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Coming soon to an EHR near you: Ads

January 23, 2013 | By More

The Business Model for Hacking Electronic Health Records

Next step in the intrusion of commercial interests in EHRs

As far as I can tell the first advertisements appeared in 17th century newspapers.  According to Wikipedia,  “Advertising is a form of communication for marketing and used to encourage or persuade an audience to continue or take some new action.”

Since the 17th century there has been a steady stream of enhancements to how ads are delivered. Lots of money to be made here. “My soft drink is better than yours.” “My car is more fuel efficient than yours.” Even Mick Jagger told us, “Can’t be a man unless you smoke the same cigarette as me”. We are so bombarded it is hard to imagine life without ads. Sometimes I think that dreams may be the only space still devoid of ads. At least until someone can find a way to monetize ad placement in our dreams. That might be a good startup business model.

We saw the first wave of ad placement into EHRs a few years ago with the emergence of ad sponsored EHRs. The EHR is provided at no charge if the provider is willing to have a few ads sprinkled about the screen. I have to admit that is one way to target a market. Those ads would appear only to providers (and their staff) and the ability to direct promotional text to that highly desired demographic group must be the envy of advertising firms everywhere. How can you top that?

I’m starting to see the next step in the intrusion of commercial interests directly into our health records. We are on a precipice and no one knows it except those few who realize the commercial potential. The vast majority of this activity will be financed by the pharmaceutical industry. From a strictly financial standpoint it makes sense for them. This effort will be cloaked under the guise of such positive terms as “tracking patient compliance” with medications. From a clinical perspective this is certainly important, but the true motivation at the bottom line is to apply subtle pressure at the point of the patient encounter that will cause more prescriptions to be filled. Real time, broad band marketing efforts will now find their place in the exam room. Follow the money. Who is paying and who is being paid? The next step will be pop-ups that recommend specific name brand medications based on a patient’s problem or allergy list. In one way this could be perceived as clinical decision support, but what commercial interests are at play? Where is the transparency? Should the patient be informed? I’m not aware of any group taking a stand on these issues. What does the AMA think?  Have the pharmaceutical associations and trade groups taken a stand or issued guidelines? This is all happening in plain view. The cows have left the barn.

Jim Tate is founder of EMR Advocate and a nationally recognized expert on the CMS EHR Incentive Program, certified EHR technology and meaningful use. 

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Category: General Interest

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