Avoiding fraud risks associated with EHRs

This is a review of the 2010 article, “Avoiding fraud risks associated with EHRs”, by Jeffrey Helton.

Introduction

As healthcare technology evolves, fraud becomes a more evident issue that we must deal with. While there is great potential for Health Information Technology (Health IT) such as the Electronic Health Records there is also a risk of fraudulent activity that can be committed; however if utilized properly Health IT could help protect and minimize the risk of fraud. Bringing awareness of the different types of fraud and how to mitigate the risk to the reader is how this article sheds light on the issue of EHR fraud.

EHR Fraud

EHR fraud can be narrowed and classified into two areas; falsely billing, also known as up coding, and inappropriate access or unauthorized access. With just these two categories alone, fraud can be committed and go undetected.

Mitigating risk

EHR systems with basic business controls put providers in a the best position to detect fraudulent activity or to gather transactional evidence should such activity be identified. Process related internal controls and system is recommended method to mitigate fraud risks in this article. Process control refers to the implication of such processes as provider identification, User access control, documenting issues, and allowing auditor access to records.

Comments

As we learn more and more about EHRs and the evolving of Health IT, fraud is one area that is over looked. Ensuring Health IT is being utilized properly should be the priority of all, especially when it comes to patient information. With that being said, there seems to be little light shed on the possibilities of EHR fraud.