Twila Brase is the president and co-founder of Citizens Council for Health Freedom. She’s a registered nurse and provides daily commentary on the Health Freedom Minute. Twila is also author of: Big Brother in the Exam Room-The Dangerous Truth About Electronic Health Records.
What is an electronic health record (EHR)? According to Twila, it isn’t simply an electronic version of your health record. It not only has the data contained in the typical paper medical record, it also has billing information, data used for quality measures, it’s used to report certain data for scoring physicians, tracking their care, determining if physicians are being compliant, treatment protocols, alerts and more.
Originally EHR’s were touted as something that would bring us cost saving benefits. On that front Twila mentioned a Harvard study that indicating that even using EHR’s it’s still going to cost from $20 to $215 just to generate a bill.
Jim then noted that the Harvard Gazette reported that billing costs were estimated at $100,000 per provider each year. He mentioned that this must get passed on to insurance companies and patients. Twila responded by explaining that EHR’s are costing the doctors in terms of researching what type of system to put in place, to buying it, to training people, to keep it updated, leasing costs while on the ‘cloud’ (if they don’t want to buy their own internal system), and more. The old paper system did require storage (as does EHR’s) but it didn’t require all these extra costs.
In the Recovery Act, Congress gave about 30 billion dollars to get EHR’s set up nationwide. Unfortunately that amount doesn’t even begin to cover the costs.
Jim pointed listeners to an article on The Hill where they reported that the Obama administration set aside tens of billions of dollars in 2009 to force doctors and hospitals to implement this. The story also noted that much of the money was wasted, there was higher costs, more errors, and no care improvement.
Twila mentioned a deadline and if you didn’t have the computer system operational by January 1, 2014, then you had to start reporting ‘meaningful use’ of it in order to obtain the full Medicare payments. So doctors and hospitals had to start looking for a system to buy. EHR’s came ‘out of the woodwork’. Many have been purchased only to be, as Twila noted, ‘gotten rid of’. In fact, some doctors are on their third EHR system in order to find one that works for them. Twila believes they weren’t designed to work for doctors. They were created to do what the government said they had to do.
Jim then cited the Harvard Business Review that is saying health professionals are now in full backlash mode against EHR’s. Twila responded by reminding listeners about the huge cost to doctors as EHR’s have required them to increase staffing which has increased the cost for them at yet another level. This has resulted in doctors hiring what are known as ‘scribes’. This is an individual with no credentials (other than the ability to type) who comes into the exam room with the doctor and who can and get all the data and click all the buttons that need to be reported so that the doctor can get paid fully.
Twila calls this whole EHR situation a ‘command and control structure’ that was forced upon doctors with the idea to take over the health care system. This is causing doctors to retire early or even find new jobs because they didn’t get into the medical profession to do what some clinical guidelines tell them what they have to do to get fully paid. They went into great debt to become medical professionals yet they’re being treated like workers on a conveyor belt. In other words, the whole system has them spending twice as much time with the EHR system than with patients.