Tuesday, September 23, 2014 Boston Globe Looks at Effects of Pulling the Plug on EHRs Electronic health records (EHRs) may be an important part of needed improvements to health care, but according to a recent article in the Boston Globe, EHRs have 1 potentially problematic quality—they can be turned off. So what happens when health care providers lose access? In the September 22 edition of the Globe, reporter Christopher Rowland retells the story of a small medical practice in Presque Isle, Maine, that got into a billing dispute with its EHR vendor and one day found itself unable to access any of its 4,000 patients' records. The clinic's vendor, a Germany-based health technology company called CompuGroup, admits that it is denying access until the bills are paid. According to CompuGroup, the clinic owes more than $20,000 in maintenance fees it refused to pay for 10 months. According to the clinic, when CompuGroup bought out the original vendor, it began charging unreasonable fees and would not respond to complaints. Now, the clinic argues, patient care is at risk. The Globe article uses the CompuGroup scenario to explore the unintended consequences that could arise after "physician practices and hospitals across the country rushed to cash in on $30 billion in federal subsidies for [EHR] systems starting in 2009." According to the article, "as contracts were inked by the thousands in the past few years, say legal experts, not enough thought was given to what happens when the computer systems stop working correctly, vendors or providers struggle financially or go out of business, or parties have a falling out." Rowland writes that while reports of cases similar to the Presque Isle practice's are "rare," a federal judge in Wisconsin "expressed little sympathy" for a clinic that was denied EHR access after withholding payments to its vendor in a billing dispute. According to Matt Elrod, PT, DPT, MEd, NCS, senior specialist in APTA's department of clinical practice, the Globe article spotlights an important EHR issue. "Prior to signing any contract, it's crucial to understand what will happen to the data and records if there is a separation from the vendor." he said. "Providers need to have legal counsel review these contracts to ensure that care for the patient is not jeopardized, and that the contract clearly identifies who owns and retains that data, and how that data will be accessed if an agreement is dissolved." The Globe article quotes Tetyana Buescher, general counsel of CompuGroup Medical USA, as saying that the clinic “had a lot of opportunities to resolve this, including getting on a payment plan; they chose not to do that. You can make an inference about … who is at fault in endangering patients, if that is the case." APTA offers several resources on information technology and EHRs, including a webpage devoted to the use of EHRs.