Thursday, November 30, 2006

Wal-Mart & Intel to establish a patient-controlled EHR?

Ok, as if it wasn't enough that Wal-Mart is planning to open its own brand of clinics (sound awfully similar to those HMOs that sprouted out in Florida in the late 1980's, then failed. Will quality suffer in the name of cost controls?). Now, they're planning to set up Electronic Health Records. These portable electronic records would be recognizable by hospitals, doctors and pharmacies. The idea -- have the patients coordinate their own healthcare among doctors and hospitals and their pharmacies. Intel and British Petroleum are also on the bandwagon, according to the article in the Wall Street Journal from Wed, Nov 29th. Should we be thankful or afraid?

On paper the ideas sound great! These companies will set up an electronic data warehouse, with of course the most top notch security, then house all private information there. This information will be used by employers and insurers to evaluate health spending patterns on millions of employees. Well, what would you expect? If the employers are paying for this, there's got to be some benefit for them. These e-records will perform the incredible task of eliminating duplicate tests and prevent erroneous information from being carried forward. It would also slash the administrative overhead that is making healthcare so costly in this country. Yes, and electronic prescriptions would help prevent the thousands of medication-related illnesses or deaths that occur yearly. Wow, that's amazing!

Who will be watching over the employers and the insurance companies these records are being shared with? What type of data mining will these records be subjected to? Will patient's privacy be respected, or will this data be used to deny job promotions or even health-care coverage? Who's going to be the watchdog to make sure this information is not misused by the companies that are providing this service for free? It seems too good to be true. Are there enough safeguards in place as of yet? The Patient Privacy Rights Foundation seems to think NOT YET. Ok, they're promising that the employee's information will be stripped off the record before the data is mined. Hmm, hmm!

I can just see it now: Wal-Mart will use its buying power to bully doctors to either agree to participate in these patient-controlled records, or else! If they don't, they will not be able to see these patients. Is it that Wal-Mart and Intel want a bite out of the healthcare spending pie? Intel chips are found in the hand-held prescription-writing PCs. Wal-Mart, with the third largest pharmacy chain in the country, now wants to open 60 "miniclinics." Are these plans to make back some of the money they spend in healthcare? Is there not some STARK II violation in there somewhere? Self-referrals in the case of Wal-Mart? And the union of Wal-Mart and Intel on this initiative was suggested by our very own Centers for Disease Control and Prevention? Wait a second, maybe this is a backdoor entry into a nationalized healthcare system?

Yes. It makes me nervous, because I don't have much faith in the individual consumer to protect their rights. We should have our antennas up and eyes wide-open on this one.

1 Comments:

Blogger Richard A Schoor MD FACS said...

Very nervous indeed!

3:03 PM EST  

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