Thursday, February 10, 2011

ObamaCare and "Meaningful Use" Part II

Part II was promised for a couple of weeks ago. However, snow, business, and minor family illnesses interfered. Better late than never, I hope!

Since my last update, David Blumenthal, the National Coordinator of Health Information Technology, has announced his resignation. This article from the Health Renewal Blog explains why this is a very good thing.

Part I of my discussion on "Meaningful Use" regulations can be found here if you need a refresher.

Continued from last update:

3. Further down, we start getting to the real meat of "Meaningful Use" and how it will fit into the overall ObamaCare scheme: Implement capability to electronically exchange key clinical information among providers and patient-authorized entities. Not so bad, right? Patient-authorized entities are, well, authorized. Actually, the term "patient-authorized entities"  refers to insurance companies and the government in the form of the Centers for Medicare and Medicaid Services. This is the provision that will allow real-time monitoring of and interference with the decisions you and your doctor make in the (former) privacy of the doctor-patient relationship. Previously, these entities could request copies of your chart but infrequently did so due to the logistics involved. Now they will simply log-in. Worse, they will have electronic algorithms that will watch and wait for signs that "poor quality" decisions are being made. This is the actual mechanism whereby our health care will be rationed.

4. Implement one clinical decision support rule and ability to track compliance with the rule. At least they aren't calling them "guidelines" anymore. The word "guideline" implies that there is some wiggle room for doctors and patients to make judgments. On the other hand, a rule is a rule. This will be where the doctor is "supported" into telling you that your mammogram must be delayed until you are 50 years old instead of 40.

5. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. "Quality improvement" refers to rules and penalties. "Reduction of disparities" is a subject I wrote about at American Thinker. Research? What about The Nuremberg Code's requirement that all medical research involve voluntary consent? I don't see any such requirement in these regulations. Lastly, since when it is the business of an electronic medical record system to provide lists of patients for "outreach". Outreach by whom?

6. The rest of the Meaningful Use regulations include more of the same. Among other things, information will be submitted by these systems to state vaccine registries, public health agencies, and will check to see if the your doctor's drug choices are on approved formularies. Oh, one last thing, the electronic chart must be capable of documenting the advance directives of people over the age of 65 years of age or older (DrRich at the Covert Rationing Blog recently expounded on the subject of advance directives).

I will reiterate that all of the above will be required if doctors and providers are to receive incentive payments from the government. We talk about corruption and money in reference to politicians getting contributions. But isn't it corruption when the government is spending billions in order to convince (or bribe) doctors and hospitals into doing questionable things with patients' medical information?

In response to those of you who have asked, I will get back to more general health care updates over the next few days. To hold you over, here is a video from today of Representative Tom Price, M.D., questioning Donald Berwick. Listen to how he talks about freedom as it relates to medical decision making!

No comments: