Monday, November 17, 2014

Should Doctors Become Proxy Data Collectors For the Government?

The Institute of Medicine (a branch of the National Academy of Sciences) is recommending that doctors use electronic medical records "to capture patients' census tract information (to estimate their median income and for geo-coded mapping), as well as information about their financial resource strain and levels of physical activity and stress."

Furthermore, the IOM is recommending to the federal government that regulators and Medicare link such collection to financial incentives to physicians -- essentially turning them into proxy data collectors for the government:
The widespread capture of data in these eight categories, or “domains,” could be achieved by adding them to the requirements of the federal government's EHR incentive payment program, the IOM committee recommended.

The recommendations will be submitted to the CMS and the Office of the National Coordinator for Health Information Technology at HHS for their consideration as they develop requirements for Stage 3 of the EHR incentive program, according to Dr. William Stead, co-chairman of the 13-member IOM subcommittee that released the report. Stead is a professor of medicine and biomedical informatics at Vanderbilt University.

The CMS writes the rules on what providers must do to become “meaningful users” of EHRs, qualify for incentive payments and avoid Medicare penalties under the program created by the American Recovery and Reinvestment Act of 2009. The ONC sets the EHR testing and certification requirements vendors must meet so providers using their systems can meet their meaningful-use requirements.
Additional data that might be collected:
The IOM panel also recommended that EHRs and their users gather information about patients' educational status; whether they are experiencing depression; their social connections and sense of social isolation; and whether or not they're subjected to violence by a partner in an intimate relationship.
It's still unclear when and how such data might be released from patient medical records to which government agencies.

(Link via Dr. Kathleen Brown.)