Today a piece appeared in the august New York Times which, frankly, got me a little bit steamed. You may feel the same way if you read it.
In the piece, two New York Times reporters cover a report issued by the HHS Office of the Inspector General looking at possible fraud and abuse among EMR users. Apparently, the report concludes that CMS isn’t kicking EHR users hard enough.
To be fair, the OIG has enough disapproval to go around. In part, the report breathes fire down the neck of CMS, which, it notes has spent more time fostering EMR use then searching for fraud and abuse among the EMR user population.
But the report also seems to have railed against doctors and hospitals, which it says are using EMRs to upcode, especially (in the OIG’s eyes) by cutting and pasting text from one EMR record to another. This “cloning,” it suggests, may turn out to be a major source of fraud.
So what am I angry about? Well for one thing, the article itself seems to by the implicit premise that cutting and pasting or other upcoding methods are widespread enough sources of fraud to deserve a full-scale investigation, and that CMS should direct a lot of its resources in this direction. Guys, okay, I’ve been doing this a long time and I know better, whereas the Times reporters may not, but shouldn’t they have at least challenged the notion that EMR related fraud and abuse is a major problem? You know, do some investigation?
The other thing that upsets me is the notion that overworked, stressed out EMR users — who have enough in their plate already — should be the ones who take it on the chin if their desperate attempt to keep up the pace do in fact result in the occasional upcoding incident. Riding doctors can only further tax the surprisingly fragile state of affairs in EMR adoption. And after spending more than 20 billion to accomplish something, is it worth endangering it to win a few brownie points with Congress?
Let’s say I go to my allergist once per week for shots. Same shots, same check for reaction, same precheck each and every week. A perfect example of how cut and paste actually is appropriate in some systems. It doesn’t mean that the specified work was not done. It only means that most times I would go that there are not any problems.
I understand that there are plenty of times it is not appropriate. But to lump all cut and paste into the ‘fraud’ category is beyond absurd and misleading.