Monthly Archives: April 2009

Ministry of Information “held harmless” by contract

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If patients die as a result of health information technology (HIT) defects, the clinicians will be liable—not the vendors. Hospital administrators have signed contracts with “hold harmless” clauses that protect their HIT vendors.

At the same time, like a Soviet-style Ministry of Information, the vendors demand secrecy about the defects. Some hospitals maintain lists of HIT defects, which might contain thousands of items, some of which pose considerable risks to patients. But they are contractually bound not to disclose them (Health Care Renewal 3/26/08).

“Enforced nonsharing of software problems is an industry norm,” write Ross Koppel and David Kreda, although anathema to improving patient care or to evidence-based medicine (JAMA 2009;301:1276-1278).

Vendors avoid liability by relying on the doctrine known as “learned intermediaries,” they note. Users are medical professionals with the expertise to recognize the errors and protect the patients from harm.

Though supposedly the panacea for correcting inefficiency and medical error, “implementations of HIT are massively complex and fraught with delays, errors, resistance, work process redesign, frustration, and outright failure,” they observe, citing numerous references.

There has been very little change in the difficulties with HIT over the past 35 years, writes Scot M. Silverstein, M.D., of Drexel University, College of Information Science and Technology. Those responsible for HIT are not held to the same standards of accountability as clinicians are, though both patient wellbeing and institutions’ financial resources are at risk. Dr. Silverstein has developed a website about “what has been shown best not to do.”

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SENATE VOTES ON HEALTHCARE RATIONING: Efforts to Oppose Defeated Along Party Lines

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The Senate had a flurry of voting on amendments to the Budget Bill yesterday, including one extremely important vote that could have helped to stop government rationing of medical care.

Sen. Jon Kyl (R-AZ) offered an amendment , SA 793, that would have thrown a big roadblock in the way of any plans for government rationing through “Comparative Effectiveness Research,” or CER.

The stimulus bill passed with $1.1 billion allocated for CER to compare the clinical outcomes, effectiveness, and appropriateness” of medical services.  That money sets the stage for a health rationing bureaucracy.
 
Yesterday on the floor of the Senate, Sen. Kyl and his colleague Sen. Pat Roberts (R-KS) expressed their concern that CER would be used to justify rationing by comparing costs, rather than effectiveness.  Sen. Roberts compared it to giving away the “golden ring” to bureaucrats.

The language of Sen. Kyl’s amendment was simple:  it would have prohibited the government from denying care to patients just to save money based on CER studies.

Stop the Senate From Sneaking Socialized Medicine into the Budget Today

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URGENT ACTION NEEDED!

Stop the Senate From Sneaking Socialized Medicine into the Budget Today

Contact your Senators NOW – the vote could come any time

[SCROLL DOWN TO BOTTOM OF PAGE TO POST YOUR COMMENTS]

The Senate is voting on amendments to the Budget Bill even as we send out this message, and there is one extremely important vote later today that could help stop socialized medicine from becoming the law of the land.

Sen. James DeMint (R-SC) has offered the “Healthcare Freedom Amendment, SA 853, that would prohibit the government from forcing you into “government-managed, rationed health care.”

WE CANNOT LET THIS OPPORTUNITY SLIP AWAY

Just yesterday, the Senate voted down an amendment from Sen. Jon Kyl (R-AZ) that would have thrown a big roadblock in the way of any plans for government rationing through “Comparative Effectiveness Research,” or CER. That was defeated along party lines.

CALL YOUR SENATORS RIGHT NOW TELL THEM TO VOTE “YES” ON THE “HEALTH CARE FREEDOM AMENDMENT,
SA 853 ON THE BUDGET.

The lines are extremely busy, so tell the receptionist you would like to leave a message with the staff member responsible for the budget. Tell them you support the Healthcare Freedom Amendment, SA 853, because it would strip out language that would open the door to socialized medicine. Leave your name and a phone number.

CONGRESSIONAL SWITCHBOARD:

(202) 224-3121

SEND AN EMAIL TO YOUR SENATOR

SEND A MESSAGE TO SEN. DeMINT

SCROLL TO BOTTOM OF THIS PAGE TO COMMENT ON THIS AMENDMENT OR THE BUDGET

TEXT OF SEN. DeMINT’S HEALTHCARE FREEDOM AMENDMENT, SA 853:

SEC. __. POINT OF ORDER AGAINST LEGISLATION THAT DECREASES THE NUMBER OF AMERICANS ENROLLED IN PRIVATE HEALTH INSURANCE WHILE INCREASING THE NUMBER ENROLLED IN GOVERNMENT-MANAGED, RATIONED HEALTH CARE.

(a) In General.–In the Senate, it shall not be in order, to consider any bill, joint resolution, amendment, motion, or conference report that decreases the number of Americans enrolled in private health insurance plans, while increasing the number of Americans enrolled in government-managed, rationed health care (as determined by the Congressional Budget Office).

(b) Waiver.–This section may be waived or suspended only by an affirmative vote of three-fifths of the Members, duly chosen and sworn.

(c) Appeals.–An affirmative vote of three-fifths of the Members of the Senate, duly chosen and sworn, shall be required to sustain an appeal of the ruling of the Chair on a point of order raised under this section.

SENATE VOTES ON HEALTHCARE RATIONING
Efforts to Oppose Defeated Along Party Lines

April 2, 2009 — The Senate had a flurry of voting on amendments to the Budget Bill yesterday, including one extremely important vote that could have helped to stop government rationing of medical care.

Sen. Jon Kyl (R-AZ) offered an amendment , SA 793, that would have thrown a big roadblock in the way of any plans for government rationing through “Comparative Effectiveness Research,” or CER.

The stimulus bill passed with $1.1 billion allocated for CER to compare the clinical outcomes, effectiveness, and appropriateness of medical services. That money sets the stage for a health rationing bureaucracy.

Yesterday on the floor of the Senate, Sen. Kyl and his colleague Sen. Pat Roberts (R-KS) expressed their concern that CER would be used to justify rationing by comparing costs, rather than effectiveness. Sen. Roberts compared it to giving away the “golden ring” to bureaucrats.

The language of Sen. Kyl’s amendment was simple: it would have prohibited the government from denying care to patients just to save money based on CER studies.

HHS Secretary nominee pushes HIT’s role in data mining even as new report of stolen electronic medical records surfaces

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On Tuesday, HHS Secretary nominee, Kansas Gov. Kathleen Sebelius, confirmed her support for the use of electronic medical records as a way of data mining patient information.

During the Senate hearings on her confirmation, Gov. Sebelius said that electronic health records (EHR) data was crucial to conduct “comparative effectiveness research [CER] to provide information on the relative strengths and weaknesses of alternative medical interventions to health providers and consumers.”

The stimulus bill passed with $1.1 billion allocated for CER to compare the clnical outcomes, effectiveness, and appropriateness of medical services. During the hearing, Sen. Pat Roberts from Gov. Sebelius’s own state of Kansas, expressed his concern that CER would be used to justify rationing by comparing costs, rather than effectiveness.

But Gov. Sebelius’s pledge to “provide every American with a safe, secure electronic health record by 2014” came on the same day that another breach of electronic medical records was leaking out.

The Mercury News reported that laptops containing 1,000 patient files were recently stolen at the Palo Alto Medical Foundation’s office in Santa Cruz, CA. (Mercury News, 3/31/09)

Even though the records were stolen in February, patients weren’t told until March 23, when they received a letter from the Medical Foundation. The records included diagnoses, treatment plans, E results and patient medical record numbers.

The laptop was stolen during a break-in when the office was closed. It was attached to a piece of equipment.

The Medical Foundation promises to do better in the future, and the Senate Finance Committee is expected to confirm Gov. Sebelius on Thursday.

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