This week CMS (Medicare/Medicaid) released requirements as to what constitutes “meaningful use” of Electronic Medical Records (EMR). Shortly after Castle Connolly Medical, which publishes  “America’s Top Doctors”, announced it will incorporate this data into its guides.  John Connolly, president and CEO of the company, lauds the new requirement and feels people may want to choose their physician based on such criteria.  One should also note that Mr. Connolly sits on the Board of and owns shares in an EMR start-up company.  Hmmm?

As we embark on the forced marched into government micro-management, be aware that the theory behind quality enhancement of EMR remains unsupported by scientific literature. But, unlike other measures, this one gives utilization managers a treasure trove of data for control of the system.  Who has access to these records remains an open issue; partially addressed by the HIPAA law (which gives access to insurers who pay for care and by extension government bureaucrats seeking to control costs, but NOT to family members without a specific release) and will certainly be the focus of legal activities in the future.  And, once again, we see people seeking to influence the debate with specific financial conflicts of interest.

Recall, AMA makes the majority of its revenue selling coding books, even while they hold specific exclusionary contracts with CMS to create the code system with which physicians must comply. Also, that AARP makes nearly $700M, again the majority of its income, off comissions for MediGap policies while supporting a Medicare-for-all policy prescription.  So I suppose it’s hardly shocking that a major shareholder of an EMR software start-up would suggest that use of EMR qualifies one as a member of “America’s Top Physicians”.  But it is worthy of some skepticism to say the least.  Likely future policies will punish physicians who do not comply, so perhaps Mr. Connolly knows his money is well staked, but whether such mandates do anything to improve the quality of care is far from certain.  What is certain is that it will drive up practice costs and give both the feds, and the private insurers, easily searchable databases with our private personal information.

From the perspective of CMS that could qualify a physician as one of “America’s Top Doctors”.  Whether it will mean the same for patients is far less clear.