National electronic health records

[backtoblue]

NEW YORK (CNNMoney) -- The ambitious goal of setting up a nationwide, interconnected, private and secure electronic health records system isn't yet a reality -- but we're getting closer.

The 2009 Recovery Act, better known as the stimulus bill, set aside more than $20 billion for incentives to health care providers that deploy and meaningfully use certified electronic health records systems in their offices or hospitals. The first incentives are set to go out in the form of $22,000 Medicaid payments to early adopters within the next six months.

snip

The problem with the current system is clear: Paper trails get lost, incorrect prescriptions get written, and doctors' time is wasted listening to patients explain their medical histories.

http://money.cnn.com/2011/11/18/technology/electronic_health_records/index.htm?source=cnn_bin



How about setting aside some of that $20 billion for actual treatment of patients?

On Edit: seems that the first incentives are going to be coming out of Medicaid... WTF???

[Avalux]

1. This isn't about taking care of patients. It's about saving time and money on the provider end. n/t

[backtoblue]

2. yep. and am I reading right that

payments are coming out of Medicaid to those who comply with this?

[Avalux]

6. Yep. That's correct. n/t

[Nuclear Unicorn]

3. Wait until your next GOP president and/or congress

And they get to run a query on who has had or provided an abortion.

[backtoblue]

5. I am thinking the same thing

Medical records that are readily available could be used against a woman criminally for having an abortion if certain legislations. nt

[Scuba]

15. Locally, such systems accomplish exactly that (or try to). Please see my post #12.

[lovuian]

4. I would suggest be careful what you say on your

medical histories

[Scuba]

16. Please see my post #12.

[nc4bo]

7. All the ambition in the world is not going to help one bit when some employee leaves their laptop

in their car to be stolen. Or drops a thumb drive in a parking lot. Or a hacker creates chaos just for shits and giggles or worse. Or some health insurance company or employer finds a way to access or get access to this information.

I love the idea but do I trust this private, personal information will be safe and confidential? Hell no.

[backtoblue]

8. the insurance companies

getting the info scares me, too. Too much as stake and really not that much to gain.

[nc4bo]

10. And it should be a major concern to every one!

We're being asked to trust without question. No - because everything has a way of being abused and misused. Who'd have thought that a negative credit report would bar you from employment?

Damn, our own MIC can't even keep out foreign hackers.

[backtoblue]

11. Yes it should be.

There are so many things wrong with this "stimulus" technology and I don't think many people realize just how harmful this can be to us. From insurance companies to biasness based on previous medical care to the very defiance of Hippa laws.

And, not to mention the incentives given to medical providers for using it are coming out of MEDICAID!

[Scuba]

13. They already have it. See my post #12.

[Ohio Joe]

27. So what is your solution?

Keep everything on paper?

[nc4bo]

30. If you can't guarantee security than what's the point of putting people

at risk to have their personal, confidential information, accidentally or intentionally, fall into the wrong hands? Convenience? To save a few bucks?

That is not the patient's problem and it won't be the patient's fault when their lives are turned upside down but I'm sure will be the patient's responsibility to clean-up the mess. That's not right.

I'm not an IT security specialist and humans will always make mistakes.

Like I said, I love the idea. My elderly mother has several doctors and specialists who could benefit from having all of her records available to them but I also don't want her being concerned that her personal information doesn't fall into the wrong hands or be misused.

[Ohio Joe]

31. Again... What is your solution?

Do you think putting the information on paper somehow makes it more secure? Guess what... It does not. You think putting it on paper only costs a few bucks more? It does not, it costs a crap load more. Filling out all that paper, filing all that paper, storing all that paper, trying to retrieve information from all that paper... Getting all that paper, the cost right there to the environment and the "customer" would be monstrous. Going backwards in technological use simply makes no sense.

No data, regardless of how it is kept, will ever be 100% secure, we all have to accept that as a given. Information can and will be stolen, lost, damaged, whatever... Shit is going to happen. The main reason data seems so vulnerable today is the same reason for so many of our other problems. The 1% are greedy mother fuckers that will do anything to make one more dollar.

They hire people who really do not know what they are doing to save on salary, they do not invest what they should into computer security to make sure they are as safe as can be, they have employees take data home instead of investing in data storage for disaster recovery.... And on and on and on.

The financial bottom line is why data is not as safe as it should be, not because of the media it is stored on.

[nc4bo]

33. In case it was lost..................

it's a good idea (x2) I don't know the solution, I'm not an IT security specialist (x2). I do know that it's less likely that a hacker(s) will walk into a doctor or hospital's record dept. and steal a truck full of records. If such a thing were to occur, it certainly won't be on the same scale that a huge honey pot like a national records system would be. Then who would be responsible for cleaning up that mess? The patient? The family? Everyone gets a nice security breach letter along with a sincere apology?

Like I said before, if the Pentagon with its huge budget and on-board staff of geniuses can't prevent a security breach or a bank or credit card company can't manage to keep its customer's records safe, why should any one trust that this information would be treated any differently?

Yes, it all has do with security, staff, equipment, knowledge, etc. - who is going to protect our information and how will they be held accountable when something goes wrong? The government? A corporation?

So forgive me for not having much confidence.

[moondust]

9. "Private and secure"?

:rofl:

Are insurance companies hiring hackers yet?

[Maine_Nurse]

14. I don't think they need hackers, I think they will have some access to these records.

[Scuba]

17. They already do. Please see my post #12.

[moondust]

20. And if the insurance companies don't

have sufficient access themselves they can probably find or plant a clerk or somebody else who does have access and is willing to supplement their crummy salary by looking up patients all across the country and passing the info along to the insurance company.

Hackers or employees--either way thousands of additional people will have access to everyone's records in such a system, with the possible exception of the 1% who will naturally try to find a way to buy their way out of the public system. And in a system that big I doubt that "unnecessary access" can be effectively policed.

[Scuba]

22. They already have everything. Please see my post #12.

[Scuba]

12. This isn't really about improving patient care, although one can cite examples...

... where a nationwide system would provide a benefit. For example, patients who receive care in different geographic areas - or even different providers in the same city - have multiple, unconnected medical records. This means the doctor on the scene doesn't have all the information he/she needs to correctly diagnose and prescribe treatment.

But in the grand scheme of things, it is less of a problem than many other issues effecting patient care in this country. It's certainly not going to be worth the money poured into it.

Trying to get the many disparate IT systems (Epic, Cerner, Eclipsys, Siemens, GE, Meditech, etc.) to share information with each other isn't just expensive. It's virtually impossible. Several of these systems cannot even share patient information between their own different modules. All are based on proprietary data structures that they don't share.

Most likely, this is a plan to get a whole bunch of taxpayer dollars in the pockets of the corporate owners of these systems (Exception: Epic is privately owned.) and the consultants, lawyers, etc. who will achieve little or nothing.


If exposing your health data is a concern, pay cash. Right now, all your diagnoses, surgical procedures, medications, etc. are passed along to your insurance company for reimbursement purposes. Even Medicare and Medicaid. Yep, the government has "outsourced" the processing of these claims to Blue Cross and others. Think they don't share such information with your employer? Then you trust insurance companies more than I.

That's just one more reason why employer-based, for profit insurance is a disaster.

I could write books on this topic.

[backtoblue]

18. thank you for this

Insurance companies are a fraud in so many ways. They are one of the main reasons we don't have universal healthcare and why so many people are denied medical treatment.

If you don't have insurance and you don't have cash - you end up paying more than what the insurance companies would have. I'm not very educated on the details of it all, but we no longer have the right to privacy and , as you have stated it seems we haven't for a while. nt

[Scuba]

21. You are correct that self-pay patients often pay more than insurance companies...

... which regularly negotiate fees lower than those paid by Medicare and Medicaid. When a corporation can threaten a hospital with taking a substantial part of their business away by saying "not in network", hospitals cave. As their margins are squeezed lower and lower, they look to make it up somewhere. Private pay is what's left.


The for-profit health insurance industry is the only reason we don't have Medicare for All. Giving a cut of our precious health care dollars to corporate investors in London, Tokyo and Hong Kong isn't just bad policy. It's immoral.

[moondust]

23. The problem isn't so much patients who are already covered.

I think the problem is using detailed private health information to screen prospective insurance customers and to jack up premiums based on every little medical issue a person has ever had. Another candidate for abuse is prospective employers getting hold of medical information either first hand or through insurance companies and using it to screen applicants based on their health history and likely future health profile (sick days, doctor bills, etc.)

[Scuba]

24. Both of those are problems. More good reasons to advocate for Medicare for All. n/t

[benld74]

19. Founder of Netscape attempted this back in the early 90's, we see how well that went

[lbrtbell]

25. That's a horrible idea

I've been to doctors who nearly killed me, thanks to wrong diagnoses. The only way I've survived was to start fresh with a new doctor who didn't see what previous doctors have written about me.

People with hard-to-diagnose ailments (chronic fatigue, fibromyalgia, etc.) are often slandered by doctors who portray them as mentally unstable, feigning illness, etc. It's happened to me, and forums abound with similarly nightmarish stories. The last thing patients like us need is for some idiot doctor's insanity to follow us around like a criminal record.

[GoCubsGo]

26. Actually, it works both ways.

I can't tell you how many people I know have told me that their elderly parents are having severe medical issues, and visiting four or five different doctors, each treating a different problem. Their problems are being exacerbated by the fact that none of their doctors knows which drugs the other is prescribing. Some of them are taking a dozen different drugs, some of which, it turns out, are incompatible. Some of them are lucky those drug interactions didn't kill them. Digital medical records allow one doctor to see what the others are prescribing. It also allows them to see the results of tests given by other physicians. They can see the results of the CAT scan or the MRI that another doctor did a few weeks ago, rather than subjecting the patient to another one, as well as not making them/Medicare/their insurance company pay for another.

[Scuba]

29. This is the real problem that could, theoretically, be addressed by a single, national system....

... please see my post #12 for more.

[Lorien]

28. Yep. It's also a nightmare for independant doctors. My GP is having to

spend a huge amount of time and money on training and programs for the new system, which is hardly ready for prime time. She would rather be treating patients.

[taught_me_patience]

32. I completely support EHR

It's a nice stimiulus that's creating jobs. It's also better for the patient and the doctors that treat them. My wife is an independent GP and we're installing a system in her office... it's neither expensive, nor difficult... but the benefits are tremendous.