Are EHR Incentives a Bear Trap?

Physicians who accepted government money to purchase a certified EHR system are facing demands to pay all the money back within 30 days, wrote Lawrence Huntoon, MD, PhD, in the summer issue of the Journal of American Physicians and Surgeons. Specific guidelines for meaningful use are retroactively replacing the vague initial guidelines, and many physicians are out of compliance, Huntoon explains.

"The government apparently recognizes that solo and small group practices may not have sufficient cash flow to immediately pay the debt in full, or may go into bankruptcy as a result of the huge repayment amount, so they offer the option of a repayment plan if the physician is eligible," he adds. "If a physician qualifies for a repayment plan, he essentially enters a period of indentured servitude with a crushing debt that may take years to pay off."

The EHRs that physicians were enticed to buy were supposed to improve quality, safety, and efficiency. The actual results are quite the opposite. The lengthy, duplicative, often incomprehensible EHR notes are often contradictory or simply false, Huntoon states.

The real purpose of the EHR is to collect higher payments by "documenting" more "bullet points."

The adverse effects that Huntoon recounts include increased identity theft and loss of patient privacy. The EHR is a major contributor to physician burnout. In the event of a power outage or computer crash, a facility may have no access to critical patient information.

"Billions of dollars have been spent on encouraging physicians to adopt a system that works poorly and degrades the practice of medicine to the extent that the doctor literally turns his back on his patients so as to better serve the EHR," he concludes.

Source: Association of American Physicians and Surgeons