There is no neutral position on fraud!

Area of Science:

• Health Informatics
• Health Information Technology
• Fraud Prevention

Background:

• In 2005, a vision for widespread electronic health records (EHRs) and health information exchanges (HIEs) was established.
• An advisory panel recommended embedding fraud management functions into the health information technology infrastructure.
• These proactive fraud management functions have not been implemented as recommended.

Purpose of the Study:

• To highlight the current challenges in managing fraud related to EHR and HIE adoption.
• To emphasize the need for collaboration between fraud agencies and the Office of the National Coordinator for Health Information Technology (ONC).
• To advocate for the integration of fraud management within health information technology infrastructure.

Main Methods:

• Historical analysis of health information technology policy and recommendations.
• Assessment of current challenges in fraud management within the healthcare sector.
• Identification of the need for inter-agency cooperation.

Main Results:

• Proactive fraud management functions were not embedded in the health information technology infrastructure as recommended in 2005.
• Fraud related to EHR and HIE adoption is a growing problem.
• Agencies responsible for fraud require assistance from the ONC to effectively manage this issue.

Conclusions:

• The lack of embedded fraud management in health information technology has led to increasing fraud.
• Collaboration between fraud enforcement agencies and the ONC is crucial for effective fraud mitigation.
• Future health information technology initiatives must prioritize integrated fraud prevention strategies.