A local television station recently reported that more doctors are “going digital.”  70% of physicians are currently using electronic health records according to their report with 80% estimated to be using them by the end of the year.  

Where’s Paul Harvey’s “and-now-the-rest-of-the-story” when you really need it?  Here is what was absent from the television story.  Think of most of the doctors using this technology as having a gun pointed at their head, as refusal to spend $50,000-$100,000 on these systems for a single physician’s office, results in drastic cuts in Medicare payments.  A typical government deal:  ”buy these products or face the consequences.” Still wondering why their use is so prevalent?

If these electronic health records are such a good and useful addition, why did the government have to make doctors buy them?  Some physicians found these systems useful prior to the government threatening them to “buy them or else,” but as usual, goons like Newt Gingrich (lobbyist for Alltel, one of the biggest players in the health information technology industry) showed up with big money to force the purchase of their client’s product.  There’s a marketing strategy for you!  

I can hear the conversation in the D.C. legislator’s office now:  ”We could make a lot more money with our electronic medical records systems if you would make these doctors and facilities buy them.  Just tell ‘the people’ that it will make care better and safer…tell them it’s for their own good.  Threaten to slash government payments to doctors if they don’t buy them.  Once implemented, you can grab all of the confidential patient data by threatening them once again, basically that unless they relinquish this information, you’ll cut their government payments again.”

Whatever was said in D.C., what I have written is exactly how it has ended up.  Physicians, in an attempt to secure the federal “subsidy” for purchase of these systems, have worked desperately to achieve “meaningful use,” part of which is the reporting of patient gun ownership.  ”Meaningful use” part 2, involves transmission of confidential patient data to the D.C. central health planners.  Failure to do this will result in either a cut in Medicare payments or some other coercive gesture.

Sorry to bore those of you that follow this blog with more about the health information technology industry, one whose entrepreneurial foundation is political bribery.  I felt compelled to give “the rest of the story.”

G. Keith Smith, M.D.