AAPS survey: Doctors should not take 'Stimulus' money to computerize their offices

The key to enforcing healthcare reform was already passed in the American Recovery and Reinvestment Act of 2009 (ARRA), also known as the Stimulus Bill. This contains $17 billion to encourage physicians and hospitals to adopt electronic health records.

Doctors might not take the bribe. An informal online survey by the Association of American Physicians and Surgeons (AAPS) so far shows that 90 percent of more than 1,100 respondents answer "No" to the question "Should doctors take the 'Stimulus' money to computerize their offices?" See www.aapsonline.org.

To get the subsidy of up to $65,000 over 5 years, doctors have to use a government-approved system. Such a system must be "interoperable" -- which means able to share patients' private information with more than 600,000 different entities.

No patient consent is needed.

Doctors are warned: "If you take the stimulus money to computerize your office, the government will own your patients' medical records -- and possibly your practice," states Jane M. Orient, M.D., executive director of AAPS.

The system will have to be capable of generating lists of patients by specific conditions, to use for "quality improvement," reduction of disparities, research, and outreach. It will have to contain decision rules as for ordering diagnostic tests, and a way to track compliance with the rules. Doctors' pay will be tied to achieving the government's desired outcomes.

The government's purposes include cutting spending and meeting population health goals. The doctor's calling, in contrast, has traditionally been to serve each individual patient.

Changing from a sickness to a wellness orientation means that healthy young workers (taxpayers and voters) have a priority higher than older, sicker folks.

Under the Senate healthcare reform bill, a computer will determine, at the point of service, whether or not an individual is eligible to receive a specific service at a specific facility. The interoperable health record would contain information such as ethnicity, race, preferred language, smoking status, weight, body mass index, age, and compliance with past treatment, related to patient worthiness and societal goals.

"Interoperability" is what the $17 billion buys for the government. It's essential for central government monitoring and control of doctors -- and their patients.