On Tue, Oct 16, 2012 at 9:20 AM, Hugh Smith <[log in to unmask]> wrote:
> I just came back from our Family Doctors and they have spent months trying
> to go digital and now that they have the records on line they say it is
> triple the cost of their old system. They also said the delays and the
> issues with records not being available has made them continue their old
> record keeping in order to be able to continue to see patients.
There is NO QUESTION there are concerns deploying electronic medical record
technologies, especially if a physicians records are in disarray to begin
with, and depending on how long they have been treating some patients,
there may regularly be a need to maintain newer records in electronic
forms, and refer to older records kept in paper form, because it simply
doesn't make sense to back file convert records that are seldom referred
to. Even in a complete paper paradigm,. physicians regularly send
infrequently accessed records to offsite providers... or worse. They have
done this for DECADES.
> Since they still have liability even if they are totally Obamacare
> compliant, they must maintain duel systems.
>
Now, here is where we break ranks. The requirement to do this isn't
"Obama-Anything"..."care" or otherwise. While he isn't perfect, similar to
most other Presidents, to continually vilify him for attempting to work to
provide healthcare to those whose employers don't provide it or can't
afford it and reduce medical care here to something along the lines of what
exists in 3rd World Countries makes no sense (soap box moved back under
table again)
It's a provision of the HITECH Act
http://en.wikipedia.org/wiki/HITECH_Act and that WAS a piece of
legislation that came out of the ARRA
http://en.wikipedia.org/wiki/American_Recovery_and_Reinvestment_Act_of_2009which
was signed into law by President Obama, BUT if you scan down to the
section on "Healthcare" in the ARRA you'll find the following as to who
approved what:
Health care
Senate — $21 billion to subsidize the cost of continuing health care
insurance for the involuntarily unemployed under the COBRA program; $87
billion to help states with Medicaid; $22 billion to modernize health
information technology systems; and $10 billion for health research and
construction of National Institutes of Health facilities.
House — $40 billion to subsidize the cost of continuing health care
insurance for the involuntarily unemployed under the COBRA program or
provide health care through Medicaid; $87 billion to help states with
Medicaid; $20 billion to modernize health information technology systems;
$4 billion for preventative care; $1.5 billion for community health
centers; $420 million to combat avian flu; $335 million for programs that
combat AIDS, sexually transmitted diseases and tuberculosis.
And further down, this shows how the $$ were allocated:
Healthcare
More than 11% of the total bill is allocated to help states with Medicaid
ARRA included the enactment of the Health Information Technology for
Economic and Clinical Health Act, also known as the HITECH Act.
Total health care spending: $155.1 billion
$86.8 billion for Medicaid
$25.8 billion for health information technology investments and
incentive payments
$25.1 billion to provide a 65 percent subsidy of health care insurance
premiums for the unemployed under the COBRA program
$10 billion for health research and construction of National Institutes
of Health facilities
$2 billion for Community Health Centers
$1.3 billion for construction of military hospitals (military)
$1.1 billion to study the comparative effectiveness of healthcare
treatments
$1 billion for prevention and wellness
$1 billion for the Veterans Health Administration
$500 million for healthcare services on Indian reservations
$300 million to train healthcare workers in the National Health Service
Corps
$202 million for a temporary moratorium for certain medicare regulations
So, about 20% of the allocation went to HITECH for electronic medical
records. The adoption is to take place in 3 Stages and intended to be
complete by 2015.
As for "penalties or liabilities" for failing to adopt, they are related
specifically to MEDICARE cost recovery and range for 1% to 3% over the
three year window, beginning in 2015. The reason there is a premium placed
on Medicare is that is the most abused part of the Federal healthcare
system in the US. By creating a system requiring electronic billing and
information exchange, the hope is fraud within the system will be reduced
and the pool of money available to those who need Medicare most will go
much further.
> I heard the same thing from my cardiologist.
>
Same is true here... it's Medicare stuff he has to be most concerned with.
> The Cloud is just another Big Data idea to make our money their money.
>
> Last night I watched my ITunes and my iPhone go back and forth eliminating
> some of my photos and 360 songs because of some complication, I thought,
> what if that was something more consequential that a song or a photo of my
> three dogs.
>
Now back on track about the management of information, irrespective of
political alignment... I fully agree with Brother Hugh Smith that the cloud
is "vaporware" intended to separate people from their money AND information
with insufficient controls put in place to ensure your information assets
are properly protected, or that you're getting the most 'bang for the
buck'.
And YES, I don't see the iCloud (for personal data) as being any different
than any other cloud for organizational information assets. There are
insufficient protections in place and a lack of acceptance of liability and
responsibility taken by service providers to be commensurate with the risk
placed on data owned by customers and consumers.
Larry
[log in to unmask]
(none of this was intended to be a political speech, just a clarification
on what HITECH was, where it came from, who approved it, and how the
consequences for failure to implement impact end users)
>
--
*Lawrence J. Medina
Danville, CA
RIM Professional since 1972*
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