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Dell Takes Health Care Online
abb_road writes "Dell will announce today that it will begin offering employees an online system to track health care; the system, which will focus on insurance claims, doctor visits and prescriptions, is expected to improve employees' medical safety while reducing costs. The electronic records are expected to dramatically improve preventative care; employees will receive ongoing alerts for suggested and continuing treatment of health conditions. The system should also improve coordination among health care providers, especially when patients need to see multiple physicians. Other employers are expected to follow Dell's lead; the government 'has estimated that health IT can add $140 billion a year to the productivity of the $2 trillion health care industry.'"
This is nothing new, my health insurance has an online system and so do many others.
Clippy pops up in the corner...
`It looks like you have cancer. Would you like to book a session of radiotherapy?'
Join the NFSNET. Our prime goal is making little numbers out of big ones. http://www.nfsnet.org/
I'm always skeptical of blanket prescriptions for health care, or for what IT can and cannot do in the macroeconomic sense to solve a problem. For example, "the government 'has estimated that health IT can add $140 billion a year to the productivity of the $2 trillion health care industry.'" Is that indeed added to the 'productivity' of the industry, or is that added to the cost? The Dell implementation looks innovative (to a degree) and hopefully for them (and their employeees) will show a benefit; but I can already hear the chorus of those who have fought against real reform in the healthcare industry saying that the best solution is throw more IT at the problem. IT has never really worked any better than the proverbial money we used to throw.
I'd be astonished if the employees ultimately benefit from these automated systems. The only thing that they'd get would be online access to their health records. The employers will say the employees benefit from getting health care in the first place. However, I'm a bit skeptical in this age of cost cutting that these tools won't be used to lump "problem" employees that use lots of coverage and force them into programs that would help the company save a bit of money. Is that legal? And how would the company get the information about the employee interactions with health providers - the insurance company, I'm guessing? It'd be an nightmare to get every doctor and pharmacy to plug into the system.
Everyone is generally dissatisfied with healthcare in the US, and there lots of people who believe that the accountability that computerized records can enforce could really change things. Now the customers of healthcare (employers) have balloning costs and very little to show that the healthcare they are purchasing is actually effective.
An obvious question is why proprietary medical software vendors have not addressed this issue already. Part of the reason is that there is no "Microsoft" in the industry. There is no proprietary player large enough to wrangle major IT changes for all of healthcare. This creates an opportunity for open source EMRs (The AMIA open source working group has an Review of Open Source EMRs btw) After all, how would Red Hat fare if there were no Microsoft. This is the opportunity for projects like MirrorMed to grow to be a dominate force.
Fred Trotter
I would call your atitude "prudent". Here, if no where else, people shoul0d be a wee bit suspect of having their most personal and sensitive information available via the web.
Avaialble to...whom exactly? -is the question
- Minutus cantorum, minutus balorum, minutus carborata descendum pantorum.
From TFA:
So let me get this straight - this incredible new initiative is actually a lightly-used website, run by WebMD, that Dell employees have had for the past two years. And the newness is that the system can now "electronically" capture results. And Dell trumpets this in a major news release.
We will set aside the interesting question of how (and whether) WebMD has convinced thousands of independent labs, as well as laboratory giants like LabCorp, to send results to WebMD. We will ignore the HIPAA regulations that will require patients to sign releases with anyone sending results to WebMD. We will overlook the balkanized, backward, and poorly-penetrated electronic medical records world in which these patients' doctors work.
Even if all of these things were somehow not an issue, does anybody except Dell and WebMD marketing droids really believe that the only thing that was preventing this dramatic breakthrough from revolutionizing medical care for everybody was the lack of a stupid HL-7 interface?
Oh, wait. Never mind. Check the last part of the article:
Yup. Sure. Got it. Tinfoil hats meet blue-sky dreamers, and the result is ugly.
If my health insurance provider wanted to provide a one-stop shop website where I could track that, that'd be good.
It (theoretically) would provide me all the info I need and provide a gateway back to the company about what health information they could get on me.
Putting the company in-the-loop for this is just a bad idea in terms of privacy. (Although I've been in companies where you had to paper file the insurance claims for doctor's visits through the HR department... though I don't know if that was required or just provided as a convenience)
HIPAA privacy regulations (there's a lot more to HIPAA than just privacy) don't for one second prevent you from consenting to the disclosure of your health care information to anybody you choose. It's not a "need to know" thing, it's a consent thing. Your consent to certain kinds of transfers (billing from your doctor to the insurance company) is obtained in writing, while your consent to others (your doctor talking to another treating physician) is implied. Your employer is completely free to solicit your consent to keep information about you, and if they offer enough compensation (read: reduced medical premiums), a lot of people will consider it.
If you consent to giving your employer all or part of your entire medical record, and if your employer has the means and the desire to obtain it, there's no HIPAA protection at all.
Which doesn't mean that this is what Dell is doing here. In fact, this has nothing to do with what Dell is doing. Dell's press release is just an attempt to dress up a fairly prosaic web service as a "breakthrough" in medical IT, and in so doing inflate the visibility of a fairly minor federal bureaucrat.
If someone else is paying for my healthcare, why should I care what it costs?
For example, when my grandmother was dying of cancer, Medicare and her supplemental picked up 95+% of the tab. Her doctor sent her to a nutritionist at first, as a way of acknowledging the mountain of research that proves nutrition is an important part of health. Grandma later said, "she wanted me to eat 5 servings of vegetables a day. She's CRAZY!" The doctor never mentioned nutrition again, and stuck to the high-tech/high-cost treatments he'd been trained in. She died after six months, after having spent $50k+ of other people's money.
A year ago I started seeing a Doctor of Osteopathy in the Cranial Field for some Osteopathic Manipulation. He works from a home-office, has an answering machine for an assistant, answers all his own messages, and basically does everything himself. He gives me a receipt that I can submit myself for insurance reimbursment, if I so desire. He doesn't accept insurance because a) he'd need an employee to handle the billing b) his practice is full regardless c) many insurances are likely to disallow his kind of therapy, or pay him pennies on the dollar.
In January I decided to see a homeopathic M.D. to see if there was something I could do about my cold hands. After taking an extensive history, he decided that my autonomic nervous system was probably out of balance, and injected me with novocain (same as what dentists use to numb the mouth) in a couple locations. He also gave me a couple of homeopathic remedies, and some fish oil/vitamin E at the next visit. I'm out $400 or $500 for his services, and am totally pleased with the results. He doesn't bill insurance either, also because it's not worth his time.
If I'd gone the conventional route, my insurance would've had to spend $2000 or $5000 on diagnostic tests (an MRI goes for $1000, and CAT scans aren't cheap either), $20,000 on hand surgery/whatever, and I still would've had the problem. As it is, I've spent approx $5,000 with the D.O., and I'm totally satisfied because the treatment program works.
Health Insurance should be carried for accidents, because you never know when you might have a $40,000 medical bill (like me, 8 years ago: a helicopter flight, a plane flight, a cat scan or two, 10 days in the hospital, etc...). But we should all pay our way, for the costs associated with living.
Modern Medicine has evolved with almost univeral insurance coverage, so our doctors have the mindset of "if cost were no object, what would I do?" (this is not a concious thing, but a mindset that gets passed from generation to generation of medical professionals) Which explains why there are so many $60,000 heart bypass surgeries being done, even though some researchers say that bypass surgery belongs in the medical archives, because it is almost universally incompatible with the patient's long-term outcome. I clipped a story from the paper a few weeks back about a guy who died in his 50's, 3 weeks after having a bypass operation. Re-plumbing the heart while ignoring the rest of the vascular system seems like a foolish way to go about attaining health. But it makes the heart surgeon wealthy, so why should he do anything else?
See also:
100 years of Medical Robery
Real Medical Freedom
Learn the rules so you know how to break them properly.
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