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Information Exchange... Where's the Beef?

August 1, 2008
by James Feldbaum
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First, let me acknowledge my strong support for Heath Information Exchange. What concerns me, however, is the present state of CAC (computer assisted crap) that is generated by physician coding-optimization programs that are imbedded in EMRs. By imbedding superfluous exam elements and long-winded verbiage that’s only raison d’être is to upcode (aka optimize reimbursement) we have diluted the value of our clinical communication. It reminds me of the old punch-line “with all of this horse sh-t there has to be a pony somewhere.” Now, I am not casting stones. I too performed and documented exam elements of dubious value to be certain that my records documented services commensurate with my billing codes. While not cheating (the questions were asked and the exam performed) I unintentionally diluted the true value of the pertinent information gleaned from the visit.
CIOs, programmers, legislators, and vendors have little concern for the value of the information that is exchanged. It is all about “exchange”, not “content”. I blame the payors. They have made “documentation” the Holy Grail, not information. A physician note or consultation has become a quagmire of computer generated/assisted text that doesn’t merit exchange.

Let’s build a Healthcare system that honors and promotes the exchange of real information. Now we have “garbage in… garbage out… garbage passed along”.

I'm not dumb. I just have a command of thoroughly useless information.
Bill Watterson (1958 - ), "Calvin", It's a Magical World

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