Difference between revisions of "Shining a little light and a little heat on the issue of EHRs and fraud"

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This is a review of the 2013 article, “Shining a little light and a little heat on the issue of EHRs and Fraud.” by Donald W. Simborg.
 
 
 
This is a review of the 2013 article, “Shining a little light and a little heat on the issue of EHRs and Fraud.” by Donald W. Simborg.
 
This is a review of the 2013 article, “Shining a little light and a little heat on the issue of EHRs and Fraud.” by Donald W. Simborg.
  

Latest revision as of 05:25, 5 November 2015

This is a review of the 2013 article, “Shining a little light and a little heat on the issue of EHRs and Fraud.” by Donald W. Simborg.

Introduction

September 2012 brought about a week of unwanted spotlight attention to Electronic Health Records (EHRs) and fraud. The cause for unwanted attention, the increases in billing upon health systems switch to EHRs, which brought about a lot of speculation and opinion based finger pointing. With all the commotion brought about during this week, neither our informatics community leadership nor our current administration gave more than a blink of an eye to the uproar and concern of EHR fraud. Typical responses were handed out from leadership that if there is fraud, it is not the fault of the EHRs but rather a tiny minority of criminals, and a warning from the current administration that fraud would not be tolerated.[1]

Where do we go from here

With typical nonchalant responses being given from leadership and government, it can be difficult to find an avenue of approach to address a rapidly growing issue. With that being said, the first step is to obtain proof. Proof that there is fraud happening and that it is not only the criminals that need to be addressed, but also EHRs that need to be evaluated and redesigned to prevent fraud. The issue with obtaining proof is that it is time consuming and costly, and despite warnings of fraud in 2005 and 2007 from the Office of the National Coordinator (ONC), the issue of fraud is often ignored.

How can EHRs be redesigned to deter fraud?

There are plenty of techniques that can be utilized to help prevent fraud from occurring within an EHR. Many like event logging, user authentication, and patient authentication, are often talked about when it comes to implementing better security measures in the EHR. Often techniques such as disabling certain functions and features in the EHR to reduce fraud go unmentioned and are not heard of. However, with false claims and fraudulent billing being the most common types of EHR fraud, one would think disabling up coding and cloning features would be a no brainer to help prevent fraud. By disabling such features and implementing event logging and user authentication, fraud could be greatly reduced. If it were not greatly reduced, at the least there would be a trail of evidence for the prosecution of those committing fraud.


Comments

Since embarking on this journey in receiving my education in health informatics, it has baffled me at how far behind technology is in healthcare compared to the rest of technology in the world. The lack of privacy and security in health information technology is even more concerning to me, especially when I come across articles where the implementing leadership, the medical informatics community, and our very own government is shrugging such issues off as nothing more than a by product that cannot be prevented. It may be a by product, but fraud, along with our privacy and security should not be taken so light heartedly. It should be at the forefront of health information technology and considered from conception to implementation, and continuously throughout the lifespan of health information technology. In a society so technologically advanced, fraud, along with privacy and security violations are only going to continue until we do something to minimize and prevent them from happening. A question that is in my mind is, how long will it be before we decide to finally do something about these issues?

References

  1. Donald W. Simborg 2013. Shining a little light and a little heat on the issue of EHRs and Fraud. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715337/?tool=pmcentrez