Whistleblowing on an Electronic Health Record Software Provider


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We live in a society where pretty much everything can now be done electronically. We receive our bills via email, many stores can now email receipts instead of printing a paper copy, and it has now become second nature to input all of our personal and financial information online to make a purchase or submit a request.

The same electronic mentality is also present within the medical industry. Years ago, you could walk into a doctor’s office and see rows upon rows of manila folders that contained the medical records of each patient. Today, the federal government now requires all medical providers to use electronic medical records.

There are many benefits associated with the implementation of electronic health records. It makes it easy for providers to have all of a patient’s information in one spot, the records can easily be transferred to other medical practices, and electronic health records can even be accessed remotely if necessary. But what happens when the electronic health record software is not living up to the expected privacy standards?

If you are an employee of an electronic health record software provider and have reason to believe that the product offered by your company does meet federal standards, you probably have a lot of different questions swirling through your mind. Let’s go through some of the most important questions you may be asking yourself right now.

Is the electronic health record software provider that I work for committing fraud?

The federal government has standards in place when it comes to electronic health records in order to protect the personal and medical information of all patients. These requirements have been established to keep the details in each patient’s medical record confidential and safe from individuals or companies that should not have access to this information, such as hackers. Unfortunately, not all electronic health record software companies are entirely honest in what they are offering to medical providers.

If a vendor is selling a medical record system that does not meet the federal requirements to a hospital, doctor’s office, or physician and is making the healthcare providers think that the software is fully legitimate, then fraud is being committed. Additionally, they are also providing fraudulent information to the government by claiming to meet the required confidentiality standards.

Why does this type of fraud happen?

Essentially, it all comes down to the money. It costs more for a company to create, develop, and maintain a software or database that is secure and can keep personal information confidential. It’s expensive to offer an electronic medical record system that meets all of the security requirements, but it can be easy for companies to claim that they are offering more than what they actually are. And unfortunately, it can be relatively easy for electronic health record software providers to get away with this fraud, since many medical providers are not savvy enough to realize they are being misled.

Do I need to speak with a lawyer before reporting that my employer is conducting fraud?

Yes, and there are several reasons why you should consult with a lawyer before whistleblowing about their suspected privacy violations. By having a lawyer on your side, you will have someone to help you understand the privacy expectations and provisions of the False Claims Act. This will allow you to report the fraud confidentially, so that you are not putting your own career and well-being at risk. If you go straight to the government, they will likely go ahead and initiate an investigation. Whether your suspicions are confirmed or they eventually find that there was actually no fraud occurring, your name will become public. This could put both your current job and future opportunities at risk.

An experienced lawyer will help you determine whether your claim is eligible to be introduced to the government, and your attorney will also act as a liaison to the government. It is also important to understand that the laws surrounding electronic health records are still relatively new and undeveloped. A False Claims Act lawyer will understand the various provisions involved and help you navigate through the process.

What information do I need to be able to report to a lawyer?

Before taking your suspicions of fraud to an attorney, there is some important information you will need to make sure you have ready. Your lawyer will want to know:

  • Name of the technology in question
  • Shortcomings of the software or database
  • How the database or technology is inappropriate or does not meet the federal standards that are in place

Can you only help me if I am in Philadelphia?

You do not have to be located in Philadelphia to receive legal assistance from the lawyers at Ross Feller Casey. As a national practice, we can take cases all over the country. In fact, it can also work to your advantage as a whistleblower to file the case somewhere other than where you live, as you are less likely to be suspected. If you think you might need help, contact Ross Feller Casey today.

Disclaimer: Ross Feller Casey, LLP provides legal advice only after an attorney-client relationship is formed. Our website is an introduction to the firm and does not create a relationship between our attorneys and clients. An attorney-client relationship is formed only after a written agreement is signed by the client and the firm. Because every case is unique, the description of awards and summary of cases successfully handled are not intended to imply or guarantee that same success in other cases. Ross Feller Casey, LLP represents catastrophically injured persons and their families in injury and wrongful death cases, providing legal representation in Pennsylvania and New Jersey.