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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Mary Cluney who wrote (6233)	3/3/2009 4:01:12 PM
From: Lane3	1 Recommendation Read Replies (2) \| Respond to of 42652

How important is it to try to locate and retrieve notes that doctors have written on paper and misfiled? Life and death sometimes. Like I said, you're ignoring costs. Sure, sometimes it would save a life. How many lives? How much should we pay for each life saved? I realize that cost/benefit is irrelevant to true believers, but I still feel obligated to mention it. <g> Today's Ipod probably hold more than the rooms full of storage devices you worked on. When last I wrote a computer program for salary, that was true. It's also apples and oranges. You're not talking about designing a program for an Ipod or even a PC but a nationwide network or mixed hardware and software. If you knew anything at all, the very thought of it would boggle your mind. But since you don't, you can easily over-simplify to the point of dismissal. I will be gone from the face of this earth before they could build the system you envision. And by then whatever they build will be obsolete.

To: Mary Cluney who wrote (6233)	3/3/2009 4:30:25 PM
From: i-node	Respond to of 42652

The question is really about designing and implementing a system that can maximize the advantages of all the new technologies. I don't think there are credible people who can make a convincing argument not to move forward. The industry IS moving forward. It is huge business. But it is a complicated business that involves assimilation of data from many, many sources in a huge number of different formats, targeting millions of users with differing needs. Have you ever looked at the current provider taxonomy listing (this is a listing of specialty IDs)? Google it and have a look. Where, 15 years ago the specialty code listing was fewer than 100 distinct codes (easily fitting on a page), the current taxonomy listing is 160+ pages and most providers have NO IDEA what their own taxonomy code(s) are. All these provider taxonomies have different attributes and their needs for data access are potentially different. While there might be times when having medical records will save a life, I can guarantee you that NOT having access when you need it will cost lives. In an emergency, as it is, there are still paper records. When you move to EMR, that's gone. A cancer clinic I know of (thankfully, not my customer) recently had THREE DAYS of downtime on their EMR system. The office comes to a halt. Chemo regimens are disrupted. Seeing patients becomes impossible. Yesterday and today, our local intermediary's gateway has been down (still was an hour ago). This means no Medicare or BCBS claims could be filed in Arkansas or Louisiana, or Medicare in OK, RH, NM or part of one other state. When I talked to EDI services a little while ago, what I got was "We're working on it, we think it could be up in the morning but can't be sure". Now, the fact that Medicare claims can't be submitted for 2-3 days by any hospital or other provider in a five state area probably isn't a huge deal. But consider what that would mean if we were reliant on them for medical records? A lot of times difficult problems don't look that difficult to the people who aren't knee deep in them. My wife looks at the satellite radio in her car, the PC on her desktop, her Navigation system, and never questions, "How in the hell do they do that?". But I know what goes into them; I understand just how complicated the technology is. And even though I have a pretty good understanding of anything that has a microprocessor in it, every day I marvel at some piece of technology. Because I appreciate just how complicated some of this stuff is. Somebody had to write code to make it work. It isn't quantum mechanics. But what it lacks in complexity it makes up for in scope.