the federal government is paying out 150 million dollars to 12 areas in Maine
I want to send out a message that the federal government is paying out 150 million dollars to 12 areas in Maine in order to have them develop centralized electronic medical records. I don't know if it is 150 million total, or x12. I feel this is just anther ploy to have human beings microchipped, and create a socialist database so that the centralized government can control people. I hope that you Dr. Paul supporters in Maine can oppose this somehow, if you have the opportunity. You can call in to WLOB morning talk show tomorrow if you are so inclined, they will discuss the matter. It is early in the morning, around 9:00 AM and the number is, I believe, 1-866-393-8255. I don't know if someone might be tracing the calls in some database; so don't call if you are concerned about being in a database.
It's already working http://www.nhinwatch.com/
... several states.
The idea of portable electronic records is great - but the idea of a federal network is bad.
For more info http://www.nhinwatch.com/
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johnlocke.org http://en.wikipedia.org/wiki/John_Locke
Problems with centralized medical databases
Here are the problems with centralized medical databases:
1. Even the Dept. of Defense has been hacked.
2. Follow the money - the insurance companies can increase rates and/or *totally deny* coverage based on accurate or inaccurate data.
3. IT employees at banks, credit reporting, and medical companies routinely have access to production data. Does that data end up on "missing" laptops, just like 29 million SSNs for veterans? How much will you pay me to get someone's medical history?
4. What rights do consumers have to see what is in their files?
5. What rights do consumers have to CORRECT FACTUAL ERRORS like we do with mistakes in our credit reports?
6. What is the retention period for those medical records? Forever?
7. Can these databases become the centralized DNA database, due to routine drug testing samples for employment?
From personal experience recently: I simply went to a new clinic to renew my blood pressure medication, since I had moved an hour away and didn't want to drive that far for a "randomly assigned doctor". There was a second stress-related medication that I also wanted renewed, but the doctor had the right to deny that renewal.
What he told me during that 10 minute first-time appointment at 9:30 a.m. was that he would renew the second medication for one month, but that he was writing in my record that no doctor there would renew it for a second month UNLESS I SAW A PSYCHIATRIST!
He ordered a set of blood tests that were done at 9:45 a.m. on a different floor.
When I went to get pick up my prescriptions, he had only given me 2 renewals vs. 5 *from every other doctor* for the blood pressure medication.
How much of the doctors actions were to IMPROVE HIS/THE CLINIC'S BOTTOM LINE?
Then, I receive the health clinic bill (my copay wasn't accepted at the time, because my company "couldn't find" me, not even with my SSN) for $181 (vs. $35 I expected to pay).
WORSE, the doctor submitted *3* diagnoses: benign blood pressure, acute stress, and *alcoholism*!
Malpractice: If he thought I was an alcoholic, he should never have renewed the second medication and he should have requested a different set of blood tests (the ones he did order came back normal).
My insurance company increased my monthly premium by 21% within a matter of 7-10 days; it could just as easily have terminated my coverage. It also refused to pay the medical bill *unless* I released my medical records to them.
After hours and hours of follow-up, I actually have a transcribed version of my health records of the clinic.
Due to several critical, factual errors (like he met with me face-to-face for *30* minutes), I requested a copy of the *handwritten* doctor notes.
The PRESIDENT indicated in a snail-mail reply that they don't KEEP those handwritten records! (What kind of reputable doctor wouldn't keep a copy of his *own* handwritten records??)
I will be filing complaints with the State regulatory department against the doctor, the clinic, and against Advocate Health (for allowing each of its member institutions to set their own record retention policies).
Ironically, due to the critical, factual errors in the transcribed version, the only way they can defend against my complaints is to prove a "mistake" BASED ON THE HANDWRITTEN RECORDS.
I have researched record retention policies in Illinois, only to find that Illinois is one of the few states that HAS NO MEDICAL RECORD RETENTION POLICY! People have lost malpractice lawsuits in Illinois because the medical records "disappeared"!
1. Even the Dept. of Defense
1. Even the Dept. of Defense has been hacked.
True. But if a medical record system is designed properly, the only real 'information' that can be garnered from a hack would be information that does not lead to any individual person.
So they could find out that someone has HIV, but they wouldn't know that person's name or address.
2. Follow the money - the insurance companies can increase rates and/or *totally deny* coverage based on accurate or inaccurate data.
True. And it also follows that insurance companies will increase their rates because of the availability of accurate data.
The more accurate the physician is when he bills the insurance company, the more the insurance company has to pay out.
3. IT employees at banks, credit reporting, and medical companies routinely have access to production data. Does that data end up on "missing" laptops, just like 29 million SSNs for veterans? How much will you pay me to get someone's medical history?
I dont know about other systems, but in my own program the only person who has access to the patients entire medical history is the doctor in charge of that patient.
The nurses that work with him can gain access to pertinent information about an individual visit - but not the whole history, and not if that history is not something the doctor has approved.
This is achieved through the use of a HIPAA officer at the clinic/hospital level giving specific access rights to each user.
The system also records data access histories, so if any question about the release of information about a patient comes up, that patient's record can be reviewed to see who accessed the data, when it was accessed, and who gave that person the permission to do so.
Basically, the only way for the information to be 'bought' would be for the HIPAA officer, the doctor and the offending person to be working together to 'get paid' for releasing the data - and there are some pretty hefty penalties for anyone who gets caught even attempting to do that.
4. What rights do consumers have to see what is in their files?
Currently, an individual patient has access to everything in their file except for some mental health data.
For instance, if a patient is diagnosed as having some sort of dangerous mental condition (dangerous to themselves or others), that patient would not be able to see the information about the doctor who diagnosed them. This is in place to protect the doctor.
Some may say that this 'loophole' is bad, and I can't say that I disagree with them, but since it is only the most 'dangerous' mental afflictions that are covered by this regulation, it's not much to worry about.
Unless, of course, doctors suddenly start diagnosing everyone that walks through their door with 'Schitzoid Rage Complex' (made up disease).
5. What rights do consumers have to CORRECT FACTUAL ERRORS like we do with mistakes in our credit reports?
The system that I built allows for amendments to data to be done by the initial physician, or the amendments to be added by any doctor the patient qualifies to add it.
It's kind of like a 'second opinion' that can go directly into the patient record.
If the patient wants a specific diagnosis to, for instance, get their insurance provider to cover an illness that their current doctors diagnosis doesn't get them coverage for, that information can be added to the system as a 'second opinion' - but the insurance company will still have access to the original diagnosis and can then figure out which doctor to believe.
6. What is the retention period for those medical records? Forever?
At this point retention requirements are very vague, plus it depends on the context of the question.
Doctors are supposed to keep records on hand for no less than 10 years, and they can then choose to destroy those records after that time if the patient is no longer in their care.
For the individual patient records, outside of that instance, medical records are kept for the life of the patient - plus 10 years.
I am unaware of any regulations which would allow an individual to demand that their medical history be 'wiped' from existance.. but if there is such a regulation, and EMR could easily be coded to allow it.
7. Can these databases become the centralized DNA database, due to routine drug testing samples for employment?
Yes. If the government suddenly decided that HIPAA was no longer in effect, and created a new rule that allowed employers access to specific portions of a medical record, this could happen.
For now, HIPAA protects the individual patient by only allowing their doctor and/or authorized health care entities to view their data.
In fact, when you go to a doctor for the first time, it is law that you have to fill out a form that gives the doctor access to your medical records. Without that approval, the doctor cannot treat you at all.
This yet another instance in which
the wisdom of Dr., Paul is so incredibly correct. The feds have absolutely no business in putting $$ into this scheme. Not one nickel. I would also say that the state of Maine ought to steer completely clear of this as well. If individuals in Maine want their records digitized that's fine. If an asscociation of medical providers wants to set up a system then that's fine too. If the insurance companies want to get involved, again fine. A free market in health care, and the necessary information, should face no impediments or guidance from government.
h-daddy
Only OK
with your consent. I, for one, would opt out and handle my own records.
h-daddy
It is not fine with me for the insurance agencies
It is not fine with me for the insurance agencies or medical people to have my records available in an open database. They could make maditory insurance and jack up the price. I don't trust insurance companies or most medical people as far as I could throw them. I hear medical people using CFR catch phrases and everything. Who do you think will inject people with phony bird-flu vaccine, and things when the powers that be say “go”? Crony capitalism does not solve anything either, it is the same as socialism. I suppose you want to sell all our store records to insurance companies as well so they can see if we purchased a cigar or fatty food or some non-PC political magazine or something right? I think many big companies are a bigger danger to us than the U.S. government. They absolutely have more power than the government does. Insurance is a rip-off. I don’t get this Microsoft or Google thing, those companies are horrible.
I do not mean
to imply that this system would be mandated. Only with consent. People who don't want to be in this system would have the right to stay out and, importantly, be able to protect that right in courts. Privacy is protected under the Constitution.
I have no love whatsoever for insurance companies. And no love for the maze of laws, and agencies of government, that protect their criminal business practices.
h-daddy
"Voluntary" - no insurance coverage without it
No violation of privacy - you just can't get medical insurance without participating. That's their right, as well.
Imagine "medical coverage for all" requirements-
How many other "voluntary" things have we been suckered into recently?
Yup. Agreed.
So...how do we "fix" the healthcare system? Do you agree with Dr. Paul that all goverment regs should be set aside and let free markets work their magic? Or, should we simply go to a Canadian style system and eliminate the insurance companies etc.
I'm with Dr.Paul. I'll take my chances, and base my decisions, on what the free markets offer.
h-daddy
About socialized medicine
Health care for all sounds like the right thing to do. The whole health care market shit the bed when the gov. got involved in the first place. Prices have been on an upward spiral since. I believe it started with HMO"s and then PPO's. I remember the pitch from our "human resources" personel at least 20 yrs ago. "It will help reduce health care costs." You had to have a Dr. that was within their "list of providers" No more frivilous claims would be made and all would save money. Yea, right.
Now a days you can't have insurance and make a claim and have it be "approved" unless it is a condition that falls within your coverage. You have to guess what you might contract. Cancer, Heart problem, what ever, and purchase extra insurance if you THINK you might develope the condition...HUH?? It sure didn't use to be that way. What if you contract a rare but deadly disease? That's not covered.
As for socialized health care, it is always a failure. They run out of funds and people are forced to go elsewhere for care, if they can afford to. Right to health care is equal to the duty to die. Not many resources wil be expended for your poor old mum or pop. I'm tellin' you, prices will be ever increasing and the money they collect will not hold the load!!!
Confusing reply
Opening sentence: "Health care for all sounds like the right thing to do."
Closing paragraph includes: "As for socialized health care, it is always a failure. "
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Private or governmental (from whose taxes) - how will health care be afforded *at all*. Think of the money bomb graphs in terms of babyboomers aging to 70-80 years of age.
I already have articles about how high the first year Medicare bills are, presumably due to people who didn't want to risk being labeled *uninsurable* before they were covered by Medicare.
Given my experience above, I certainly will not use any of those health battery of tests that are offered until I am covered by Medicare. (Scam warning - "free" ones turned out be turned into insurance company for payment, only to have a friend's brother totally lose his insurance, as a result.)
Think of the athletes who had "routine" blood tests to get married, only to find out they had HIV. How expensive if their insurance, *if they can get it at all*.
A fascinating topic. The libertarian in
me insists that only solution to the mess we have in this country is to do exactly what Dr. Paul advocates. Get all levels of government out of the health care system and see what happens. My guess is that some really good insurance products would come on the market, some cost effective health care systems would pop up, and individuals would benefit in terms of health and expense.
That being said, it is unfair to say that "socialized"medicine is always a failure. All the evidence suggests that the Canadian provincial systems provide excellent care at a far more reasonable cost and, importantly, everyone is covered. Of course, it is paid for through tax revenues! But it is not a failure. I do not believe a system like that could ever be implemented in the USA. Far to many vested interests and $$$$ involved.
h-daddy
See my long post at the top
Does my "freedom" to pick an insurer (that I can afford) in my lengthy post at the top help me at all?
As my father always said, you find out what your insurance *doesn't* cover when you need it!
To be honest, the medical insurance groups (*including Medicare/Medicaid*) cannot possibly cover the medical care/costs of the aging of the babyboomers (or their parents).
After all the natural disasters of fires, floods, hurricanes, the insurance companies are simply not insuring those any longer without expensive riders.
diagnosis: “bourgeois delusions in opposition to scientific soci
I suppose that should have read:
The main problems are: 1. They want to implant microchips in people, in my opinion. Many Christians think this is part of “The Mark of the Beast”, 2. They want to have centralized records of illnesses so they can blackmail people, and inter dissidents who they want to label as, “mentally ill”, you folks, for example, would be mentally ill according to the old soviet system for diagnosis: “bourgeois delusions in opposition to scientific socialism”.
I wont go to your 'number of
I wont go to your 'number of the beast' comment, because that is for the individual to decide on their own.
But to your comment about a centralized record of illnesses so they can blackmail people - there could be debate on that issue.
The system that I put together, after realizing that there was no logical/practical way for there to be competition among medical record software companies unless a standardized way for them to communicate was created, solved many problems.
Basically, it didn't matter which software a doctor, clinic, hospital, pharmacy, lab or other medical releated area was using. The system I designed would all for them all to communicate among themselves.
It did so in a very secure fashion and was very inexpensive to impliment. Most of the time there was no 'cost for setup' or 'cost for integration' involved at all.
For example, lets assume that you got a cold and went to your doctor. He decided that your problem might be more than just a cold, so he took some of your blood for lab tests.
The blood is then shipped off to a lab, where they test it for whatever the doctor asks for tests on.
The results are then sent back to your doctor, through a computer, and straight into your record.
Now this could have potential issues of privacy, but with the system I developed there were none. Your blood was sent to the lab with a number on it - not your name. The lab did the test and returned the results to your doctor with a number on it - not your name. The system would then put the lab results into your individual record, using a number - not a name.
The only thing that would know what medical record was to have those results put in it, in regards to the number assigned to that lab test, would be the software that had to route the information to the correct locations, and even THAT doesn't know your name.
The only way anyone, outside of you, your doctor, or anyone with a 'need to know' in regards to your medical record, can get to the information with your actual 'name' on it is by court order. That is already in place - so it's not like it was something that had to be 'coded'.
So what are the 'good points' about a system like this?
For one, The Center for Disease Control (CDC) could set up specific requests from this system.
For instance, they could say "If the disease 'Cholera' were to suddenly appear as a diagnosis in any medical record - and 'Cholera' appeared in 7 records within a 50 square mile radius in a 2 day period", the system could send an alert to the CDC to let them know that it happened - if it happened.
The CDC would still not have anyone's 'name'. They would, however, have the information about a cholera outbreak during a specific timeframe and in a specific location.
They could then take the steps needed (if any) to investigate further, which usually means contacting local clinics and hospitals to monitor the situation - if there is one.
The only way the CDC, or any other entity, could gain knowledge about exactly 'who' was diagnosed with a specific disease or condition would be through the courts - which is how it already works.
The fact that an outbreak of anything at all - whether it is Cholera or anthrax, or just a widespread outbreak of the flu - can be instantly detected, in itself can save lives.
As it stands now, if there is an outbreak of any disease at all in a specific location - that could be potentially dangerous to the population at large - it can take many days, or even weeks/months for the information to make it to the people who are in charge of keeping an eye on such issues (CDC).
With the system I'm discussing here - that information could be sent to these entities the same millisecond the illness is diagnosed.
Unfortunately, as I've stated before, it appears that the entire issue of Electronic Medical Record systems is leaning on becoming just the opposite of what we (the medical programming community) were lead to believe it was.
Instead of a way for records to be maintained and shared in a more rapid and secure manner - it seems that the restrictions, rules and regulations involved in this whole system have been geared to make it impossible for multiple EMR design companies to use the free market to allow doctors to choose which system is best for them.
The ONLY way that this system can work on a nationwide basis is if every doctor is required to use the same software package, the same pharmacies, the same labs and the same diagnostic tools as every other doc in the country.
This creates a defacto monopoly for whoever it is that lands the job of designing and providing the software to do it.
Since the regulations and restrictions make it impossible for any one company to get that 'lead', and it appears that the only entity that has the ability to lay claim that they 'made it work' is the government itself - I fear for the safety, security and privacy of everyone's personal medical data.
In reality, if the government were to hand $150 million over to me and my own company, I could set up systems that were secure, easy to use and blanket all 50 states - not just 'Maine' - with an electronic medical record system that could stand up to the scrutiny of any programmer, analyst or investigator.
150 million for 12 locations in one state is a complete joke. Even if I used the initial cost/fee pricing that my own company was using, that same 150 million would be enough to get 50 THOUSAND doctors set up with their own medical record software systems AND pay for the maintenance/upkeep/storage for a full year for all of them.
That 50k doctor amount is based on the original idea of charging $1500 per doctor and $150 per month.
Fortunately, the more doctors that use the system - the less expensive it gets to maintain it on a per-doctor basis. So a more realistic number would be that 150 million dollars would set up 250,000 doctors (the total number of active practitioners in the entire country) for a year.
After that first year, the docs would pay for their own 'upkeep' a rate of somewhere between 50 and 100 dollars per month.
That's not 50-100 per patient - but per doctor. Since the system I designed can allow a doc to see more patients at less cost, and get more money for it, the average cost per individual patient visit would be somewhere in the neighborhood of 25 cents per visit.
Considering docs get paid a minimum of $40 just from a patient walking through their office door - 25 cents shouldn't be a problem.
Without the checks and balances of private industry - through competition and innovation - letting the government run all of this the way they see fit by saying "Well, the rules say doctors have to have electronic records now, and since noone has stepped up to the plate to provide them we, the government, will take care of it so the rules can be followed" is bound to be a disaster.
We have been fighting this thing for years now. My own company even has the former president of the NMA, learned doctors in multiple fields, and highly experienced software engineers on our team.
First and foremost our goal was to make a system that both worked for doctors in an easy to use way, but also retained total security for a patient.
Secondly we set out to make it so doctors/clinics/hospitals would not have to pay millions of dollars per unit to impliment the new software.
Third, we set up teams that would instruct each and every doctor who was using the system on how to use it - how to interact with it - and how to help grow it by making suggestions for additions or modifications to the code.
But.. in the real world.. when you follow the rules and try to help, when you provide something that costs a doctor $150 a month instead of tens of thousands of dollars per year, when you set up a system that doesn't provide kickbacks to executives and/or hospital administrators, when you provide a practical and viable solution to the inherent problems within the government-designed program regulations - you step on toes.
I've pretty much given up on the idea that the healthcare system can work in a fluid and secure way. Since many options and demonstratable solutions to the problems faced in this arena have been provided, and promptly ignored, I can only come to the conclusion that the government doesn't really want these answers.
They'd rather have a system that is not secure, has flaws beyond reasoning and that they can be the sole controller of.
It was a nice idea - but it's gone down a path toward serious problems that only the surface has been scratched on.
CF
How is it up to the individual to decide when the government mak
So, you think it is up to the individual to decide? How is it up to the individual to decide when the government makes it mandatory like auto insurance and attempts to force people to get a microchip implant? Is a SSN just a retirement account number like Roosevelt 33* said and "not for I.D."? There are socialist think tanks like the Tavistock Institute, population control advocates, Globalists and other weirdoes running all over Maine. Some rumors even imply that workers have overheard the population control people advocate wipping out masses of people.
Whoops.. you misunderstood
Whoops.. you misunderstood my meaning... I can understand why so I'll rephrase:
It is up to the individual to decide whether they think a microchip put in their body is 'the number of the beast' or not.
It may not be up to the individual to decide whether to 'get' the chip if it is eventually made a requirement to get medical treatment - but it is up to the individual to decide whether they think it has anything to do with biblical prophecy.
That's what I meant :)
CF
The move from paper to
The move from paper to electronic medical records has been happening for years.
At first, it appeared that the benefits of being able to pull up a patient record from 'anywhere' that patient might end up (different doctor, hospital emergency room, clinic, etc) were great for the patient.
If you were on vacation and got sick or injured, you could go to any doctor and they could pull up your medical records to check for any medical history or condition that was important. After all, if you were taken to an emergency room unconscious and were allergic to a medication - it's a good thing for the EM doctor to know about the allergy.
The whole idea seemed to be a win-win situation for everyone involved.
The thoughts of the insurance companies making more profits are offset when you understand how the systems can work.
If a doctor is using an EMR (Electronic Medical Record) for his patient, there are very specific things that the program can do that can make the doctor more money.
For instance, if a type of 'learning' computer is used that has a form of artificial intelligence, it can automatically detect and fix errors in a doctor's billing system. Insurance companies are very strict on what they will pay for, what the actual 'coding' needs to be for the doc to get paid, and the timing of billing apps being put through their systems.
As of about four years ago, the average doctor made about $65 for every $100 they billed to insurance companies. The vast majority of the losses were due to incorrect codes being used on the billing forms. An EMR can learn the correct codes and basically be set up so that if an error ever does take place, that error is 'learned' and never repeated again.
Also, an EMR can be used to help the physician increase his patient flow. If a doc has to fill out forms by hand, or look things up in reference books, or rely on a large staff to do numerous tasks, that takes time. If the EMR is programmed to do it, a doctor can double the number of patients they see in any given day.
So, increased total revenue per patient and increased total number of patients. That equals more revenue for the physician, which translates to more payouts from insurance companies.
A doctor can go from a staff of 12 assistants/nurses to 4 assistants/nurses, see 24 patients a day instead of 12, bring their insurance-based payments from $65 to nearly $100 per $100 billed, and do their job more effectively.
Where the problem sits is that there are about 200 different EMR systems on the market today - and few of them are capable of 'talking to one another'. So if you do happen to be a patient of a doctor who uses an EMR, the likelyhood that your personal medical information could be retrieved in an emergency, at a location other than your doctor's office or clinic, is unlikely.
The HL7 protocol was created to get medical software systems to communicate with one another. An EMR at a doctors office could send prescription information to a pharmacy, or request labs/tests from a clinic or hospital. The results of the tests could be discovered at a lab, and that lab could then return those results to the doctor's EMR - straight into the individual patients medical record.
No phone calls. No forms. No mail. No faxing. Just instant transfer of the information to the location that needs it.
So what's the problem? HL7 was written by doctors - not programmers. The doctors said "We want it to do this thing" and they wrote that down. Then they said "We think it should react this way to this criteria", and they wrote that down.
They may have had a small amount of computer programming advice while they were coming up with this plan - but from the standpoint of a computer programmer, whoever they used lacked reason, experience or real-world application knowledge for the task that was being designed.
So we've got hundreds of EMRs out there, and only a couple of them can even communicate between themselves - let alone to the hundreds of thousands of other clinics, hospitals, labs, research facilities, pharmacies and emergency rooms.
It's a mess and the only thing standing in the way of cleaning it up and making it safer, functional and easy to impliment is bureaucratic red tape.
They spent so many years coming up with this 'grand plan', and put so much money into developing the farce of an idea that was then pushed on the medical community, that they are unwilling to admit the plan is fatally flawed and cannot work.
Oh, they'll be happy to take a programmers money, to the tune of $15000 the last time I checked, to 'verify the program meets the minimum standards'. Unfortunately they will not only not listen to the complaints and reasoning about the whole system being a failure, they refuse to hear alternative ideas about it. They spent the money (unwisely) to set up the rules - and now the doctors are expected to follow them. The doctors accepted these rules as workable (unwisely) - and now programmers are expected to adapt programs to them.
You cant fit a round peg in a square hole unless you use a very heavy hammer and lots of force - neither of which are suitable for programming or medicine.
I wouldn't worry too much about having your information all wrapped up in some database.. at least not for many years to come. The current rules, combined with the inability to get software to conform to them, is the major roadblock that is your 'friend'.
How do I know this? Because I wrote the first EMR to be HIPAA certified in the world. I spent years attempting to make sense of, and impliment, the HL7 standards into medical record systems. I wrote an alternate software system that not only replaced the HL7 system - but was accepted by every medical programmer it was reviewed by as easy to use, easy to impliment and cost-effective.
I took these findings to the AMA, CDC and folks in charge of HL7 and HIPAA. For those who even bothered to review the information I provided, and actually use the working model of the software system, they showed little interest because there was no major money to be drawn from it.
Most of the attempts at even getting a meeting set up with someone in charge were met with refusal, 'wait until next year' or utter silence as a response.
CF
Thanks for 2 enlightening posts.
What a mess the "system" really is.
I would value your opinion on this question. Which system would be "better" ( I'll let you define that as you see fit); a totally free market system (such as RP advocates) OR a total government run system (ala Canada)?
h-daddy
That's an easy answer
That's an easy answer :)
Neither.
A total free-market system would give rise to monopolistic control over the digital healthcare records. Since no usable standard for moving the digital traffic from one EMR to another, or from an EMR to a non-EMR source (such as a pharmacy or lab) is in place, the individual programming companies would have to come up with their own methods to get the data from point A to point B.
If those methods were not standardized into something that any programmer could use - easily - without a need for a multi-million dollar research team to interpret the data, then there would be just as many 'data transportation' methods as there were EMRs.
A government run system would give too much personal information (or, at least, give too much access to it) to people with no 'need to know'.
Yes, it could produce a standardized method of information delivery that each EMR programmer could then use to make their own programs.
Then it would be up to the program itself to be accepted and used by doctors across the country.
Some EMRs would come out that have nothing but the basics - just a way to store simple data. It could be as simple as scanning a document into a computer and then that document being stored in a database.
Or, they could be as complex as the one I built, which has patient scheduling, lab requests, multiple office interoperability, 'any location' access for the doctors, interactivity with numerous billing systems and labs, an internal/external messaging system so doctors can share information or get advice from their peers, and a one of a kind artificial intelligence engine that actually learns from the doctors - and can be used to alert doctors to a variety of potential alternatives - and potential dangers - based on the diagnosis that the doctor arrives at.
So you've got EMRs that run the gamut.. from extremely simple to extremely complex. At that point it would be up to the individual doctor, clinic or hospital to decide which of the available software solutions was right for them.
The problem isn't with the security of information - because a good system will have a tamper-proof system in place to protect patient data.
The problem is in the beaurocratic mess that has been put in place to prevent such a solution from being used.
Take the government out of the formula. Let the programmers work together to create the information routing system that all EMRs can easily adapt to, then it's just a matter of 'Who has the most widgets and prettiest interface' as the deciding factor on what the doctors will decide to use.
CF
Makes sense to me.
So create a "free market"environment - by the absence of governmental regulations - in which businesses can, by free association, create their own standards for informational systems. Is that right?
h-daddy
That about sums it up. The
That about sums it up.
The only 'regulation' that should be done by any governing entity would be that of the systems already in place to do so.
The surgeon general, for instance, heads the U.S. Department of Health and Human Services.
I would not have a problem with HHS having some kind of oversite into the security aspects of the data transmission methods, or even the security aspects of any given EMR.
After all, if it's left wide open for any programmer or firm to say "Our EMR is available", but that EMR has serious security issues - an individual doctor may not know about it until it's too late.
A doctor needs to manage and treat his/her patients - not learn how to detect intricate internal design flaws and security holes in the programs they decide to use in their practice.
A governing body of some sort - which could even be made up of non-government entities - put in place to verify the security and data standards of any proposed EMR makes a lot of sense.
CF
You sound like an intelligent person.
You sound like an intelligent person, a computer scientist, or engineer. You may be much more intelligent than me, but I think you are missing something. I don’t know what your religious belief is, but you seem to believe in the U.S. Constitution. I want you to consider the 4th amendment. Your system, how ever well intentioned surely would become a tool of tyranny. Look at the SSN, it was supposedly just a retirement account number. It was even printed on the obverse, “not for identity purposes”. The SSN severely violates my religious beliefs. I have had people demand that I use my SSN number, and give it to them or they would cause me to loose my career. The SSN number to me is just an account number, not an I.D. I believe the Masons forced that upon us as an identity number, in their mania to force society to run like a “hive”. It absolutely crushes me inside to be forced into a surveillance police state like this.
I am so sick of people saying, “If I have nothing to hide, why am I concerned with my privacy? “If they have not committed a crime, why don’t they go live in a prison.” it is the same. How about they place a camera in your bathroom in case you fall? Falls are a leading cause of injury according to the National Safety Council. If you don’t want a camera in your bathroom, you must be trying to increase people’s insurance premiums.
I have a God given right to my privacy, not to buy insurance, and to trust in my God for healing and not the government, or some CFR socialistic company, or weirdo, euthanasia, population control, Globalist, medical person. This is America, and no company has a right to tell me how to live. That is slavery. I have a God given right to my privacy, not to buy insurance, and to trust in my God for healing and not the government, or some CFR socialistic company, or euthanasia, population control, CFR, medical person. This is America, and no company has a right to tell me how to live. That is slavery. It is sad to me that many Americans would allow a the police to stand in their living room 24 hours a day for the rest of their lives for one stale box of crackers.
Thanks for bringing that
Thanks for bringing that concern to light. I have it too.
So.. would you rather have your medical history stored on some government database for tyrants to abuse.. or in a privatized system that is only subject to slight government regulations.
Myself.. if the government suddenly popped it's head in the door and said "Hey there! We have an order here for you to release all the data of every person in your database" my response would be "HIPAA?".
If they decided that HIPAA regulations did not apply to them, which would break the law, they would have to use force to get at the data.
Luckily.. programmers in the private sector are very good at keeping data from the hands of those who are not supposed to have it.
Push a button - deleted.
"Here's your file sir"
"But its got a filesize of zero bytes, that cant be right"
"Yes it is, it is all the data we have, have a nice day"
Ok.. that's a bit extreme.. but could happen.
Personally, since the government is FORCING this thing on us all, I would rather know that someone like myself - who will do everything in their power, both physically and programatically, to keep a persons medical information private - are the one's doing it.
Not some government run 'office' that has no soul.
In the end, it will probably be that government run, government controlled system that we're all force to use if we want health care. Giving the ability to provide the same basic service to the population without the government getting their hands into it has demonstrated to be a pipe dream.
CF
Refuse to allow your records to be input, or change doctors
Just one former medical office manager's opinion. I helped usher in first the HIPAA changes, along with a host of other things in the post 9-11 haze. The push for electronic records seemed so reasonable back then, better patient care and such. After working with an ERM system for a few years, I came to understand who is actually benefitting from this arrangement, and it is not the patient. There are some perks for the people, but it is the insurance companies and the government that gain the most, by far.
20 years in healthcare, now I avoid the system at all costs. If you need trauma care, go for it, we still have outstanding trauma treatment. Just about anything else you can do a better job treating yourself. I realize many people are now permanent fixtures in the system, having been made entirely dependant on some medication. You have to start taking care of yourself before you get to that point.
Truth exists, and it deserves to be cherished.
Ok...
I live in Maine and, furthermore, I work for Information Systems at a hospital. I've never heard of this. Do you have a source? Also, what's wrong with electronic medical records? I obviously have an issue with the Government subsidizing it, but we have all kinds of uses for EMR's. Our EMR system allows physicians and clinicians to access patient care information much quicker and more accurately than paper based systems. This can be a life-saving advancement in emergency situations.
Again, of course, I object to any government funding or involvement. Don't kill the technology itself, however.
Brad
Diagnosis: “proletarian delusions in opposition to scientific
The main problems are: 1. They want to implant microchips in people, in my opinion. Many Christians think this is part of “The Mark of the Beast”, 2. They want to have records of peoples illnesses so they can blackmail people, and inter dissidents who they want to label as, “mentally ill”, you folks, for example, would be mentally ill according to the old soviet system for “proletarian delusions in opposition to scientific socialism”.
It depends on who you consider "they."
If "they" refers to the government, then I agree absolutely. If "they" is private enterprise, I disagree. In a free market, you have the choice to support or ostracise an organization with your dollars.
I would like for you to consider:
1. Big corporations are not democratically elected and the "Shareholders" often do not exercise as much control as one would think. 2. Big corporations are not individual citizens and the do not have God given unalienable rights the same way as individual citizens do. 3. Big corporations often have some weird socialistic agenda, and they are in with the Fed, so they print as much money as they like. They can even perhaps lose billions and they don't give a care as long as their Globalist agenda is implemented.
I thought I read somewhere
that they are requiring medicare recipients to be chipped.