Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Back when....my employer changed healthcare insurers every damn year. This almost always meant switching medical and dental practices to avoid paying out of network fees. It was necessary to physically go in and request a hard copy of records. Some practices charged a fee for this service.
Back then it was common to submit a hard copy claim and wait and wait and wait for payment. MDs, hospitals and patients waited for the paper to be processed assuming it was not lost, somewhere. Errors and omissions were common and the wait for correction meant further delays in payment.
Creating a system for coding major disease diagnosis goes back to the 1700's in Australia, of all places. An international list of causes of death, based on codes, was adopted in the 1920's.
Medical practices, hospitals and insurers began trending towards electronic record keeping and claims processing more than 20 years ago. Medicare and the Stimulus helped to defray the cost of converting to a standardized Electronic Medical Record ( EMR). Hard pressed to imagine anyone who would think maintaining and processing hard copy records ensured greater privacy or was more efficient than EMR.
Prior to the ACA a majority of states allowed insurers to discriminate against those with pre-existing conditions. Most states had a defined look back period that varied state to state. One state, Indiana, had no defined limit of look back. A 25 year old Cancer diagnosis could disqualify someone from future insurance. The ACA eliminated discrimination on the basis of prior or current health situations.
One would not know how widespread the flu was if there were no metrics. One would not know that say, Vermont was harder hit than other areas of the US. One would not be inclined to pursue why Vermont got hit harder than NH. Maybe fewer people in Vermont got flu shots or vice versa.
It would be impossible for states to monitor drug prescriptions or cooperate across states. Why are the MDs in Palm Beach writing 752% more scripts for Oxy than in say Boca?
If your doctor wants to electronically make your medical record available to another doctor there is nothing to stop him from doing that. But why do all of these Federal agencies (and whole departments) have to have access to your medical records?
One thing preventing all this analyzing is patient privacy! You cannot do research w/o a patient's consent.
You can do it easily, by not using names. It took me maybe 3 minutes at a meeting with a very obstinate IT director to prove that. In fact, you can seed a random number generator to assign a numeric speudonym after the word "patient_" and achieve all manner of analytical study that violates neither HIPAA nor the Privacy Act. Ask me how I know.
Quote:
Originally Posted by Katiana
When we started this mess in July (using Office Practicum, I'd like to know what you think of that, Volobjectarian) I said it will not be better or worse than what we're doing now, it'll just be different. So far, it's working out that way. There are some things I like, and some things I absolutely hate. Just like the old system.
You're exactly right, and for all the wrong corporate reasons. Office Practicum and any of its ilk are being vastly under utilized based on licensing, proprietary contracts, and lack of being able to adapt them to the specific business. There's also a serious groupthink component to all this, where little guys and big guys alike do whatever the biggest does. For example, I think of the top 10 hospital systems in America, 7 are on Epic. So guess what everyone down the food chain thinks is the best answer? And they have no clue at any level what they are getting into and just how much money and time is about to get wasted to, using your words, change very little in the day to day life of a doctor, nurse or patient. It's not better, it's not worse, it's just different....and it cost a lot of money to be different.
The point being, if you are not going to set people like me loose on all that data, there's no point in collecting a lot of it beyond the systems you once had. Sure, back them electronically, maybe make separate disaster recovery systems, but rarely does anyone get much use out of the data they collect, and nowhere what they were dreaming when they wrote those sick checks.
My wife is a nurse, and she represents absolutely the most common users of these systems, and another gem of the EMR boondoggle is that most are designed totally devoid of any input from those most common users, and when it comes time to implement and then do whatever licensed customization you can, none of the most common users are asked for input beyond token surveys that get whitewashed by a manager who doesn't want to anger an executive.
^^True, but if you're doing any kind of special intervention study, like does "Drug A" work better than "Drug B", the patient has to know they're in a research project and consent to same. Supposedly, anyway.
^^True, but if you're doing any kind of special intervention study, like does "Drug A" work better than "Drug B", the patient has to know they're in a research project and consent to same. Supposedly, anyway.
To submit to being given the drug, yes. What I am talking about is doing that study, collecting and inputting all the data, and that data never, ever gets used for the purpose it got collected. Happens more often than anyone would believe or be happy with.
It goes like this:
Bureaucrat - "Volobjectitarian, please build me this analytic system to tell me about XYZ."
Volobjectitarian - "Blah blah corporate project management, bureaucracy blah blah and a year later, here's your analytic system...in Dev/Test, please review so we can put it into Production."
Bureaucrat - "Uhm wow, we'll need to test this really thoroughly, QA, etc. We'll get back to you."
...
...
year passes...
...
Bureaucrat - "hey Volobjectitarian, can you build me analytic system to tell me about ABC?"
Volobjectitarian - "Sure, but whatever happened to XYZ?"
Bureaucrat - "We decided to cancel that because of blah blah HIPAA blah blah license blah blah senior management. So, about ABC..."
Welcome to about 14 of the last 20 years of my life. And EMR is the WORST because every executive in the medical industry knows 0.00 about database analytics and is scared sheetless about HIPAA, ObamaCare, licenses, etc.
The ACA (Obamacare) is not the law for electronic medical records. It was instead placed in the Stimulus Bill.
Understood, and EMR isn't law, the 2009 Porkulus is just where a bunch of EMR giveaway coin was tossed around. ObamaCare has additional kickback provisions for installing EMR systems as well.
It's law the way is practiced anymore - do this thing and get a bag of taxpayer money, don't do it and oh well, guess we have to really audit your taxes and EEOC compliance, like really really hard. Want that free money now?
And essentially, it's a boondoggle meant to keep Judy Faulkner in the lifestyle to which she's become accustomed.
You know, one of the government agencies getting access to health records is the Office of Personnel Management. Very surprised the government employee unions aren't screaming about it.
So, let me see if I have this right. The same federal government that can't even develop, or even contract to have developed, a simple website through which you can purchase insurance....is now going to implement a database that contains and maintains patient medical records? The same one that does nothing to hold the responsible person accountable.
The same government that looses secure e-mails because a "computer crashed" and can't manage to retrieve them is going to be "holding" your medical data for various actual health care providers to use? Sure hope it doesn't pull a Learner when there is an emergency and an ER doc needs to know of any allergies you have.
The same government who couldn't maintain a secure Obamacare database and had records leaked is going to have your secure, private, medical history? The same government that illegally "hacks" private phone records of reporters that don't sing the company tune, and that uses the IRS to intimidate political opponents? THAT government is the one that NOW is going to have your health care records?
What can possibly go wrong?
How many opponents of the current regime in power are going to find out that the media knows they have HIV, an STD, have had an abortion or is being prescribed Viagara? How many reporters on Fox (or MSNBC and CNN when Rs are in power) will have that info, or any illegal drug use leaked? Don't think that will happen? Well, I have a bunch of money in Nigeria, half is yours if you give me your banking info.
But it sounds like a better idea than anything Republicans could come up with at that time, given what we knew then.
It's not better or worse, it's the same waste of time and money that is meant to distract the voters into thinking someone is doing something. Republicans jumped onto the idea at the same time. Gingrich has been touting the savings of EMR since the Contract With America. And before that, the right wing and their I-270 tech corridor cronies were all about trying to force that never ending racketeering scheme down everyone's throats.
Huge windfall for the tech sector. It's like extended hostilities for defense spending and the corporate defense cronies. Because as I've said, these systems are never really "up & running" or anything....they're perpetually "in progress" and require oodles of consulting, new hardware, new licenses, approved add-ons, new development, etc etc. Add in the lovely factor that every year the federal government updates/changes all the medical industry compliance regulations, which means every year your absurdly complex and oversized EMR system requires patching by approved consultants, and this is a bigger corporate welfare giveaway than even Big Agriculture and Big Pharma are familiar with.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
No, I don't remember
