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And they are issuing grants here and there for different health care systems to set up Electronic Health Records systems.
But the funding has to be scaled up greatly now.
It's part of Obama's stimulus package that folks here keep deriding..
W.r.t. digitizing records - is there really a question here? Procrastination to move in the right direction will continue to become more and more expensive. Get it on down the road folks.
1. outsource any part of it to India. You'll never see the end of the project. Indian outsourcing firms tend to use underpaid, undertrained "code monkeys" instead of talented developers; most talented developers from India try to leave and work for firms which treat them better...
2. Same goes for South Africa, where, because of an effective unemployment rate hovering around 60%, firms tend to believe that programmers are interchangeable and a highly perishable commodity.
Use American talent (there's a hell of a lot of it), and be willing to pay more for it. The government is likely to get most of its investment back in the form not only of direct income taxes, but also on various other taxes derived from the increase in consumption which would be the result of such an investment. We all know what good consumers programmers are...
There are some consortiums out there working on equipment and security standards.
That has to be nailed down first.
*I trust the hackers more than the insurance industry.
It happens to hospitals all the time.
Get a single-payer NATIONAL health care system in place. Then worry about the paperwork.
1. Cost
2. Try getting doctors to them.
Is it possible this could be a stealthy prelude to nationalizing the U.S. system? Be still my beating heart!
I'd love to see this done for two reasons. 1. There is no such thing as privacy right now anyway and 2. There are so many IT professionals in this country who have lost jobs to the H1B visa holders. Escort those folks back to their own countries and hire American IT workers (like my cousin who had to train his own replacement) to do the job here. Let's honor the American worker once again.
One big advantage I forgot about was elimination of duplicate tests. I can't tell you how many times people go to different doctors/clinics/hospitals and get the same test several times over.
http://en.wikipedia.org/wiki/Electronic_health_...
My huge HMO seems to be fully digitized, with test results and e-mail from MDs readily available on line. They use the data generated internally for research as well. There are lots of upsides.
Yeah I prefer my privacy thanks.
The main problem is the interfacing -- much of the necessary data is already available in the hospitals billing, coding, digital imaging, and other systems. But how to integrate that all into one database? HL7 is the language of preference, but it's not used in a consistent manner. There needs to be translation tables and interface engines between all these systems and the 'electronic health record.'
Maybe, just maybe, a huge player like Microsoft, Google, or even Yahoo could provide the necessary storage, but then who's going to implement the technology nationwide? Who's even going to train the trainers? It's unthinkable that a single entity can do this -- which means lots of contracts, which means too little standardization. It does us no good to digitize it all if the appropriate people can't access the appropriate data at the appropriate time.
Most x-rays are digital now, and they are transferred from hospital-to-hospital on CD's through the mail. The data type, DICOM, is very standardized except for the odd Nuclear Medicine study. The studies could be transferred over the internet easily enough, except no security exists to protect this patient data, and no process is in place to do this. Would it enhance patient care? Yes -- timely access to a patients prior x-rays is a huge help in reading the current x-ray. The problem is there's no economic advantage -- it's purely a better health care metric.
The same problem exists with the electronic medical record. It's better for the patient, but does it save money?
BAD IDEA!!!!!!!!!!!!!!!!!!!!!!
Although the VA disability system had a well deserved rep for delay and incompetence, the VA Medical care System is first class.. Once you can get into it.. Many veterans, promised this care during their service, find they dont qualify if they werent wounded or injured in service, and if they make too much money, and that level is set very low. The Bush neglect of the system hasnt helped either...
But the electronic health record system they have developed is first rate.. lets hope we can just replicate that into a nationwide system instead of many different hospital systems all developing their own, incompatable systems...
When there are privacy leaks at every financial institute all the time, I don't know if I want my personal medical information sitting on a server ready to be hacked.
I would rather see hospitals show better competency at using technology to help them better care for patients in the short term , per stay, etc, better log of meds, etc.
If a full records system does go digital, I hope it will not be a requirement for participating in any national plan.
Self-reported medical histories are a huge source of medical errors, especially in the mental health field. If we are going to treat mental illness on a parity with physical illness, we are going to need some way to verify actual patient histories, not simply their beliefs about their life stories.
Privacy is an issue, but the current system is basically "security by obscurity." Records are safe only because they are so difficult and time consuming to obtain. The thing that is keeping them "safe" is harmful to your health.
And you can deal with your doctor by email! And get emails reminding you that you need an checkup or test and offering you several open appointments!
Develop a sysytem and philosophy where drugs then surgery are our last choices and then you'll be onto something. But there will continue to be many deaths and injuries from the delivery of an ass-backwards system of attempting to deliver health when it is really only a haphazard system of responding to health crisis.
The health care approach by medical doctors is fucked up between their ears and will remain so for a long time. I don't see Obama changing much other than the record keeping.
Around 2005 the UK finally gave up on trying to institute national EMRs after spending billions of pounds. If Great Britton, with a single payer system, cannot get EMR to work properly, it is a fools errand for us -- with our multiple payers system and byzantine coding requirements -- to even attempt such a feat.
The first stage -- long before the first record is put into a computer -- would be to set a national coding standard for ALL healthcare professions and providers; this alone would take Omaba's first term. The second thing to be done -- before any record is digitized for sharing -- would be to establish a national standard for insurance filings -- this would probably take only 2-3 years. Finally, a the enactment of a digital privacy act would be required, so records and information remain property of the patient -- given healthcare, government, and other commercial interests against such a act this would take 5 additional years.
I've worked on government software development for a number of decades and I'm quite sure that if the US attempts to start from scratch on a system like this, establishes standards, puts out RFPs for competitive bid, etc. they will spend billions of dollars, a decade or more of time, and fail completely. Adopting VistA is really the only possibility.