This Week In Government-Managed Health Care Failure
The health care bureauwonks aren't having a good week.
The Washington Post notes an early experiment with the sort of coordinated care that ObamaCare's authors are relying on for long-term savings:
A key government experiment that set out to lower costs and coordinate care for Medicare patients — now the blueprint for an innovation the Obama administration is trying to move to a national scale — has failed to save a substantial amount of money.
And here's The New York Times on Medicare's technocratic mess of a payment system:
Medicare uses inaccurate, unreliable data to pay doctors and hospitals, the National Academy of Sciences said Wednesday….In a new report, a panel of experts from the academy's Institute of Medicine said the payment formulas were deeply flawed. The system of paying doctors has "fundamental conceptual problems," and the method of paying hospitals is so unrealistic that almost 40 percent of them have been reclassified into higher-paying areas, the report said.
And here's MarketWatch on the government's flailing $30 billion program to subsidize the adoption of electronic health records:
Under a government-led effort tied to the 2009 economic stimulus, doctors across the nation will spend on average roughly $40,000 on software to build digital databases of patient records. But even after all that expense, few physicians will be able to send patient records to other doctors who could benefit from having rapid access to medical histories, according to interviews and government advisers.
On the other hand, Medicaid's administrators have finally decided to stop paying for seriously botched treatments like transfusing the wrong blood type or operating on the wrong body part. Progress!
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This Week In Government-Mangled Health Care Failure
And once again, I prefer the way I initially misread a headline.
Under a government-led effort tied to the 2009 economic stimulus, doctors across the nation will spend on average roughly $40,000 on software to build digital databases of patient records. But even after all that expense, few physicians will be able to send patient records to other doctors who could benefit from having rapid access to medical histories, according to interviews and government advisers.
Just store medical records in an XML format on a USB stick. The patient carries it from doctor to doctor.
What's that? Patients don't own their own medical data? Who thought that shit up?
Patients don't own their own medical data? Who thought that shit up?
Why should data created and maintained by someone belong to anyone else?
If I go to the car dealer, they'll print a record of all the work they've done on my car for me.
Because it was created for the benefit of that someone else? And the creator got paid for it?
"Just store medical records in an XML format on a USB stick. The patient carries it from doctor to doctor."
Actually, that's one of the things that providers should be able to do. Any certified system should be able to create and import what's called a Continuity of Care Document (CCD). You could very easily but it on a Flash drive or a CD. I think the article is referring to the transmission of CCDs from doctor to doctor. That's being held up by the government.
Given the struggles we have just getting an electronic prescription sent to a pharmacy, or claims sent electronically to an insurer, it's more than just the government holding this up.
Insert the government into it, and it'll just get worse, though.
Remember HIPAA? Health Insurance Portability and Accountability Act?
So much for that.
Any certified system should be able to create and import what's called a Continuity of Care Document (CCD).
Ah, interoperability. The Holy Grail of electronic medical records. Rarely sighted in the wild.
Ah, interoperability. The Holy Grail of electronic medical records. Rarely sighted in the wild.
Fixed.
Just store medical records in an XML format on a USB stick. The patient carries it from doctor to doctor.
Uhhh huh. It's always just that simple.
How in the fuck can GE make all the money selling software and support if it were that easy?
Sheesh get with the cronyism dude....
Medical information systems are all proprietary, even to the point where each lab in the machine needs a translating interface to talk to the laboratory data system, which in turn usually needs a translating interface to talk to the hospital medical records system. Repeat for pharamcy, radiology, etc. You have no idea how fucked up medical informatics actually is.
That should be "machine in the lab" sorry.
from a privacy point-of-view, I'm not too keen on this national "medical record" plan.
Like no system has ever been hacked or misused.
I can already imagine someone digging up dirt on someone - "did you know that candidate Smith takes anti-depressants?"- is that the type of person we want running blah-de-blah?
I can already imagine someone digging up dirt on someone - "did you know that candidate Smith takes anti-depressants?"- is that the type of person we want running blah-de-blah
If they have nothing to hide...
Anal condylomata.
Medicaid's administrators have finally decided to stop paying for seriously botched treatments like transfusing the wrong blood type or operating on the wrong body part.
If we stop paying for useless and counterproductive treatments, we'll be just like Somalia!
Privacy concerns ARE a critical facet to the mix - however, availability of relevant, current, and accurate information in a useable form is also critical to prevent mistakes, or waste the effort.
A larger obstacle to the development of an effective and efficient medical information architecture, is probably the lack of any kind of uniform standardization. Oh, squeals of terror be damned - what I'm referring to are the standards such as were used to define the internet. Without such standards, how would your browser render a web page? Roll them dice, bucko. The other is the establishment of a structural approach that allows portability combined with stringent access controls for just about everyone other than a patient and his physician.
The government's role in all this? Not that of keeper and maintainer or oberseer of some 'national repository' of citizen's private data - but solely as the keepers of the particular file cabinet where the write up describing the data formatting and other protocols is kept, available for review by all. And that's about it.
Yes, the government's approval has been critical for establishing web standards.
Wait, what? Are you trying to fuck things up? Just let Google deal with it.
Yes, the government's approval has been critical for establishing web standards.
The government has had a shitload to do with it, yes, from the funding of Arpanet to the establishment of quasi-governmental corporations like the IANA and ICANN.
Just what I was looking for ? thank you.
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Govt just gives us only promises that they are actually doing hard work on this. But the reality is that they just do shoe off kind of things.... I don't believe that govt is actually caring for peoples' health
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