, it's just uncommon for us to hear about it because of course the govt doesn't want us to be good little informed patients. LOL  What's going to happen is you won't get to "pick/choose" what is in your record, you will either have to "opt out" or accept all conditions will be recorded on the EHR. You will also be able to "opt out" at any time there after as well from what I understand so far. I'm looking into this further and will keep everyone informed.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DMK

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #3 on: November 28, 2011, 01:24:24 PM »
As always, THANK YOU for hunting down the important issues.  It helps me keep my patients informed!

djohnson1026

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #4 on: November 28, 2011, 06:44:53 PM »
Thanks for the latest info as always, but may I ask why are you against the EHR policy? Do you think there is a possibility of the patients info being leaked bc. it is electronic?

PMRNC

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #5 on: November 29, 2011, 06:25:19 AM »
Quote
Thanks for the latest info as always, but may I ask why are you against the EHR policy? Do you think there is a possibility of the patients info being leaked bc. it is electronic?

Like most things that go electronic or digital blunder's happen, I've already had two almost potentially BAD situations with EHR. My daughter went in for a re-check for mono and were ready to write her a script for a heart medication. On another date, my oldest daughter went in for a sore throat and they proceeded to prep her for an ultrasound.  Not so much concerned with Privacy as I am mistakes that could cost people their lives.. JMHO and I won't be sold on EHR.
Linda Walker
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DMK

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #6 on: November 29, 2011, 10:24:07 AM »
Thanks for the latest info as always, but may I ask why are you against the EHR policy? Do you think there is a possibility of the patients info being leaked bc. it is electronic?

If Dr.s, staff, billers take their computers out of the office ABSOLUTELY it can be leaked!  And there are very unscrupulous hackers out there who would love nothing better than to start misappropriating information and selling it to the highest bidder.

But Linda's point is the best.  Doctors are Doctors, and many of them aren't worth a darn on computers!  It's really easy to punch in the wrong diagnosis code, wrong body part, wrong medication or the wrong amount.  Computer data has and always will be "Garbage in Garbage out" and until they can make it idiot proof it will never be perfect!  Even with the best of intentions, and I can completely see the great things that are possible with EHR, there will always be inept, stupid or just plain evil people.

My other concern is that with reimbursements from insurance companies continuing to decline and costs of doing business continuing to increase, Doctors will be trying to see more patients in less time and they will make MORE mistakes.  EHR has lost its thrill for me!

PMRNC

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Re: PATIENT's CAN OPT OUT OF MANDATORY EHR!
« Reply #7 on: November 30, 2011, 12:33:13 PM »

Marino’s records bill contentious
Congressman’s electronic health care records proposal has supporters, detractors.

JONATHAN RISKIND Times Leader Washington Bureau

WASHINGTON – A report released this month helps make the case for a proposal by Rep. Tom Marino, R-Lycoming Township, to give health care providers who use money-saving electronic records more legal protections, proponents say.

Read more: http://www.timesleader.com/news/Marino_rsquo_s__records_bill__contentious_11-27-2011.html#ixzz1fDOG8BET

But a critic of Marino’s bill says granting legal immunity for reporting medical errors caused by faulty electronic records deprives patients of the right to seek compensation and takes away incentives for records vendors and the health care community to make needed improvements.

When Marino introduced his Safeguarding Access for Every Medicare Patient Act in October, he said it would create a system for reporting potential errors in electronic records without the admission of the mistake being used as a legal admission of wrongdoing. The bill also applies to Medicaid patients, and since so many providers accept patients from the federal health care programs for seniors and the poor, Marino’s bill effectively would apply to most of the medical community.

“Many providers are reluctant to use electronic records because they believe the practice will make them more vulnerable to unnecessary legal action,” said Marino, a member of the House Judiciary Committee, when he unveiled the bill in late October.

The report released Nov. 8 by the nonprofit Institute of Medicine, which was sponsored by the U.S. Department of Health and Human Services, said the federal government is spending billions of dollars to encourage hospitals and other health care providers to more widely use electronic health records, but also needs to develop a method for technology vendors and providers to report record-related injuries or deaths. Reporting “events related to patient safety should be mandatory for vendors and voluntary, confidential and non-punitive for care providers,” the report said.

“Just as the potential benefits of health IT are great, so are the possible harms to patient safety if these technologies are not being properly designed and used,” said Gail L. Warden, president emeritus of Henry Ford Health System and chairman of the committee, in a statement when the report was released Nov. 8. “To protect patients, industry and government have a shared responsibility to ensure greater transparency, accountability and reporting of health IT-related medical errors.”

Joel White, executive director of the Health IT Now coalition that includes providers, employers and insurance companies, said Marino’s bill is a way to help put some of the Institute of Medicine’s recommendations into effect.

“The question is how to create a system that identifies and allows people to report errors and fix them without engaging in a punitive environment,” said White.

Marino’s bill wouldn’t stop a lawsuit from going forward if an electronic records-related error – for instance, an intravenous infusion machine that dispenses the wrong dosage – occurred, White said. But it would protect the confidentiality of a reporting system designed to prevent the same mistake from happening again, he said.

But Williamsport attorney Cliff Rieders, a past president of the Pennsylvania Association of Justice, said granting the legal immunity Marino seeks in his bill will discourage, not encourage, improvements to faulty electronic record systems.

“Giving doctors immunity is exactly the wrong thing to be doing,” said Rieders, a medical malpractice attorney and a board member of the Pennsylvania Patient Safety Authority. “If you say to people that there is no repercussion to doing the wrong thing, you are going to encourage the wrong thing.”

The Pennsylvania Patient Safety Authority is an independent state agency whose 11-member board is appointed by the governor and legislature and is made up of physicians, attorneys, nurses, a pharmacist and a non-healthcare worker. It is charged with taking steps to reduce and eliminate medical errors.

Marino’s bill has not yet received a hearing in the House Energy and Commerce Committee, which has jurisdiction over health care issues. But Marino also hopes to see the bill referred to his judiciary committee, his office said.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com