One person's efficiency…

…is apparently another person’s opportunity to use new, improved record-keeping capabilities to enhance profitability.

At least that’s what we’re inclined to take away from the recent revelation that “the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care.”

In the eyes of this longtime observer, that assessment of the situation may not quite be accurate.  She notes that “Since before the HITECH act and before the meaningful use epidemic, EHR vendors promised doctors an automated way of documenting a visit, so they can spend more time with the patient and not have to constantly write things down. Instead, a click on a couple of boxes would do that for them. Furthermore, physicians won’t have to waste money on expert coders to go through their scribbled notes and figure out a visit level.”

In other words, the problem may be that at least some vendors have delivered on their commitments, and doctors can now document -- and bill for -- the granular level of detail policymakers have wanted.

Or, as she puts it, “So the 'unintended consequences' of pushing physicians to use EHRs seem to consist of doctors actually using EHRs, as effectively as possible, to document all the little details Medicare wants to see.”

We’re comfortable assuming the situation may be more complicated than either of these two perspectives portrays it, but it does leave us wondering what other unintended consequences may arise as providers and vendors do what policymakers want and move across the digital frontier.

Anyone care to make a few predictions?

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