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

To: i-node who wrote (18335)	7/13/2010 12:07:58 AM
From: dybdahl	Read Replies (1) \| Respond to of 42652

"American IT is far ahead of the rest of the world..." Don't tempt me :-) This statement is very black/white, and definitely contradicts my perception. While I agree that you have some very large IT systems based on technologies from the 1970s (MUMPS?!?), a good share of the world's fastest computers, Microsoft etc., there are also many things that USA doesn't have. I could mention various kinds of IT businesses where USA is behind, but I guess the most famous misjudgement of the status of American IT was done by Microsoft, who bought a Danish Business software company in order to get into the European market, and bought Great Plains in order to get into the U.S. market. They assumed that Great Plains was ahead, so the plan was to market Great Plains software in both places. After a while, they figured out that the Danish software was significantly superior, and then changed their opinion, and now markets the Danish software in USA, too. This non-U.S. software is called Microsoft Dynamics today. I could tell you similar stories about IBM and CSC in health care IT, and I would be surprised if Boeing is much more advanced than Volkswagen or EADS. Remember that EADS introduced fly-by-wire before Boeing. SAP is also German. Besides software producers, software vendors and software installations, there is the question of market penetration and use statistics. USA is late on several technologies and usage patterns, and for instance, many advanced phone never make it to the U.S. market - maybe because of usage patterns, maybe because the U.S. mobile coverage is so poor. Even in New York, you may lose coverage in the subway or inside the Rockefeller building, whereas I have no idea where in northwest Europe I should go in order to lose coverage, maybe a mine or something like that. I see many U.S. IT systems that are basically electronic paper, where you did not move to an IT-based paradigm, yet. Afaik, this is one reason why Great Plains lost to Navision, but in health care IT, this seems to be the case, too. Just the idea of having a "CPOE" system seems extremely outdated, today.

To: i-node who wrote (18335)	7/13/2010 12:32:28 AM
From: dybdahl	Read Replies (1) \| Respond to of 42652

"...more than 10 different IT systems that they need to log into..." "I agree about this being a problem, and this problem is everywhere. But that is what HL7 is about, and ultimately, is a standards-based approach to solving the problem." I wouldn't put my money on that. Health Care is much bigger than USA, and HL7 is very USA-centric. Many of the HL7 substandards don't make sense elsewhere, and are simply not compatible to existing IT systems, and the health care IT solutions are becoming global. There are still many very large U.S. health care IT companies, that don't generate much turnover outside USA. There are also many international players, that have not entered the U.S. market. It's just like inches and miles, there are 6 billion people outside USA who doesn't do U.S. standards, and it's still funny to see Americans use them. Several European countries are running into serious problems these days because ICD-10 starts to look old and worn-out, and inadequate to solve modern health care IT problems. ICD-10 is simply not detailed or precise enough to plan a large health care system well. Many American hospitals still use ICD-9! Maybe that's why the international HQ (IHTSDO) for SNOMED-CT was placed in Copenhagen, about 50 meters from my office.