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

To: dybdahl who wrote (18342)	7/13/2010 10:52:33 AM
From: i-node	Read Replies (1) \| Respond to of 42652

When you break the boundaries of existing technologies, you need to replace it with something better. I would not argue that the data couldn't find use somewhere and for some reason, but I don't think in this country the people who have to do the work are going to embrace it anytime soon. Perhaps in some countries it isn't difficult to change. Here, moving from ICD9 to ICD10 is a big deal. I don't see us undertaking additional coding changes anytime soon unless someone can make a conclusive case for such a change, and I don't think that case can be made.

To: dybdahl who wrote (18342)	7/13/2010 1:24:58 PM
From: i-node	Read Replies (1) \| Respond to of 42652

Do you guys use the ANSI Taxonomy codes that we use here? Until the ANSI4010 standard, we basically had a set of about 99 provider types ("Specialty" codes) to identify, well, provider specialty. When ANSI4010 became the standard, the current taxonomy listing was established to identify provider types. And, as you would expect, the comprehensive listing ballooned from one page to hundreds of pages. No longer do we simply have "Physical Therapist" as a specialty, but now we have: * Cardiopulmonary - 2251C2600X [definition] * Electrophysiology, Clinical - 2251E1300X [definition] * Ergonomics - 2251E1200X [definition] * Geriatrics - 2251G0304X [definition] * Hand - 2251H1200X [definition] * Human Factors - 2251H1300X [definition] * Neurology - 2251N0400X [definition] * Orthopedic - 2251X0800X [definition] * Pediatrics - 2251P0200X [definition] * Sports - 2251S0007X [definition] # Physical Therapy Assistant - 225200000X [definition] # Prosthetist - 224P00000X [definition] # Pulmonary Function Technologist - 225B00000X [definition] # Recreation Therapist - 225800000X [definition] And no longer do we have Occupational Therapists, we have: # Occupational Therapist - 225X00000X [definition] * Driving and Community Mobility - 225XR0403X [definition] * Environmental Modification - 225XE0001X [definition] * Ergonomics - 225XE1200X [definition] * Feeding, Eating & Swallowing - 225XF0002X [definition] * Gerontology - 225XG0600X [definition] * Hand - 225XH1200X [definition] * Human Factors - 225XH1300X [definition] * Low Vision - 225XL0004X [definition] * Mental Health - 225XM0800X [definition] * Neurorehabilitation - 225XN1300X [definition] * Pediatrics - 225XP0200X [definition] * Physical Rehabilitation - 225XP0019X [definition] The problem with all this is that the "data" actually became LESS meaningful with the adoption of this new listing, even though the level of detail was expanded massively. The reason is that ordinary people are having to choose from a highly technical list of options. The same happens all the time with ICD9, ICD10, and any other more extensive coding scheme you will ever come up with. More detail in categorization does not imply a more informational result. Honestly, this mistake is one I've seen made time and time again over my decades designing and building systems. I saw it in the 70s when I was designing accounting & tax systems; in the 80s when I started doing health care EDI, and it has continued until this day when I see another giant boondogle coming with the adoption of ANSI 5010 and ICD10. It is all a big pile of useless crap for the most part. I can give you a hundred examples where useless data is being collected in the futile quest for "more detail", while the really important stuff is totally overlooked. I am confident this happens in Denmark as well as in the USA. I wouldn't be shocked if Denmark does a better job than we do here, though.