The improving state of technology in the healthcare industry is usually seen as a positive factor, one that greatly increases a physician’s capacity to heal and help the sick. But what happens when that technology suddenly disappears or becomes inaccessible? As one tiny medical practice in northern Maine found out, the answer is almost a complete cessation of function — and severe risk to their patients.
In July, Full Circle Health Care was denied access to their online medical records after the vendor for their electronic storage system, CompuGroup, blocked their service over a billing dispute. These records included the medical histories of 4,000 patients, making it impossible for nurses and physicians to check necessary information, such as diabetes records, blood pressure logs, allergy reports and lab results. While the step was highly unusual, specialists in digital health say that it created a serious safety hazard for patients.
CompuGroup, a German health technology firm whose American headquarters are in Boston, defended their actions by comparing the situation they found themselves in to a utility customer who stops paying their bills; if a medical provider would expect to have their electricity eventually shut off if they stopped making payments, why shouldn’t they expect the same thing to happen to their medical records? A few weeks after Full Circle Health Care lost access to its information, they received an email from a CompuGroup lawyer, informing them that their records would remain locked until they paid $20,000 in overdue charges.
Full Circle Health Care’s owner and operator, E. Victoria Grover, has admitted that she did stop paying CompuGroup’s $2,000 monthly fees around 10 months before her service was shut off. However, Grover says that she stopped making payments after months of disputing expensive and unexpected maintenance fees and charges for hardware that was never delivered. She claims that CompuGroup never responded to or corrected these problems, causing her to stop making payments and hire a different electronic health records vendor. Unfortunately, her practice’s old records, which are still controlled by CompuGroup, contain important patient information which is vital for making treatment decisions. These files are inaccessible on her old servers and cannot be moved migrated to the new system.
This is especially problematic given Full Circle Health Care’s position as a rural medical clinic: located in Presque Isle, a city with its own hospital that is also surrounded by a large rural region, many residents lack easy access to medical care. Additionally, the small practice is struggling financially, and only employees about 10 health care providers. Since the July shutdown, these employees have been forced to scramble every time a patient schedules an appointment. Typically, they have to track down separate pharmacy and lab reports to piece together what care the patient is receiving, as they no longer have access to valuable doctor’s notes and other information that recorded most of the patient’s experiences at the clinic.
“It is important to have patient records in order to provide appropriate medical care.” says Carol Woodard, Director of Coding and Revenue Cycle at Immediate Clinic.
Full Circle Health Care first obtained its electronic medical record system in 2010, when it was owned by a Georgia company called HealthPort. HealthPort charged the clinic $72,000 for the up-front costs, including their software and hardware. At the time, maintenance fees worked out to about $300 a month. However, when CompuGroup purchased the business for $18 million, several months later, the monthly maintenance fees reportedly grew to $2,000 a month. Because the original contract with HealthPort states that Full Circle Health Care’s in-office system works in conjunction with the vendor’s off-site application system, CompuGroup is able to legally establish some authority over the use of their technology.
Fair or not, this dispute between a tiny medical office and a multinational corporation could have an influence on the electronic medical record industry as a whole. Beginning in 2009, numerous medical providers hurried to take advantage of $30 billion in federal subsidies for electronic health record systems. Legal experts say that in these rushed transactions, proper attention was not always given to the potential consequences of system malfunctions, financial problems, or company disputes. Because of this, Full Circle Health Care’s difficulties are far from the first situation of this kind; in 2013, a federal judge denied a temporary restraining order being sought by Milwaukee Health Services against its Altanta-based vendor. The judge pointed out that the medical group’s records could be easily unfrozen if they would simply pay their bills.
Due to the prevalence of electronic medical records in the healthcare industry, particularly as method of exchanging important patient information among state or local records, the situation in Maine has gathered attention around the United States from concerned medical practices.
So far, neither Full Circle Health Care or CompuGroup has filed a lawsuit. The medical clinic is reportedly seeking 48 hours of access to move its patient data to its new system. However, it seems that until the overdue money is paid, the situation will continue to go unresolved, putting patients’ health at risk.