1
THE REAL FACTS ABOUT EMR
Any fact that needs to be disclosed should be
put out now or as quickly as possible, because
otherwise the bleeding will not end. Henry
Kissinger
There are in fact two things, fact and opinion
the former begets knowledge, the later ignorance
Hippocrates
"Practical politics consists of ignoring facts."
Henry Adams
2
Terms and Acronyms
MRI - Medical Records Institute, which sets many
of the definitions frequently used today in
reference to information technology, as explained
below. CCHIT - stands for a voluntary,
private-sector organization to certify HIT
products. It was initially founded by three
leading HIT industry associations the American
Health Information Management Association
(AHIMA), the Healthcare Information and
Management Systems Society (HIMSS) and The
National Alliance for Health Information
Technology (Alliance). CPOE - computerized
physician order entry. C-EHR - stands for
certified electronic health record. EHR
electronic health record, which is a
computer-accessible, interoperable resource of
clinical and administrative information pertinent
to the health of an individual. The information,
drawn from multiple clinical and administrative
resources, is used by a broad spectrum of
clinical personnel. This enables them to
coordinate the patient's care and promote
wellness. EMR electronic medical record, which
is a computer-accessible resource of medical and
administrative information available on an
individual collected from and accessible by
health care professionals involved in the
patient's care within a single care setting. HHS
- Health and Human Services, currently chaired by
Secretary Michael Leavitt. HIMSS EHRVA is a trade
association of EHR vendors which functions as an
advocacy and lobbying group founded to fight for
the optimal use of healthcare information
technology (IT) and management systems for the
betterment of healthcare. Founded in 1961 it has
offices in Chicago, Washington D.C., Brussels,
and other locations across the United States and
Europe.
Slide 2
3
FACTS ABOUT CCHIT
4
(No Transcript)
5
On 7/2006 CCHIT began certifying EMR software
systems

• And now the average cost of the typical
  certified EMR is about twice as expensive as
  those that arent certified.
• The uptake of certified EMR software systems
  has stagnated while those that arent certified
  have seen the overall prevalence in the market
  grow to almost 30.
• The failed installation rates are estimated at up
  to 50 in the c-EHR software systems industry
  the deinstallation rate is reported to be another
  8.
• Only 10 of those that buy c-EHR software systems
  
• actually use all the features that Medicare
  wants to
• eventually force onto physicians.
• The special features that government and
  Insurance
• companies want to implement have more to do with
  
• withholding payment to providers than in
  actually
• improving patient care.

• http//www.healthcare-informatics.com/ME2/dirmod.a
  sp?sid349DF6BB879446A1886B65F332AC487FnmtypeB
  logmodViewTopicmid67D6564029914AD3B204AD35D8F
  5F780tier7idEDE4B65E6FA344C286C02EFB2CD4D223
• http//www.ihealthbeat.org/articles/2007/10/31/Sur
  vey-Finds-Health-Care-Providers-Often-Backtrack-on
  -EHRs.aspx?topicID54

6
Reason for the High Failed Installation Rates An
artistic depiction of what a typical CCHIT
certified enterprise EHR chaotic installation
could look like in real time.
Slide 6
7
In 2006 CCHIT began certifying EMR software
systems, offering assurance

• Since 2006 approximately 100 EHR software systems
  have been CCHIT certified. Of these, 3 of which
  have declared bankruptcy, and at least 2 dozen
  other certified EMR software systems have seen
  their stocks fall in the past year alone over
  30. And these are just the ones that are
  publicly traded. Little is known of the majority
  of EHR software systems that are privately owned.
• On several blog sites on the net there are
  several discussions of EHR software system
  vendors that leave their users angry, and on one
  occasion holding patient records hostage waiting
  for more fees. Here are the most recent
  discussions
• eCW (https//md.sermo.com/medical/ticket/details?n
  avonid23060)
• Cerner (https//md.sermo.com/medical/ticket/detail
  s?navonid18593)
• NextGen- discussion still active after more than
  a
• year! (http//www.emrupdate.com/forums/t/12000.as
  px?PageIndex1)

8
The Medicare P4P and e-prescribing rules show
that the government has conspired with HIMSS
enterprise EMR vendors to try to  force
physicians to purchase a CCHIT-certified EMR in
the future if they wish to be paid a fair wage
for services rendered when they see those
elderly patients in their practices. This could
be illegal, but

• There exists a situation, "extortionate
  extensions of credit" which can apply to
  CCHIT-related activity
• For vendors The purported CCHIT "buy-in"
  certification costs of 30000 if you wish to stay
  in business within the HIT industry.
• Physicians The department of HHS P4P payout of
  money only if you purchase a CCHIT-certified EMR.
• Legalese "By its very nature, however, extortion
  causes the victim to consent to the taking of
  property. Extortion does not necessarily involve
  the use of force or the threat of the use of
  force. For example, the victim storeowner
  voluntarily pays a Mafia enforcer 1000 per month
  because the Mafia enforcer said, pay us 1000
  per month of we'll break your legs.

http//www.emrupdate.com/forums/p/7953/60493.aspx
60493
9
The Medicare P4P and e-prescribing rules show
that the government has conspired with HIMSS
enterprise EMR vendors to try to  force
physicians to purchase a CCHIT-certified EMR in
the future if they wish to be paid a fair wage
for services rendered when they see those
elderly patients in their practices. This could
be illegal, but

• In Summary "Governmental power, by its nature,
  is legalized extortion, i.e. unless you buy a
  CCHIT certified EMR you won't be able to make a
  decent living in the practice medicine in the USA
  anymore You only have 2 options-
• Dont vote for elected officials that dont
  understand the implications of their
  representation.
• Dont consent to forced HIT rules which may pay
  you an extra pittance for consent or
  participation which legitimizes the process
  further.

http//www.emrupdate.com/forums/p/7953/60493.aspx
60493
10
Occasionally a Physician May Claim It would
however be more positive and productive if
doctors as a profession would actually accept the
challenge and work with CCHIT to design
appropriately suitable standards.

• If you try to work with CCHIT, all you end up
  doing is giving this politically contrived
  public/private company more validity. Its whole
  premise is wrong and flaunts the Clayton and
  Sherman antitrust acts simply because of the
  backing of the Department of Health and Human
  Services.
• CCHIT functions not unlike the mafia, providing a
  method of racketeering in which if you didn't pay
  their 30000.00 a year, your business dies. This
  decreases competition, leading to increased
  prices that impacts every physician office in the
  USA. On top of this they through massive
  donations which are usually poorly known, they
  have been able to get bipartisan support to force
  doctors into purchasing their bloated, costly,
  difficult to use EMR software.

An Antitrust Primer- http//www.emrupdate.com/fo
rums/p/7196/56269.aspx56269
11
Occasionally a Physician May Claim It would
however be more positive and productive if
doctors as a profession would actually accept the
challenge and work with CCHIT to design
appropriately suitable standards. (continued)

• When I first began looking into this, I found
  that CCHIT itself, a nonprofit organization,
  had planned on making a million dollars in the
  first 6 months of existence in 2006, then divide
  the profits at the end of the year. I exposed
  that, and subsequently they reorganized on
  11/2006. Subsequently, an article stated that
  Cerner spent 180,000 in its lobbying efforts in
  Q1 of 2008 in Congress to forward the agenda of
  the "enterprise" EHR.
• So those that are contemplating on working with
  this process- dont!

URL for the CCHIT original charter and minutes
demonstrating how not-for-profit CCHIT was going
to make a profit in 2006 http//msofficeemrproje
ct.com/Page3.htm
12
CCHIT Facts According to Histalk

• Incorporated as an LLC in 2004, reincorporated as
  a non-profit C-corporation in 2006.
• CCHITs address on the tax form is 200 S. Wacker
  Drive, Chicago, IL 60606.
• CCHIT took in 4.7 million in FY2007, spent 3.6
  million of that, and banked 1.1 million,
  bringing its fund balance up to 2.7 million and
  total assets of 3.4 million.
• Of the 4.7 million in income, 2 million was
  from certification fees, 2.7 million was from
  government contracts.
• CCHIT reported 866K transferred to AHIMA (the
  enterprise EHR vendor lobbying group) in a
  category that includes sharing of equipment,
  facilities, or employees. HIMSS
• received 196K for a category that includes
• performance of membership services.

http//histalk2.com/2009/02/21/monday-morning-upda
te-22309/
13
CCHIT Facts According to Histalk

• The tax records indicate that CCHIT chair Mark
  Leavitt is still a HIMSS employee, "on leave from
  his position as HIMSS Chief Medical Officer
  while serving as Chair of CCHIT. CCHIT pays HIMSS
  an hourly rate for Dr. Leavitts services that is
  intended to cover the portion of his salary and
  benefits allocable to those hours." Thats at
  odds with both his CCHIT bio and his LinkedIn
  write-up, which say hes finished with HIMSS and
  working full-time for CCHIT (he put on LinkedIn
  that he left HIMSS in September 2005), although
  on tax forms he is shown as being paid 164K for
  40 hours a week at CCHIT, possibly more.

http//histalk2.com/2009/02/21/monday-morning-upda
te-22309/
14
FACTS THE ECONOMICS ABOUT BUYING A c-EMR
SOFTWARE SYSTEM
15
If you try to take advantage of the Stark Law
Relaxation to allow hospitals to buy you an EMR

• First you have to find a hospital willing to
  donate money to your cause.
• By law, the most that the hospital can buy is 85
  of the initial outlay of the EMR.
• The hospital will not cover the training, which
  can cost as much as the EMR itself.
• You still have to pay for-
• The yearly ongoing fees, usually costing about
  15 of the initial cost.
• The cost of the hardware which can handle an SQL
  server backend, plus the technical assistance to
  make it work.
• You still have the loss of productivity
  associated with workflow disruption that in many
  cases does not improve with time.
• The response to date has been lukewarm due to
  both hospital and physician reluctance to enter
  into binding agreements, costs, and problems
  related to patient confidentiality.

http//www.hschange.com/CONTENT/1015/
16
Multiple Vendors Claim Physicians need to
understand that this is an investment, so they
will not only make their initial costs back, but
in the next five years, they could make an extra
125,000!

• As stated in the previous slide, the initial and
  ongoing costs provide a large hurdle to overcome
  before a provider begins to make money.
• Just the 50 failed installation rate, the 8
  deinstallation rate, and for those that do
  install the EMR, the 90 less-than-full use, and
  lastly the loss of productive workflow, alone
  will kill any possible increased income using an
  expensive CCHIT-certified EHR.
• In 2 case studies published at the www.aafp.com
  site, the total outlay just for the technology
  was reported to cost anywhere between 125,000.00
  to as much as a 250,000.00 for 2 doctors over
  the first 5 years (2002 dollars).

• The two aafp website articles referenced above
  http//www.aafp.org/fpm/20020400/57howm.html
  and http//www.aafp.org/fpm/20030500/37impl.html)
• http//www.emrupdate.com/blogs/ducknet/archive/200
  8/10/01/ehr-adoption-remains-off-in-the-distance-g
  etting-way-to-complicated.aspx

17
The 2/13/2009 stimulus bills 44,000.00
incentive payment for significant use of a
c-EHR may seem like a lot, but not really

• The current (2009) estimated average cost of
  purchasing an EHR system is 33,000 for each
  physician, with an additional cost of 1,500 per
  doctor per month for maintenance. So if you do
  the math, 33000.00 plus 1500 x 60months
  123000.00 (http//blog.case.edu/case-news/2008/10
  /30/ehrregulation)
• Add to that 1/3 of a full-time employee to follow
  the trail of the reporting and documentation, and
  it comes out to another 10000.00/year x 5 years
  50,000.00
• Workflow losses The costs of P4P with the added
  extra data input needed to capture the granular
  data is an estimate, as the specifics havent
  been posted yet, but say it takes an extra 5
  minutes per encounter. An office grossing
  100,000.00 a year in Medicare funds, at 100.00
  per encounter, equals to 1000 encounters. Do the
  math again- 1000 x 5 min/encounter 5000
  minutes
• 5000/20 min per encounter 250 lost
  encounters, or
• another 25000.00/year x 5 years 125,000.00
• Total losses over 5 years 298,000.00

http//www.hcplive.com/mdnglive/articles/PC_Medica
re_HIT_mandate
18
FACTS ABOUT E-EHR SOFTWARE SYSTEMS AND QUALITY
19
Big government, EHR vendors, health insurers, and
Presidents Bush Obama all believe that EHR
software systems improve quality save lives

• But there is not one prospective study
  demonstrating this fact.
• There are several showing the opposite, s.a.
• In one study published in 2005 involved a
  pediatrics ICU using EHR and CPOE systems. The
  final result was that more children died using
  HIT- Univariate analysis revealed that mortality
  rate significantly increased from 2.80 (39 of
  1394) before CPOE implementation to 6.57 (36 of
  548) after CPOE implementation.
• In another study, the CPOE system was so bad that
  physicians could not put in the orders in a
  timely manner, and after only 3 months the whole
  project was discontinued. See Cedars-Sinai
  Doctors Cling to Pen and Paper URL below.

• Pediatrics, Vol. 116, No. 6. (December 2005), pp.
  1506-1512, http//www.citeulike.org/user/scheufele
  /article/505501
• http//www.washingtonpost.com/wp-dyn/articles/A523
  84-2005Mar20.html?subAR

20
Big government, EHR vendors, health insurers, and
Presidents Bush Obama all believe that EHR
software systems improve quality save lives
(continued)

• In 2007 one study, published in the Archives of
  Internal Medicine, showed that for 14 of the 17
  quality indicators, there was no significant
  difference in performance between visits with vs.
  without EHR use.
• In 2008 a study performed at the Richmond, VA
  MCV/University of Richmond Medical Center they
  concluded that for 10 quality indicators,
  there is limited evidence of the relationship
  between hospital EMR use and quality.

• http//archinte.ama-assn.org/cgi/content/abstract/
  167/13/1400
• http//mcr.sagepub.com/cgi/content/abstract/65/4/4
  96

21
One study finally showed that EMR software
systems might lower malpractice risk

• But this was a retrospective study which involved
  varied amounts of EMR use by practitioners.
• The survey response rate was only 71.4 (1345 of
  1884), and only 1140 respondents of these had
  significant data on the presence of EHR.
• The purported 40 reduction was not statistically
  significant In logistic regression analysis
  controlling for sex, race, year of medical school
  graduation, specialty, and practice size, the
  relationship between EHR adoption and paid
  malpractice settlements was of smaller magnitude
  and no longer statistically significant (adjusted
  odds ratio, 0.69 95 confidence interval,
  0.40-1.20 P .18).
• A subgroup analysis revealed that although only
  5.7 of frequent EMR users had paid malpractice
  claims, compared to 10.8 of those not using an
  EMR, those that infrequently/partially used an
  EMR (s.a. "hybrid systems") faired WORSE than
  those using only paper records (12.1).
• The facts remain that despite the cheerleading
  for EMR software systems theres still not a
  shred of evidence they have a significant impact
  on outcomes that matter.

http//archinte.ama-assn.org/cgi/content/abstract/
168/21/2362
22
On the contrary, another more recent study showed
the opposite- that EMR software systems pose new
legal risks

• For one thing, an overarching concern is that
  Federal Rules of Civil Procedure, approved by the
  U.S. Supreme Court in December 2006, make any
  electronically-stored data discoverable in a
  trial--and those details can catch doctors off
  guard.
• Doctors may run into problems if the EMR software
  systems metadata (the time stamp indicating who
  entered what and when) conflicts with his or her
  version of events.
• Perhaps even more vexing, it's still not clear
  what the legal status of an EMR is. At present,
  it's still in question whether all EMR software
  systems meet the legal definition of being
  medical records, a concern that could become
  important in some forms of legal disputes over
  patient care.

http//www.fiercehealthit.com/story/emrs-pose-new-
legal-risks/2008-10-06
23
On 7/2008 Congress passed a bill forcing doctors
to use e-prescribing or suffer a cut in
reimbursement

• This bill was pure politics at its worse.
• For most practitioners, e-prescribing is a
  workflow slowing tedious procedure.
• Allscripts claims that they offer a free
  system, but its a marketing ploy. Its database
  is not open source and no plans are in the
  works to make it accessible to most EMR software
  systems so as to prevent double entry. This
  "free" e-prescribing is what convinced Congress
  to put e-prescribing on their recent 7/2008 HR
  6331 bill.
• Although on 7/2008 there were up to 10 of
  physicians capable of e-prescribing, only 2 of
  prescriptions actually were legitimately sent by
  e-prescribing as described by law.
• It was meant to make a transition from
  handwritten prescriptions to a format that was
  more legible overall, but what is not known is
  why they prohibited the faxing or simple printing
  of prescriptions from an
• EMR?

https//md.sermo.com/medical/ticket/details?navon
id21117
24
FACT C-EHR SOFTWARE SYSTEM AGENDAS HAVE MORE TO
DO WITH POWER, MONEY, AND GREED
25
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• You have to follow the money. The internet first
  mentions a relationship that Obama has had with a
  technology guy call Robert Blackwell who kept
  him, a newly minted lawyer, on retainer.
  Blackwell seemed to later get quid pro quo
  payments where his company, EKI (Electronic
  Knowledge Interchange) profited.
• EKI is a business and technology consulting firm
  that specializes in delivering measurable
  business value to mid to large size corporate and
  government organizations, which is something that
  Obama wants to bring to health care through the
  use of c-EHR systems.
• Obamas presidential campaign website reported
  that
• Blackwell in 2008 committed to raise between
• 100,000 and 200,000 for Obamas White House
• run that year. I'm sure that eventually we'll be
  hearing
• more of this Blackwell relationship. 

• http//citizenwells.wordpress.com/2008/04/29/robe
  rt-blackwell-obama-money-laundering-eki-consulting
  -rod-blagojevich-illinois-tony-rezko/
• http//news.lavenderliberal.com/2008/04/27/obama-
  supporters-how-do-you-justify-barrys-blackwell-eki
  -killerspin-wheeling-and-dealing/

26
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• TULLMAN Shortly after Obama gets elected, he
  makes Glen Tullman, CEO of Allscripts, his
  personal IT advisor.
• Mr. Tullman personally gave President Obama at
  least 144300.00 in donations in the 2 years
  prior to his election. His employees gave 20662
  during the same period. His company,
  Allscripts/Misys also gave the possible future
  HHS Secretary Daschle 12000 speaking fees on
  8/2008 for a lecture.
• This lobbying put him into the unusual position
  where he can influence legislation which can
  ultimately enrich himself by forcing the use of
  e-prescribing and c-EHR systems while the
  American taxpayer, and especially doctors have to
  foot the bill.

• http//histalk2.com/2009/02/05/histalk-interviews-
  glen-tullman-ceo-of-allscripts-2509/
• http//hotair.com/archives/2008/04/27/an-obama-pay
  off/
• http//www.talkleft.com/story/2008/4/27/145012/15
  4
• http//www.obamamustgo.com/
• http//www.discoverthenetworks.org/Articles/black
  well5.html

• http//www.campaignmoney.com/political/contributio
  ns/glen-tullman.asp?cycle08
• http//fundrace.huffingtonpost.com/neighbors.php?t
  ypeempemployerALLSCRIPTS
• http//www.democraticunderground.com/discuss/duboa
  rd.php?azview_alladdress389x4968435

27
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• On a more recent note, several of Obama's health
  information technology related appointees have
  been found to be "problematic" (I'm trying to be
  kind here)
• DASCHLE Allscripts/Misys (CEO Glen Tullman's
  company) also gave the possible future HHS
  Secretary Daschle 12,000.00 speaking fees on
  8/2008 for a lecture. Fortunately "buy me out"
  Daschle failed to pay his taxes, so he had to
  resign.
• KUNDRA  On 3/10/2009 the FBI raided the former
  office of one of President Obama's appointees,
  Vivek Kundra. An employee of the D.C. Office of
  the Chief Technology Officer and a private
  contractor were charged with corruption,
  including bribery of a public official, money
  laundering, wire fraud and conflict of interest. 
  As the raid took place, Obama's appointee,
  Kundra, was giving a speech at FOSE - an annual
  government technology expo - about changing the
  way the government purchases materials from
  vendors. Kundra is on leave from his White House
  job until further details of the case become
  known, a White House
• source told the Associated Press. He was at the
  job only 7 days before this
• occurred if he stays on, he would be an
  integral part of the push to c-EHRs.

• http//www.democraticunderground.com/discuss/duboa
  rd.php?azview_alladdress389x4968435
• http//voices.washingtonpost.com/posttech/2009/03/
  vivek_kundra_to_be_obamas_chie.html 
• http//www.huffingtonpost.com/2009/03/12/fbi-raids
  -obama-technolog_n_174265.html 
• http//groups.google.com/group/alt.politics.democr
  ats.d/browse_thread/thread/6c3ddc4a3f4bee10 

28
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• Other lobbyists include
• DEPARLE President Obama's health technology
  "czar", Nancy-Ann DeParle, has some deep
  financial ties to the healthcare industry shes
  supposed to reform. Among them is the fact that
  she served as a Cerner board member since 2001
  and that she was paid 195K in stock and cash and
  held around 1 million of CERN shares at the end
  of 2007.  She donated 39,400.00 to various
  Democratic party officials. On 3/6/2009 she
  resigned from Cerner's board.

• BLUMENTHAL President Obama recently selected
  David Blumenthal M.D., to serve as national
  coordinator within the U.S. Department of Health
  and Human Services. Blumenthal was director of
  the Institute for Health Policy at Massachusetts
  General Hospital in Boston, part of Partners. An
  interesting disclosure he is receiving grant
  support from GE Healthcare.

• http//content.nejm.org/cgi/content/full/NEJMp0901
  592
• http//www.chicagotribune.com/news/nationworld/chi
  -deparlemar29,0,7090806.story
• http//www.histalkpractice.com/2009/03/02/news-330
  9/ 
• http//www.campaignmoney.com/finance.asp?typeinc
  ycle08criteriaDeParle

29
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• An editor from the Chicago Tribune questions how
  DeParle and others in this administration can
  avoid conflicts of interest, particularly given
  the size and market share of some of the firms
  they have served.
• "What the administration is going to have to
  guard against is this perception that there is
  some benefit given to companies who know people
  in the administration."

http//www.chicagotribune.com/news/nationworld/chi
-deparlemar29,0,7090806.story
30
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• FRIEDEN Dr. Thomas Frieden, M.D., an infectious
  disease specialist, who worked at the CDC from
  1990 to 2002 as an Epidemiologic Intelligence
  Service Officer investigating a range of issues
  include the spread of multidrug-resistant
  tuberculosis, who served as the former Chairman
  of the New York City Department of Health and
  Mental Hygiene since January 2002, has been named
  by President Obama as the director of the Centers
  for Disease Control and Prevention.
• Frieden has been a strong advocate of
  electronic health records, and as such his
  department two years ago signed a 19.8 million
  contract to fund deployment in underserved areas
  of integrated practice management/electronic
  records software from eClinicalWorks Inc. (eCW),
  Westborough, Mass.
• I suspect that he will be the the fourth c-EHR
  system
• lobbyist surrounding Obama, representing eCW. To
  date
• I was not able to find the exact behind the
  scenes reason
• for his strong patronage of this particular EMR
  but Im
• still looking.

http//www.healthdatamanagement.com/news/CDC-28210
-1.html?EThealthdatamanagemente872555astemai
lchanneldisease_management
31
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• GLASER Mr. John Glaser, VP CIO Partners
  Healthcare in Boston was appointed to a 6 month
  stint as an adviser to David Blumenthal, the
  recently appointed national coordinator for HIT.
  Glaser will spend 4 days/week for 6 months
  working with ONC.
• Blumenthal, a practicing physician and Harvard
  Medical School professor most recently worked for
  Partners HealthCare as director of the Institute
  for Health Policy at Massachusetts General
  Hospital.
• Glaser is a fellow of HIMSS, CHIME and the
  American College of Medical Informatics. He also
  serves on the editorial board of Healthcare IT
  News and is a regular columnist at
  www.histalk.com.

http//www.healthcareitnews.com/news/glaser-advise
-onc-chief-hitech
32
There is a dark side to the certified EHR
software systems currently being pushed by
President Obama- a World Where Money Buys Power,
Greed, and the Ability to Manipulate the
President of the United States

• PARK On 8/3/2009 Mr. Todd Park, co-founder and
  board member of Athenahealth, has been named CTO
  of the US Department of Health and Human
  Services. He resigned from Athenahealths board
  on 8/10/2009 and had promised to divest his
  Athenahealth stock position. Park will report to
  Deputy HHS Secretary William.
• Athenahealth (Nasdaq ATHN), another
  enterprise level EHR vendor is a leading
  provider of internet based business services for
  physician practices, and received the 2008
  Certification Commission for Healthcare
  Information Technology (CCHIT) for its
  AthenaClinicalsSM Version 9.15.1.

http//histalk2.com/2009/08/03/todd-park-athenahea
lth-co-founder-named-cto-of-hhs/
33
SUMMARY FACT STATEMENTS
34
EMR FACT SUMMARY
List of quick facts about EMR

• Physicians do NOT like c-EHR systems.
• EMR does NOT save time.
• EMR does NOT improve workflow, and most likely
  will make it worse.
• EMR does NOT save money, especially for the
  doctor.
• EMR does NOT make a physician money and will
  NOT offer a ROI.
• EMR has NOT been demonstrated to improve
  quality of care over paper in prospective studies
  when looking at the same quality measures.
• EMR does NOT prevent redundant testing.
• EMR does NOT lessen your risk of malpractice
  litigation.

• https//md.sermo.com/medical/ticket/details?navon
  id24242
• https//md.sermo.com/medical/ticket/details?navon
  id31562

Slide 34
35
EMR FACT SUMMARY
More of the list of quick facts about EMR

• EMR does NOT save paper.
• EMR CAN bring organization to an office.
• EMR WILL print out a hell of a 3 page
  consultation on an OV for a sore throat, whether
  or not the patient was seen.
• EMR WILL erode the patient privacy and make
  everyone's file available to government,
  insurance companies, and anyone else who wants to
  see it.
• The c-EHR agenda has more to do with power,
  money, and greed than with issues of quality,
  errors, and ROI.

Slide 35
https//md.sermo.com/medical/ticket/details?navon
id31562
36
EMR FACT SUMMARY
Finally, quotes from David C. Kibbe

• "One has to question whether or not a
  vendor-founded, vendor-funded and vendor-driven
  organization should have the exclusive right to
  determine what software will be bought by federal
  taxpayer dollars.
• "It's important that the people who
  determine how this money is spent are
  disinterested and unbiased . . . Even the
  appearance of a conflict of interest could poison
  the whole process."

Dr. Borges in his organized office using his EMR!
http//www.washingtonpost.com/wp-dyn/content/artic
le/2009/05/20/AR2009052003600.html
Slide 36