Secret Evils of EMR

A minor controversy has erupted over the health care provisions that
were slipped in to the economic stimulus bill without discussion. 
It has provisions such that..

Your medical treatments will be tracked electronically by a
federal system...One new bureaucracy, the National Coordinator of
Health Information Technology, will monitor treatments to make sure
your doctor is doing what the federal government deems appropriate and
cost effective. The goal is to reduce costs and "guide" your doctor's
decisions.

This verbiage is found in a href="http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs">Commentary
by Betsy
McCaughey, published at Bloomberg.com.  Interested readers
might want to read href="http://www.prospect.org/csnc/blogs/ezraklein_archive?month=02&year=2009&base_name=the_secret_health_care_plan_of">Ezra
Klein's post on the subject:

THE SECRET HEALTH CARE PLAN OF THE FUTURE.

It's easy enough to establish that href="http://www.prospect.org/csnc/blogs/ezraklein_archive?month=02&year=2009&base_name=lies_damn_lies_and_betsy_mccau">Betsy
McCaughey is lying.
The stimulus does not do what she says it does. But there's a method to
her mendacity. She's trying to get Democrats to disavow a bad thing
that's a close cousin of a good thing. It's a nicely laid trap, and a
good guide to the sort of attacks liberals can expect health reform to
receive in the coming months.

Go back to McCaughey's central charge: The stimulus contains
provisions that "will monitor treatments to make sure your doctor is
doing what the federal government deems appropriate and cost
effective." That's not true, and isn't likely to become true...

Partly, this is an old controversy.  It is not going to go away,
either.  The fact is, information is power.  That power could
be used for good, or it could be used for evil.  Or it might not
be used at all.  Those things always will be true, no matter what
the specific subject is.



However, McCaughey's Commentary is not merely a reiteration of the old
controversy.  It is the cornerstone of a Republican crusade
against the economic stimulus bill.  This aspect is href="http://wonkroom.thinkprogress.org/2009/02/11/betsy-mccaughey/">covered
in the Wonk Room at Think Progress:

I'm tracking the Betsy misinformation tour. Last night,
McCaughey appeared on FNC's Glenn Beck, CNN's Lou Dobbs and the Laura
Ingraham radio show. Today, she was a guest on FNC's America's Newsroom.

So it is part of an organized, concerted effort. 



What is curious, is that this scare tactic is being used by someone who
is a member of the Party that thinks it is OK for the federal
government to listen in on your phone calls, read your emails, and find
out what books you are reading.  All those breaches of privacy,
and now they are worried about electronic medical records (EMR)?



McCaughey is an href="http://www.hudson.org/learn/index.cfm?fuseaction=staff_bio&eid=McCaBets">adjunct
fellow at the Hudson Institute.  One of their people recently
published a book ( href="https://www.hudson.org/bookstore/itemdetail.cfm?item=1070">Fixing
Intelligence: For a More Secure America, by William E. Odom) that href="http://findarticles.com/p/articles/mi_m0NXL/is_4_18/ai_n13650887">expressly
advocates consolidation of data:

General Odom also believes that the various intelligence
methodologies (signals intelligence, imagery intelligence, human
intelligence, etc.) would benefit from more centralized control, under
the aegis of a single agency...Under Odom's plan, CI would become the
domain of a new federal agency, melding elements of the CIA and FBI...

Umm, it would seem that if you are worried about what the federal
government might do with the information it collects about you, you
might be a little more worried about the CIA and FBI than about
Medicare.



Of course, those views are not necessarily those of McCaughey.  It
is clear, however, that she is not exactly a champion for civil
liberty.  In an href="http://www.hudson.org/index.cfm?fuseaction=publication_details&id=1019">article
she wrote in November 2001, she expressed support for expanded
quarantine laws and mandatory vaccination. 

The bill would give state officials the authority to occupy
virtually all private buildings, including warehouses, theatres, and
hotels (and to compensate the owners of those buildings), in order to
convert them into quarantine facilities.

To be fair, she is thoughtful about it: she cautions against the
government going too far with emergency powers.  But it seems odd
that someone would freak out about the possibility that the government
might misuse medical records, while also thinking it is OK for them to
force people to get vaccines.  In her view, the quarantine and
vaccination provisions are OK, because they could be important for
homeland security.  But of course, the same could be said about
EMR!  In the event of a pandemic or a bioweapon attack, a
standardized and comprehensive EMR system would be extremely valuable.



And that is not all.  McCaughey has founded an organization known
as RID: Reduce Infection
Deaths.  It seems to be a reasonable organization.  They
work on health policy issues in order to reduce hospital-acquired
infections.  But does she not realize that EMR systems that are
all compatible, that allow for easy data extraction, exchange, and
reporting, would greatly facilitate the cause she is championing?



Of course she realizes that.  Just look at her href="http://www.huffingtonpost.com/betsy-mccaughey">qualifications:

Betsy McCaughey, Ph.D., is a health policy expert and the
former Lt. Governor of New York State. She is founder and Chairman of
the Committee to Reduce Infection Deaths (RID). RID is a national
campaign to support greater infection control in hospitals and other
healthcare institutions.



In addition to serving as Lt. Governor of New York, she has taught at
Columbia University and the Manhattan Institute. Dr. McCaughey has
written hundreds of articles for both academic and popular
publications. Her research on how to prevent infection deaths has been
featured on many national television and radio shows in the United
States. Betsy McCaughey has presented her research at several
international conferences.

Just a couple of points about this.  Her Ph.D. is in
Constitutional History, not anything related to health care.  And
her research?  href="http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=DetailsSearch&term=McCaughey+B.%5BAuthor%5D&log$=activity">Medline
lists exactly two citations for her:

href="http://health.usnews.com/usnews/health/articles/070715/23clean.htm">US
News World Rep. 2007 Jul 23-30;143(3):82, 84-5

Why aren't hospitals cleaner?

McCaughey B.



href="http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20060130/REG/601300314&nocache=1">Mod
Healthc. 2006 Jan 30;36(5):23

Saving lives and the bottom line. Hospitals must answer growing
pressure to act on homegrown infections.

McCaughey B.

I'm not saying she hasn't done any research.  But she has not
published research in any medical journal.  ( href="http://www.modernhealthcare.com/section/aboutus/">Modern
Healthcare is "the industry's leading source of healthcare business
news," not a medical journal.)



Some things are clear from all of this: McCaughey does not like
germs.  She wants them dead.  And, she does not like
Democrats.  She does not like the idea of universal-coverage,
single-payer health care.  And I suppose she does not like the
economic stimulus bill. 



It is OK for her to not like germs.  It is OK for her to not like
the economic stimulus bill.  But it is not OK for her to make up
stuff in order to press a political agenda.  That is the kind of
thing that went out of fashion last month.



What makes her attack so sneaky, is that she is attacking two things at
once.  She is trying to undermine the economic stimulus bill, and
she is trying to undermine the push for sensible health care
policy.  The brilliant thing about a Medicare-for-all type of plan
is its efficiency.  This would be maximized in part through the
use of standardized EMR.  If she wants health care reform to fail,
one way to do that would be to sow fear of EMR.