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Guest Post: HITECH - Your Medical History In The Machine
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Coming soon to a "clean" garage near you:
Black Market Surgery!!!
Perhaps it's just a 'simple' surgery, and you don't want it on the monthly premium radar...right? This scenario courtesy of gov run health care and Federal Reserve currency destruction.
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I'd say that's about right. In DC, there is one pharmacy that doesn't have computerized records. That's where all the big shots get their prescriptions filled. Wonder why?
Any way you can post a PDF copy as well? Scribd blocked @ work...
+1.
Tyler usually gets the .pdf up where he is able to. I have requested this ever since they started educating the masses.
god, sometimes the people around here are just morons. e-records would be the best thing for doctors, for patients, and for patients' wallets.
always a conspiracy, always something nefarious to go crazy about.
ooh!! let's make buying stuff on the internet illegal!! people can steal your credit card number!!!! oooh!! they can do that in restaurants and stores, too!! let's make restaurants and stores illegal!!!
let's close down everything and always be afraid of the worst that could happen!!! east europeans with my medical records--ahhh!!! they might......do what, exactly?
what a bunch of crap.
I don't have a problem with a private company having my records. If they screw up I can sue them and have my day in court.
I have a big problem with the government having my health records. And yes, I don't trust them. Let me give you a couple of reasons why:
1. The Clintons used the IRS to threaten people with an audit. Nixon did also
2. The government can't even count votes, how are they going to secure your SSN? and I don't want an e-chip. thanks
3. Ever heard of the Patriot Act? The abuse in that is astounding courtesy of John Ashcroft.
Maybe you can explain why we should hire you since you've had two treatments for syphillis and your wife has had an abortion.
e-records are also the best thing to facilitate the creation of a FICO-style health score for Obamacare. It's real, and it's coming. You need a liver transplant, better have a score greater than some specified value or it's off to hospice for you.
It's obvious that the author of this paper has never had a long term health problem. Having just ended a 5 year heath crisis let me clue you in to what happens each time the patient is referred to a new Dr., hospital or private clinic.
You have to give each of them your lifes story on their forms, they will not take a perprinted list, before you can start working with them. Of course they do not share this info with any of your other health care providers so medications can counter act medications from other Dr.'s who are only treating one problem. You haven't lived until you have a serious drug interaction, which leads to additional testing & procedures and of course new meds. At one point in my health crisis I have no fewer that 8 medical specialist (oncologists, neurologist, etc) advising me, not counting my GP and the Dr's in the hospitals. Don't get me started on surgeon's; cutters like to cut.
You literally much carry all your "pictures" (X rays - CT & PET scans) to each Dr.'s office or hospital or they will order new pictures. Some Dr's will not accept an picture from another Dr.
Then of course the fun really begins when a new Dr. tells you that the previous Dr. got you diagnosis wrong and he wants you to change your treatments. WFT are patients supposed to do?
The author needs to understand the issues before he worries about a hacker. Frankly a hacker is the least of a US patients worries in the US Rube Goldberg medcial system.
George, my sympathies concerning the hell you describe. Under our current system, any physician who relies on tests, histories or other work done by other providers becomes liable and responsible for that work. So they redo the tests. (Sometimes the tests really do need to be updated and sometimes the provider just wants to bill for it again, though repeated tests deemed unnecessary are often denied payment.)
There are some easy ways to improve this system, but don't expect the administration to spend much time on measures the trial lawyers don't like.
You nailed it, buddy. The so-called "health care system" is actually 22 midget clowns in a giant suit.
http://www.liveleak.com/view?i=373_1237822809&c=1
Despite the usual reservations about abuse, this will be a MAJOR improvement in efficiency and effectiveness. Just as a liberal is a conservative who just go laid off, and a conservative is a liberal who just got mugged, I promise that anyone who has had to deal with a serious illness or injury realizes that your "health care providers' are more of a loose ad-hoc confederation of (mostly) small business people hounded by the insurance industry to not spend more than 120 seconds with any given patient, and glued together by $20k a year clerks who don't know you from Adam or a phalange from a philodendron. You or your significant other will spend countless hours introducing Mr. Right Hand to Mr. Left Hand, as well as trying to prevent errors in medical judgement due to incomplete or missing information. "You want me to go for a chest X-ray this afternoon? Did you know that Dr. Y sent me for one yesterday?" Trust me on this. Also, the initial projects will be probably be in Medicaid programs (actually these are already in flight).
Your premise that the government is going to improve this situation has no basis in empirical data. Let's start with Medicare, which has billions in waste and is broke. Then, we proceed to the post office, which is also broke and gives horrible service. Then, we proceed to the current state run health care providers that are all broke. Obamacare is the new Brokeback Trail.
We are all speculating at this point. True enough. The devil will be in the details, eh?
I've already seen enough actual details. It stinks
Hey Doc. Since the patient records you keep constitutes most of your practice and keeps patient coming back, you won't have much to sell when you retire now.
who owns the record, though? Who has access, and who can grant access? In France, the livre de sante is held by the patient, and the docs and caregivers read from and make entries into it.
Great question. We sure don't want the records held by anything resembling the credit reporting agencies, where errors take an act of congress and time-spans of geological duration to get corrected.
Don't put the legislation online. Don't put the government contracts tied to this legislation online. And certainly don't put the political contributions of those who benefit from this bill online.
Just put every living person's medical records on this network and an RFID chip in each person's arm so we know who you are and can access your entire mdeical past before you walk in the examination room. Take the chip and give consent or you get no public option.
/tin foil hat
By the way, if your government insurance policy recieves a request for a pricey medical procedure that your doctor says is required, lets cross reference your medical past with your tax records to see if you qualify. Oh you didn't pay any income taxes the past 5 years? Sorry, you don't qualify.
This is a slippery slope, no matter how you try to rationalize the benefits.
The slipery slope is bad medicine disguised as free market policies.
Next time you are in the emergency room at 3am with a life threating situation and they have to get your history before they treat you, think about your slippery slope.
YES I want a chip in my body that carries my medical records, when your unconscious (high fever due to septicemia) and your spouse is stressed out of their mind, filling out forms is criminal.
And what if Big Brother doesnt like what he sees in your medical past compared to the younger, more productive patient on the bed next to you? Be carefull what you wish for pal. You might just get it.
You are right, and being from Crook County you should know. It's a $19B political payout that will have no benefit to us. Medical records are already electronic, and according to some studies and the Physicians for a National Health Program, the savings and reduction of errors is overrated.
This site spends a lot of time covering issues of fraud made more efficient by computers. Funny how many think this will not also make healthcare fraud more efficient. It is also a superior way to outsource jobs. If anyone doubts it, look into Jonathan Bush's athenahealth. It's ALL about sending medical jobs to India to save money. Who will control those records, the CIA or some other mafia trading in blackmailing politicians? Certainly not the patient.
Crook Country goes national.
"The government has already installed the plumbing..."
I don't know if you folks know this, but the internet is a bunch of pipes...
What you all must not know now, since nearly all MDs and their office staff I work with are also not aware of this, is that there already is a national medical data bank, funded by our private insurance companies, called MIB, or Medical Information Bureau. It is a storehouse of OUR medical records, that ONLY insurance companies can access (unless you write them to request your file - and do they send it all to you? You can never know). Its purported purpose is to alert "...its member insurance companies to omission and fraud in the underwriting of individual life, health, disability, long term care insurance...". Ever been denied insurance, or coverage by your existing coverage? It may be due to records the MIB holds. I was denied coverage when I moved 10 years ago, and it took me 2 years, and a lot of due diligence, to discover why; a Dr I used 15 years prior had put something incorrect his medical history of me during a routine physical. I cleared this up eventually, but was without coverage for over two years, and still was unable to convince my carrier of choice to take me even AFTER I had the MIB correct this (through threat of a lawsuit).
I have been in the Medical business for years, and it is an indisputable fact that our current record system is a significant contributor to our high medical costs, both for care and for insurance. Our current US medical records system also impedes positive outcomes, causes more litigation, makes it difficult to hold our MDs accountable, increases unnecessary testing, ... I could go on and on.
We should ALL welcome a full, nationally based electronic medical records system, one we can personally access, question, correct if we find mistakes, and keep insurance companies away from. We could allow an opt out for those who are afraid of someone unauthorized accessing their record. My opinion: we should use the French system as a model to work from.
Full disclosure - I have no association with any EMR (electronic medical records) company. Please excuse my rant, but this is one issue I know too much about - because I was forced to.
Opt-out? No way they're gonna let you opt out because everyone will opt-out.
I can just see it now. There will be so many people with access to my health records that they might as well just insert it into my credit report. A new arguement for the lenders will be "We have to know whether or not this borrower is healthy enough to repay the loan". How many times were they burned because someone died and didn't leave crap behind?
I'll laugh if the new health care legilation includes a clause that for the good of the country and to comply with the wellness program, anyone who hasn't had a physical in the last 5 years must get one or a fine of $$$ will be levied.
France will seem like a model of democracy by the time our socialists in Washington are finished.
Well, look in the mirror first, please?
http://www.npr.org/templates/story/story.php?storyId=114163862
Having been employed in the business of overturning wrongful denials by health insurance companies I can type with first hand knowledge that OrganicGeorge's experience is extremely common.
To put things in perspective, basic paper records (i.e. no x-ray photos, MRI recordings, or the like) can be scanned into .pdf form at 100KB per page or less. At that size a common $150 2TB off-the-shelf external hard drive will hold in excess of 20 million pages. Knock off 20% for filing system overhead, improve seek speed, and reduce the chance of drive failure and that is still 16 million pages per drive.
Your average doctor or small hospital keeps everything on yellowing paper. That paper is shipped off in bulk to either public storage or to a medical records storage facility. If the records go to public storage, it's no different than shooting into a black hole. If it goes to a storage company then the records are housed and possibly scanned. The storage companies will then sell back copies on request of records at between $0.25 to $1.00 per page, even when there are thousands of pages for a single visit.
Large hospitals and groupings of hospitals under a single corporate banner occasionally keep digital copies but still many pay to warehouse and pay again to get copies. The big difference here is that when the bigger chains get records back, they are more likely to then scan. (If you ask why they did not just scan and keep in the first place then obviously you are not qualified to be a "pointy-haired-boss.")
This should help explain why the costs doctors are so reluctant to give you or other doctors medical records after the fact because of the costs (in time and wages) and hassles of asking staff to to hunt for records, let alone the time delay and copy charges for retrieval from storage. The lack of common electronic storage leads to massive redundancy buildup at each treating facility as well as strange record gaps. Please note that insurance companies love to use these gaps to deny coverage.
The gaps also necessitate testing, re-testing, and re-re-testing so each new medical provider can learn your literal ins and outs. That greatly increases the time and and cost of treatment while decreasing efficacy, if not outright endangering the patient, are simply flaws which have been engineered into the system.
At the end of the day full digital storage is needed and the only real concern is keeping Big Brother (corporate or governmental) from peeking at your records.
P.S. these captchas are way too easy
Having been employed in the business of overturning wrongful denials by health insurance companies I can type with first hand knowledge that OrganicGeorge's experience is extremely common.
To put things in perspective, basic paper records (i.e. no x-ray photos, MRI recordings, or the like) can be scanned into .pdf form at 100KB per page or less. At that size a common $150 2TB off-the-shelf external hard drive will hold in excess of 20 million pages. Knock off 20% for filing system overhead, improve seek speed, and reduce the chance of drive failure and that is still 16 million pages per drive.
Your average doctor or small hospital keeps everything on yellowing paper. That paper is shipped off in bulk to either public storage or to a medical records storage facility. If the records go to public storage, it's no different than shooting into a black hole. If it goes to a storage company then the records are housed and possibly scanned. The storage companies will then sell back copies on request of records at between $0.25 to $1.00 per page, even when there are thousands of pages for a single visit.
Large hospitals and groupings of hospitals under a single corporate banner occasionally keep digital copies but still many pay to warehouse and pay again to get copies. The big difference here is that when the bigger chains get records back, they are more likely to then scan. (If you ask why they did not just scan and keep in the first place then obviously you are not qualified to be a "pointy-haired-boss.")
This should help explain why the costs doctors are so reluctant to give you or other doctors medical records after the fact because of the costs (in time and wages) and hassles of asking staff to to hunt for records, let alone the time delay and copy charges for retrieval from storage. The lack of common electronic storage leads to massive redundancy buildup at each treating facility as well as strange record gaps. Please note that insurance companies love to use these gaps to deny coverage.
The gaps also necessitate testing, re-testing, and re-re-testing so each new medical provider can learn your literal ins and outs. That greatly increases the time and and cost of treatment while decreasing efficacy, if not outright endangering the patient, are simply flaws which have been engineered into the system.
At the end of the day full digital storage is needed and the only real concern is keeping Big Brother (corporate or governmental) from peeking at your records.
P.S. these captchas are way too easy