EHR – The Good, The Bad, & The Ugly

by Michele Redmond
Monday I was in one of my physician’s office and he asked me to watch a video about EHR and give him my opinion. It was a 15 minute video of Craig M Wax, D.O. speaking at an AAPS (American Association of Physicians and Surgeons) event. Dr. Wax is against EHR (electronic health records) and isn’t afraid to share why he feels this way.

As a biller EHR really doesn’t affect me much on a professional level. Some of my providers ask for my advice on what they should do as far as EHR goes, but that’s about as far as it goes. But while watching Dr. Wax’s video I did get thinking about how I feel about EHR on a personal level, not as a biller, but as a patient and it was eye opening!

First of all there are two types of EHR. The first is an EHR system that is on the physician’s server. All files are stored right in the physician’s office and can only be accessed by someone on that system. The second type is what they call “on the cloud” or web based. This means the information is stored on the internet. I will talk more about the issues with the internet based systems in a minute.

According to Dr. Wax the government says that certified EHR technology will improve quality of health outcomes, improve the efficiency of healthcare and provide privacy and security safeguards. But what does the government base these promises on? Do they actually have any proof or anything to back up these claims? Even the Wall Street Journal published an article called “Looking for EHR Benefits But Can’t Find Them”. It appears that the implementation of EHR may actually just be one massive experiment using physicians and patients as the guinea pigs.

My primary care doctor does use EHR and I have seen both pros and cons. The first con is that he walks in the room, sits down at the computer facing the wall and begins typing while he’s talking to me. Where is the face to face contact? It is kind of annoying. He is asking me what is wrong but he is not looking at me. I think it takes away some of the doctor patient relationship. On the pro side, if he sends me to one of the other specialty physicians in the building they have everything they need regarding my medical records at their fingertips.

Let’s get back to the cloud based EHR or the internet systems. The argument is that your physician can access your records from any device connected to the internet anywhere they need to access it. The first problem that pops into my mind is “who else can access it?” Now of course all those pushing EHR would immediately say that the security is top notch, etc. etc. But I’m not stupid. Sarah Palin’s personal email and President Obama’s cell phone were both hacked. Information on the internet is constantly compromised, stolen, hacked, lost, etc. There are stories on the news all the time about companies who have had their information compromised. Credit card companies, banks, etc. An employee inadvertently takes a laptop home and it gets misplaced.

According to Dr. Wax, 9 out of 10 small healthcare organizations have reported a data breech already. That’s 90%! Once PHI (personal health information) is online it can be stolen. Stealing EHR is big business. EHRs contain all of your PHI. PHI consists of your personal contact info, SS#, date of birth, possibly your credit card info and more. This brings identity theft to a whole new level.

Another thing that may be contained in your PHI is genetic information. For example, do you carry the breast cancer gene? Do you want that known? There are companies that would pay for that type of information.

Personally there is another issue I have with EHR. All of my personal conversations I have with my doctor will be able to be accessed by many. Think about that. Are you okay with that? Do you want a nurse at a hospital where you are having a CAT scan to be able to read your private conversations with your doctor?

We are assured that only authorized people will be able to access the EHRs but in my opinion there are a lot of “authorized people”. For example, will EHR allow a pediatrician in California to access records on his daughter’s ex-husband in NYC? Will he be able to check his records to monitor his alcohol use to assist his daughter with a custody battle?

I may be reaching a little far in some of my examples but I think we really need to think this through. How many times have you heard of a doctor’s office being broken into and having paper charts stolen? In my opinion, EHR is forcing patients to have their private business become public. Why does government feel that they need to force everyone to participate? I don’t know what the process is for patients or providers to opt out but I personally think that should be an option.


5 Responses to “EHR – The Good, The Bad, & The Ugly”

  1. Cyndee Weston Says:

    Michele – excellent food for thought. You managed to put some of my fears with EHR in writing. I only tell doctors what they need to know and nothing more. I try not to provide anymore personal information than what is necessary to process my claim. If I can avoid giving my social or a copy of my drivers license, I do so for the reasons you gave – too many breaches.

  2. Isabel Reyna Says:

    I totally agree wih this because the same happen to me with a Dr’s office
    appt I just had. While asking me questions, the whole time he was looking into a computer and not me. It’s actually rude, but that where this field is heading too. I also though about hacked in programs. Is their a way to fight this new idea?

  3. Bridget Claire Says:

    I see only providers who do not accept insurance and do not have the ability to file a claim to the insurance carrier. If they do I request I be a private pay and ask not to be added to their computer system. I have had no one provider refuse my request.

  4. Deb Walekr Says:

    Personally, I am not for EMR’s, especially ‘in the cloud’. Fearful of my personal information being compramized. And I do believe all physicians are looking at the dollar signs vs protecting the patient, because I feel the government wants more control over cost for medical care, and more data. Pretty sad. I am a biller, with 30 years experience. As a biller, I like easy access to what I need for billing purposes. BUT, then again…who else is gaining access? Especially in the cloud, how many hands are in the cookie jar? There is a LONG list of people wanting access to your chart, ME, MA, IT people, Support people, and the list goes on. Ug Un…paper charts remain ‘perfect’ for me.

    Deb Walker, CMA

  5. Senthil Muthiah Says:

    I agree. All are looking only the dollar value, not the patient. But some EHR are good.

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