Health Care Reform in the Breach

Carol Peracchio, a registered nurse, writes:

Two weeks ago, I received a letter from the radiology department at a large university medical center in my state. The return address specified their mammography registry. Assuming that it was a reminder to get my yearly exam, I started to toss it out. Then I remembered that I’d never had a mammogram at that hospital. So I opened the letter. The first sentence was quite a surprise:

Dear Ms. Carol Peracchio: I am writing to notify you about a security breach that may have resulted in the unauthorized exposure of your personal information.


This appalling incident prompted me to research Electronic Health Records (EHRs) in Nancy Pelosi’s health care reform legislation, the Affordable Health Care for America Act. When I entered “EHR” into the document word search, I discovered several references. On page 154, the Secretary of HHS is charged with conducting a study to increase the use of “qualified” EHRs. (What “qualifies” an EHR is not defined.) This study should include incentives such as “higher rates of reimbursement or other incentives for such health care providers to use electronic health records” and “promoting low-cost electronic health record software packages that are available for use by such health care providers.”

EHRs also play a major role in the “integration of physician quality reporting and EHR reporting.” Page 407 describes:

Not later than January 1, 2012, the Secretary shall develop a plan to integrate clinical reporting on quality measures under this subsection with reporting requirements under subsection (o) relating to the meaningful use of electronic health records…clinical quality of care furnished to an individual…The collection of health data to identify deficiencies in the quality and coordination of care for individuals eligible for benefits under this part… such other activities as specified by the Secretary.

The phrase “meaningful use of electronic health records” is repeated twice more in the references I found. What does Mrs. Pelosi mean by “meaningful”? And you can drive a truck through this loophole: “such other activities as specified by the Secretary.” What it boils down to is a big push for centralized EHRs in order to gather data to be used for physician monitoring.

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