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Dr. Simborg,

Regardless of whether it is politically correct yet (and all evidence suggests it isn’t yet PC), there will be an accumulation of cases in the near future that demonstrate the new opportunities for fraud provided by poorly designed and poorly implemented EHRs.

I am optimistic that the value of metadata will increasingly become apparent due to the high level of interest among health care attorneys. At an August meeting on the Legal EHR co-sponsored by Loyola’s (Chicago) law school, the entire second day was dominated by legal discovery aspects of EHRs, not the least being the incredible expense of sorting through terabytes of data looking for smoking guns. These costs will contribute significantly to pressures to standardize validity auditing functions in EHRs. Fraud costs get distributed to everyone but legal discovery costs are borne by the individual plaintiff AND the defendant AND the courts.

While it may not be PC, it is going to be more and more pertinent as people ask the question, “How are we going to pay for health care reform?” The ready answer is there in the $200 billion (minimum) lost annually to health care fraud.

Also, as I noted in my comment on your first Blog, companies are seeing a great business opportunity in ferreting out fraud. Lexis/Nexis is getting into fraud-management data mining and, despite delays, RAC will be loosed upon the world in time. It may not be PC to discuss health care fraud but it is becoming very PC to do something about it.

RDGelzer

Advocates for Documentation Integrity and Compliance

For those who might be interested in following up on the Lexis/Nexis presentation, here’s the (lengthy) link:

https://event.on24.com/eventRegistration/EventLobbyServlet?target=registration.jsp&eventid=117626&sessionid=1&key=3128283E6AD9543CF470012631A7E310&sourcepage=register

Or try searching on its title: LexisNexis Presents a Webinar on Medicare and Medicaid Fraud Waste and Abuse

Sadly, its a growth business.

RDGelzer

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