Your BMI and EHR and meaningful use

As part of the government's recent health care bill, there is $20 billion allocated to get doctors to use electronic health records (EHR). For us Kaiser members this is nothing new, that company spent some billions recently and put all the records on the computer. Long gone are my fond memories of the Doc coming into that little uncomfortable room with a fat paper file that was me since age one month.

In order to get the private doctors into the digital age, the health care bill offers $44,000 to a practice that can demonstrate "meaningful use" of EHR. Two years later the final rules are now in place defining what constitutes "meaningful use". It basically means the practice has to use a certified software package and to also meet the requirements on a checklist of items for things like ordering prescriptions and procedures that can vary based on the doctor's specialty.

My current employer provides computer services for more than 800 physicians in the San Francisco bay area. The numbers are a little vague because it's not really a public company so the annual report is pretty skimpy. More pictures of the good life than financial data. But whatever the actual numbers, $44k times hundreds of practices is a good chunk of change. So the company is scrambling to get these docs to meet the standard and then we all can share a piece of the reward. We're good on the software, what we offer is certified, the challenge is the extra checkoff items. Some doctors don't care and some do, so are guys are out there pumping as fast as they can.

Sounds good right? Simple to take your records to a new doctor and continue with seamless treatment? Well, sort of. The certified systems don't always inter-operate so well. You can be reduced to paying your current doctor to print out some of your records and then carry them to the new place to be entered into the new system. But some data is standardized and portable between certified systems. Like your Body Mass Index (BMI) for example. Is this a good idea? The government is already asking to collect this data for every patient who receives care from a provider that receives any government money. In other words, they can collect the data about everybody! Prepare to be in a new database.

Now I'm not much of a conspiracy theorist, but I wonder when I'll get a letter from Uncle Sam reminding me to eat more vegetables. Or do they already know from the traffic cameras?