Grassley questions hospitals for HIT investigation

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Fred Schulte and Emma Schwartz continue to stay on top of the stimulus/health information technology/Sen. Charles Grassley investigation story for the Huffington Post Investigative Fund, this time explaining how and why the Grassley-driven inquiry into plans to spend an estimated $19 billion in stimulus money on HIT is now asking leading hospitals for input on their experiences with EMRs. The reporters also posted a copy of Grassley’s Jan. 19 letter.

Sen. Charles Grassley

Sen. Charles Grassley

Grassley sent the 11-question letter to 31 hospital organizations and requested that they respond by Feb. 16.

At this point, Grassley seems focused on technical issues that threaten patient safety, as well as potential conflicts of interest. Here are some of his more prominent lines of inquiry:

  • How hospitals make purchasing HIT decisions.
  • Potential financial or incentive-based relationships between HIT vendors and hospitals.
  • Whether or not hospitals rely on outside contractors for HIT implementation.
  • Procedures for and costs of training staff on new technology.
  • Quality control and bug/problem-reporting procedures.
  • Communication with tech vendors, peers and government officials.
  • The relative liability of vendors and hospitals for HIT-related problems.

Grassley also asked hospitals to “provide a list of HIT problems or complaints that have been identified by or reported to your facility since January 2008 that directly or indirectly impacted patient safety or the delivery of care, including any complications or adverse events that have occurred as a result of HIT product design and/or usability.” He also requested that they “provide examples of contracts with HIT vendors that include non-disclosure clauses” and list any payments or discounts the hospitals received from those vendors.

Related: Fla. docs, vendors battle over EMR headaches

Sammy Mack’s piece for Health News Florida is a lively recounting of the complete meltdown that occurred between a group of Florida doctors and an EMR vendor, one rich in scandalous details like cease and desist letters and collection agencies. Mack’s work highlights the cultural divide between tech-savvy IT specialists and medical professionals and points out that the number of such conflicts is likely to increase as EMR adoption rises. Here’s Mack’s description of one such conflict, a dispute which happens to have a unique connection to journalism, medicine and ethics:

In another complaint against [EMR vendor Joe] Castranova, Dr. Linda Kaplan said she too was surprised by charges on her invoice. When they first met, Castranova recognized her as a former medical editor at the local NBC television affiliate. She said he offered to waive her software and training fees if she would endorse the product.

Kaplan agreed, but she said she was unimpressed with the system once it was installed in her Hallandale Beach office. She was reluctant to drum up business when she wasn’t a satisfied customer.

Kaplan said Castranova was displeased with her lackluster endorsement and locked her out of some 600 patient records on his server. He billed for the software system anyway.

Castranova said he gave her four months’ notice before locking her out – plenty of time to retrieve patient files.

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