Posted on 12/31/2019 3:31:47 PM PST by spintreebob
Sorry “Employee” not “Employer”
The physical record belongs to the doctor.
The information in it belongs to you.
The Federalist recently had an article about this.
The EHR is a catastrophic error!
Check out Rand Paul’s fight against the National Patient Identifier. There is a lot more than just guns at stake.
The big push now is to collect SDOH Social Determinants 0f Health.
What criteria do you think will be collected as the SDOH of Mental Illness?
The Pre-Cogs of Tom Cruise are about to place their dreams in the database. When the next Richard Jewell becomes a suspect, his name will already be in the database with SDOH data to point to his guilt.
Separate from the ACA, Obama and the Pubbies in Congress passed the HITECH ACT which funded many billions for EHR. It had very elaborate regulations. Those who wrote the regulations were still living in the FAT CLIENT era of failed technology that was biased to be anti-mainframe.
Many young developers, both on shore and off shore were hired to develop the HITECH software and learned that was the way to do it.
Then, Obama and the Pubbies wrote and passed the CURES Act, which resulted in many regulations that totally contradicted the HITECH regulations.
The contradiction the industry is concerned about in INTEOPERABILITY... the ability for other doctors and hospitals and other payers to be able to access the data across all databases.
Not only are the two non-Obamacare bills wasting hundreds of billions of taxpayer money because the swamp cannot make up its mind, but they are building a mess that intentionally has so many backdoors it looks like a house of horrors.
Never believe a plaintiff’s lawyer. His goal is extracting personal financial gain by lying to a gullible jury.
The computerized health records available to patients at password protected sites are a boon to maintaining one’s wellness. Those who are ignorant and lazy will not benefit, but that is their problem and not the fault of the available records. .
Don’t blame JUST those in India. The same Indians are in the US working for EPIC, CERNER, IBM Watson Health, DeLoitte, Siemens and hundreds of others like them.
And don’t blame JUST the Indians. The Americans are just as incompetent, and just as unconcerned about quality as anyoneelse.
IT workers in the Government Sector have far lower standards, lower expectations, than those working for State Farm or Allstate type shops that are very similar in nature of the IT software and hardware.
UHC, Humana, BCBS seem to have mid-level quality, far worse than State Farm and Allstate, but maybe a little above the ONC of CMS of HHS.
You may have hit the nail on the head. The regulations and young developers are all focused on websites. There is no attention or understanding of the databases and backend processing needed support the websites.
It is GIGO. But they are obsessed with pretty VISUALIZATION of the Garbage.
it starts with good-ole-boy networks
It started when Cain created the Brother’s Keeper Paradigm.
God Asked Cain a question. Cain did not like God’s question, nor the answer. So Cain created a new way of looking at things rather than God’s way. Cain created the Brother’s Keeper view of the world.
God had created the Brother’s Brother view of the world.
Brother’s Keepers know best what is in your own self-interest and will tax you to impose it on you.
Republican Congresses appropriated that money after 2010 .... in addition to the Democrat Congresses of 2007-2010.
Michelle was a lawyer for the University of Chicago Healthcare System. It was her job to find the loopholes so her employer could get the moneey without going to jail.
Or, you can seek out a physicians group and insurer with good electronic record keeping that enables you to see your current records and those over time. That keep track of appointments and current perscriptions and allow confidential communication
If your physicians and specialist groups lack the ability, you need different providers
Typos and fat finger is one thing. Incompetent regulators is another.
Sub-agencies of HHS have 3 different sets of race codes. I am either Caucasian, or White or 1 depending on which agency you ask. My co-worker is either African-American or Black or 2. Native Americans, Native Hawaiins, Native Alaskans have so many code alternatives they could be anything.
The result is that when the data moves from one system to another system, the receiving system does not recognize the code and defaults to UNKNOWN.
So why collect the codes when 80% ends up as UNKNOWN?
Sex, Gender, Gender-self-identity is even worse. Nobody can agreed on the codes. New identities are being discovered all the time.
The wrong sex code could (including UNKNOWN) could trigger someone... as likely trigger the PC health worker as the patient.
DH and I went to our PCP the other day for the Medicare annual “Wellness Exam”. He was all excited, believing it would be a free physical exam. I told him it wasn’t, because the ladies in my quilting group had given me a heads-up. Still, he was thinking “physical”.
So my appointment was first. Doc is going down the list of questions asking if we had area rugs in the house, if we had smoke detectors (I knew the gun questions was coming soon), and I started to laugh. I said, “You don’t need to know that. This isn’t medical; it data harvesting for the government.” That that was the end of that.
Hubby was next. When he came out I saw the look on his face. He had told her the exact same thing and, boy, was he pissed. I laughed; I had warned him. NOT a physical.
So if you’re going for your annual WELLNESS exam, be forewarned.
On what do you base this assessment?
Government contractors have specialization. One department does nothing but respond to RFPs with Proposals. They are totally separate from the Department of the same company that implements that contract if they win the contract vs the competitors.
Of course, many sub-contractors are involved also.
For a data warehouse My government shop started with RFIs and identified 23+ potential contractors for a $100 million contract. We narrowed it down to 16, then 13, then 9, 7 and 5 and finally 2 and the 1... the winner for $100 million.
Included in the bidders were 5 or 6 companies that had existing contracts to create part of the data that would go into the new data warehouse. Included in the bidders were the companies the managed the 3 existing data warehouses that we wanted merged into 1 data warehouse that was new and improved over the existing.
One company that was the #1 supplier of informatiion to the existing data warehouses and created and managed one of the data warehouses submitted a proposal that was the worst of the top 7. Whoever wrote that proposal was incompetent.
Yet I know some of the workers in the trenches for that company who are far more competent than was revealed in their proposal.
The company whose proposal ranked #2 in quality was written by someone who really understood what we needed and wanted. It was probably written by one of their small subcontractors as the prime contractor suggested a joint venture with several sub-contractors.
So the companies with the #1 and #2 Proposals were in a bakeoff for the winner and required to answer additional questions and clarifications. Whoever was assigned to write the response to the bakeoff for Company #2 was totally incompetent. Their answers were like those of a high school sophmore.
The result was that company that had the #1 proposal won the contract. It took years to go through the “Protest Period” where any of the 7 losers could protest the process, and the substance on any real or imagined grounds. Then for the lawyers for each side to draw up the contract fine print.
Remember, this is happening while the government is changing and contradicting itself with regulations.... and technology is rapidly changing.
So May 2018 the $100 million project actually started. The winner hired a total of about 100 people. As many as 75 on the project at any one time. The single largest group was natural born Americans. But there were significant numbers on naturalized citizens and non-citizens also. (I didn’t know everybody on the project well enough to know their status.)
8 of the top 10 leaders/bosses were natural born citizens. None of the top 10 had the slightest idea how to design and build the data warehouse. None of the 10 had been involved in writing the proposal. A couple of the 10 had been on the Colorado Project earlier but apparently were unable to learn from the mistakes made on that project.
From May 2018 to Aug 2019 we tried to get the winning bidder to get it together and start designing and building the data warehouse. After 15 or 16 months we gave up and cancelled the contract.
Nobody broke the law. Nobody can go to jail. Incompetence is not illegal.
(PS of the 100 people hired there may have been 5 or 6 down in the trenches who actually were competent. But leadership did not listen to them and bluntly told them that they were not leadership and their comments not welcome.)
On occasional communication with them. (I used to work for BCBS, State Farm and Allstate ... and 35 shops not mentioned.)
And on seeing the quality of their data that goes into my data warehouses.
In terms of data quality, State Farm and Allstate would fire anyone who produced the quality of any of the others listed.
When the quality of the data is so poor, what makes them a boon?
What level of quality would you accept as a boon?
If my shop, or a hospital, has access to data on a million people and the data is wrong on allegies to medicines in some how many errors are acceptable?
1 in a million? 1 in 100,000? 1 in 100? 1 in 10?
When determining how much taxpayer money goes where, what level of data quality is acceptable?
Let’s spend taxpayer money on Maternal and Infant death. What level of data quality is acceptable to design the program and actually have a positive effect on the death rate?
The quality of the data is a function of the data provider. If your data is bad, it is your task to find a different provider.
I deal with several providers that all have excellent electronic records that allow me to know the status of my health as currently established.
Laziness is the culprit. To access and actually use the data, you must spend some time and effort. Or, in a state of laziness you can try to remember and disremember what you think you were told.
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