Michael S. Benninger, MD, Chair of the Head and Neck Institute at the Cleveland Clinic in Ohio, shared these concerns. If I’m utilizing a tool to take care of individual patients, where there are biases being introduced, and those biases are largely financially driven, not necessarily qualitatively driven, and there’s no true editorial censorship, to me, that raises major ethical issues, he said.
Explore This IssueJuly 2008
Dr. Benninger doesn’t take issue with advertisements in general. He views advertisements that accompany Internet pages when he specifically searches for certain conditions or treatments as acceptable. In addition, ads appeared in Otolaryngology-Head and Neck Surgery, for which he served as editor from 2000 through 2006. We had no trouble with advertisements, he explained.
However, Otolaryngology-Head and Neck Surgery created policies that stated that no advertisements could be within a certain number of pages of an article of the same content. For example, he explained that if there were an article on allergic rhinitis on one page, accompanied by an advertisement for allergy medication, whether it’s an indirect or direct affect, it biases individuals. Dr. Benninger stated simply, The article should be independent from any advertisement.
Regarding Practice Fusion, Dr. Benninger stands firm about the separation of commercialism and medicine: Industry trying to bias providers in the context of a medical exchange for an individual patient is absolutely inappropriate.
Pharma and Privacy
Another, more specific concern both professionals and laypeople have seems to be the ever-encroaching presence of pharmaceutical companies. Mr. Howard does not dismiss these as trivial. It’s kind of a double-edged sword for physicians today. Our chief medical officer, if he were in this conversation, would argue that the advertising is much less intrusive than actually having a pharma rep come onsite, he said.
For the record, at the time of the interview, there were no pharmaceutical advertisements in Practice Fusion, according to Mr. Howard: A lot of our partnerships are dictation, transcription, and billing services. To which Dr. Benninger responded, But how do we know those are the best services?
Beyond this, privacy matters-always a hot topic in health care, especially with HIPAA and with the boom of health information technology-continue to cause anxiety. Mr. Howard assured, All the ads are triggered off physician demographics and specialties, very nonprivate pieces of information.
He explained that Practice Fusion never sells any private patient or physician information. This is to protect the patients, the physicians, and themselves: The reality is if we compromise that, we’ll compromise our model, and we’ll be out of business. You haven’t heard about [breaches in privacy] because it hasn’t happened [with Practice Fusion].
At the end of the day, at least for now, it seems that Practice Fusion, a proposed solution to the looming question of how to establish electronic medical records, conjures up at least as many questions as it does answers.