20 August 2013

Why Aren't Technology Vendors Held Accountable?

Because Congress gave them a golden egg and now that it has hatched into the golden goose, you can bet they will never be held accountable. They will continue to wait for the goose to lay more golden eggs so that they can continue with their proprietorial ways to get more dollars for their products and obtain the golden cow to continue to milk the healthcare system until it dries up. They have padded the coffers of Congress to influence the printing of laws that do not require them to have their systems validated for safety, efficacy, usability, interoperability, or to report adverse events or crashes.

Heavy lobbying will not turn the tide as long as they have the golden goose to parade before the members of Congress. I could almost agree with Jordan Dolin, founder and vice chairman of Emmi Solutions if he would abandon the buzz words. If he would use the terms with real meanings that had known definitions it would make more sense. However, using terms like patient engagement is what the medical people use to hide what they are talking about and most patients are beginning to understand this and want no part of patient engagement.

Even he admits that the term patient engagement lacks a standard definition. Then the medical community muddies the water by alternating this term with meaningful use to keep patients off balance. Jordan also admits that what many health information technology types are doing is not going to fit within the definition of meaningful use that the Centers for Medicare and Medicaid Services (CMS) is looking for to satisfy the requirements.

Handing out a 100-page binder of information, call centers that remind patients of their appointments, waiting room entertainment systems, and printed hospital discharge instructions is being used to say that patient engagement is taking place. This is fallacious at best and is not engaging and assisting the patients in their care. To me as a patient, this should mean communications that is not one sided, but between a provider and patient, occasionally including an advocate or a patient's caregiver. This is communication that will encourage a patient to want to take better care of themselves and expend the time and effort to obtain better health. The term “patient engagement” should be relegated to the trashcan and replaced with the term communications.

Even one of the comments to Jordan's blog stated, “I know of providers who have a typed line on every piece of paper handed to patients that recommends smoking cessation. This enables them to successfully check a box on meaningful use e-templates (with 100% participation!). For all I know, it may help. But I wouldn’t hold my breath.” This is the asinine use of patient engagement and not of value, as I doubt these providers even knew which patients smoked and which did not.

Vendors should be willing to commit to their patient engagement promises, present proof showing improved outcomes and face some financial risk for failing to deliver. I won’t be holding my breath. And, I bet the boilerplate disclaimer “…[Vendor] makes no express or implied warranty for merchantability or fitness for any particular use…” remains a staple of all EHR contracts. Yes, the golden goose clause exempting them from penalties.

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