Are EHRs Are a Threat to Freedom of Speech and Academic Freedom?

A nationwide ban of non-disparagement terms in consumer contracts is making its way through Congress. According to TechDirt, the bill seems to have the support necessary for passage. (I’m surprised that TechDirt is now handicapping legislation, but perhaps this is a sign of the reach of technology or that the regular political pundits are all fixated on national elections, which are nearly a year away.)

If passed, the Consumer Review Freedom Act would enable state attorneys general and the FTC to take action against businesses that attempt to deter complaints about poor customer experiences. Many hospitals are working on ways to incorporate consumer reviews as part of their websites, and although that’s not required, doctors and hospitals would be blocked from making patients sign over their freedom to comment on their treatment.

Unfortunately, this bill won’t apply in a similar way to contracts between hospitals and the businesses that serve them, specifically electronic medical records (EMR) providers. I picked up on this topic from Naomi Fried at Children’s Hospital in Boston, who called out this practice as reported over at Forbes.


A Politico investigation used public records requests to gain copies of 11 contracts between some of the biggest firms marketing electronic medical records and taxpayer-subsidized healthcare organizations. These contracts carried terms forbidding healthcare providers from talking about their experiences using these systems. Of the six biggest EMR vendors, all but one added clauses to restrict what users of these systems may say about them. Healthcare Dive extended this theme, suggesting that EMR gag orders compromise the professional ethics of physicians and the academic independence of researchers.

As individual hospitals become more transparent about their costs, health outcomes and patient satisfaction scores, doctors may more forcefully assert their prerogative to speak publicly about the systems they use, and how beneficial or disruptive they are in clinical practice.


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