Monday, March 12, 2012

I Am So Screwed

I thought I'd start the week off right, get up early, have a cup of coffee, and get prepared for the week ahead,  Little did I know what was in store for me when I checked my e-mail.

Margaret Polaneczky, MD (aka, @tbtam the incredibly bright OB-GYN of The Blog That Ate Manhatan fame) had left a comment on my last post suggesting I check out my profile on the CMS's Physician Compare website. 

What I found was so discouraging, so demoralizing, so indicative of what we can expect from our newly-contructed computer databases compiled by a Central Authority without its own quality assurance checks, that every US doctor and patient should demand an immediate halt to what we're creating until the developers of this mess can prove they can get it right.

You see, according to the government's database, I'm not a cardiac electrophysiologist.

That's right.  I do not practice cardiac electrophysiology and never have.  Instead, I am just a general cardiologist.  Never mind that I have searchable credentials and billings to prove it. 

And if that's not enough, according to the same database, I have offices in 254 locations (I'm not kidding).  Something as simple as my vocation and office locations are already completely screwed up. 

And that is not even the half of it. 

Mark Hamer, MD, whom I replaced at our facility in 2001 and has practices in Rochester, NY since then, is still listed as working here in Chicago.  John Alexander, MD, a prominent cardiothoracic surgeon at our facility? He's retired now and no longer sees patients.  Yet there they are: fully credentialled and, according to our government's CMS physician finder database,  working from the same 254 offices that I work in.

According to Dr. Polaneczky, I can expect it will take at least a 6-months to correct these errors on the CMS database. (And, if you'd like some ocean-front property in Arizona, I can sell you that, too.)

I am so screwed.


But as bad as it is for me, I'm not the only one who's screwed, am I?  You see, if this is as good as the government can get at culling their vast repository of information collected by hoards of coders, billers, and legions of other non-medical folk upon whom they entrust to get the data right, we are in trouble in many more ways than this.  One only has to imagine the issues that arise when our government regulators turn to similarly-contructed databases to make life-and-death payment decisions.   We ALL had better reconsider the wisdom of our complete reliance on such unverified databases going forward.

One thing is now perfectly clear: just because our government health care regulators have all this quality assurance and billing data at their disposal, they have no earthly idea how to use it correctly.

-Wes




8 comments:

Jay said...

i searched my profile too.

I'm a Cardiac Electrophysiologist/Dematologist/Internist!!

Cool.

Jay

Hal Dall, MD said...

I'm not listed within 150 miles of my 20+ year location(under my real name)! With these Keystone Crats, maybe I'll fly under the radar!

Anonymous said...

I knew you were just making up all that EP stuff.

Phft wannabe.

-SCRN

Margaret Polaneczky, MD (aka TBTAM) said...

Thanks for the shout out, and so sorry I ruined your day.

It's incredible isn't it? How badly they have screwed up? To put up a website with so many errors and then tell patients they can use it to compare us to one another!

SImply sending us each a link to our data and allowing us to correct it would have been way too easy and too intelligent for them.

This doesn't even touch at whether or not the quality data being reported on this site is correct. Our health systems are reporting on our behalf and much of the data is generated from computerized databases. In our department we crosscheck every time a quality indicator is going to be reported as non-fulfilled by our computer (we set up a TES edit in the back end to stop the claim from going out till we've vetted it.), Using this system , we end up correcting quite a few codes - not all mammograms get scanned in and labeled as such, sometimes code changes screw us up) so that erroneous quality indicator data does not get reported on behalf of our physicians. I'd be happy to share our little crosscheck system with you if you are interested.

The amount of back end work we are doing do to assure the quality of the quality data is enormous. But if you don't do it now, you're going to be so sorry later...

Hang in there. It's only going to get worse.

Peggy

Margaret Polaneczky, MD (aka TBTAM) said...

PS - you misspelled my name (I get it wrong half the time myself ) -it's Polaneczky

:)

Peggy

Dr A said...

I learned several things from this post. First I am a prominent cardiothoracic surgeon and second I work at 254 offices. I guess that is why I get so many calls from far flung places. Wes will you change my status when you make contact with the Central Authority?It might be fun to see if the other cardiologist at NorthShore also work at the 254 offices.

John Alexander

Anonymous said...

https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do

Is your information correct at this site?

DrWes said...

Anony 01:37PM -

Quite a consumer reference website you gave there. Thanks.

But yes, my data on the CMS site you referenced were correct.

But we should ask, why are we wasting our tax dollars on feel-good public "find your doctor" databases that can never be used functionally?

Perhaps we should direct our citizens to this website to report these wasteful spending tactics instead:

https://www.gao.gov/cgi-bin/fraudnet.cgi