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Obama Proposes Digital Health Records
An anonymous reader writes "'President-elect Barack Obama, as part of the effort to revive the economy, has proposed a massive effort to modernize health care by making all health records standardized and electronic.' The plan includes having all conventional records converted to digital within 5 years. Independent studies are fixing this cost somewhere in the range of $75 to $100 Billion, with most of the money going to paying and training technical staff to work on the conversion. Early government estimates are showing 212,000 jobs could be created by this plan."
Good point, but the other question to ask would be who saves the money?
Having these records would make it easier to switch providers. Without them, more tests might need to be done since "we don't have the records". Switching providers isn't in the providers' interest. Charging for lots of tests is.
Having health records as a standard brings more transparency to the Health care industry, start with that and then soon people will want them standardized invoicing and billing etc. Obfustication seems to be a popular method to profit.
"Enjoy what you're doing! If it becomes drudgery, you're doing it wrong!" - Jim Butterfield
$100billion? There are millions of patient records, but they do not reside in millions of databases. Let's be generous and say there are thousands of databases. But most of those databases are already manned by DBAs. Some of them may not be up to the task, but most can convert their tables to the specified format if you tell them what that is.
So it seems the task is coming up with a standard format and enforcing it. Security is another question, but again it seems a matter of mandating healthcare providers adhere to a specified standard. But hospitals and insurance companies are quite used to such bureaucracy, so it's difficult to understand where they're pulling this $100billion figure from.
Saying they'd need to hire an entire new class of DBAs and techs to make it happen is silly, since they already exist.
Odds are the figure was thrown against the wall by companies hoping to win a fat contract, and counting on the knowledge that politicians have no sense of what it takes to get the job done. I hope Obama's CIO has the knowledge and grit to tell them to take a hike.
Do what you can, with what you have, where you are.
"why isn't the health care industry already doing it"
... While it will create jobs, it will also wipe out existing jobs. Political drones just want it to sound like its creating jobs. Plus even if its adding more jobs overall, then surely its going to end up costing more money in total to keep funding the system?
Because it'll cost a fortune, and be a nightmare to implement. (Look at the mess the UK is making of their health computer system, with loads of interest groups, all pulling in different directions, pushing up the costs).
"Early government estimates are showing 212,000 jobs could be created by this plan."
Yeah, and how many paper pushers etc.., will it put out of work?
There are 10 kinds of people in the world... those who understand binary and those who don't.
Having these records would make it easier to switch providers. Without them, more tests might need to be done since "we don't have the records". Switching providers isn't in the providers' interest. Charging for lots of tests is.
There is that possibility, but I'd be more inclined to believe inertia in record keeping is more to blame for them having different formats.
You know that all providers are going to need to pay out cash to get new software that obeys the rules and there will also have to be a data migration effort. And you also know who that cost will be passed on to. Hint: not the providers.
The question is: is it worth having health care customers pay for this? Will the investment be worth it? I think it might be, if it does help with the need to dispense with tests, retests, and other administrivia.
In case most of you had forgotten, Obama is basically copying John McCain who specifically mentioned doing this in the debates. Of course at the time McCain did it Slashdot thought it was an evil intrusion of privacy. But now that Obama wants to do the exact same thing it's an enlightened 21st century idea that only some Luddite old guy like McCain could ever oppose.
AntiFA: An abbreviation for Anti First Amendment.
Maybe the open source community should get off their butts and help to create client software and server software that will implement this standard, and provide it free to the medical community thus lowering the cost of entry into standardized medical records and systems.
This could be the best achievement of open source collaboration, and usher in a new era of open source projects that benefit mankind at the very basic level of existence.
Interoperability is where the government steps in, for better or worse -- only the most ideological libertarian would deny that such a role exists.
I'm not a libertarian and I've never denied that Government has some roles. I'm just really skeptical about UHC. Here are just some of my concerns (off the top my head):
1) What evidence do we have that it will actually make health care more affordable? When has Government ever been able to do anything cheaply or efficiently?
2) Will Government in health care be used as yet another excuse to expand the nanny state? Will alcohol be taxed higher because it's bad for me? McDonalds? Doritos? Will all of this enforced by my employer similar to the way the so-called War on Drugs is enforced? Stop smoking or lose your job? Lose weight or lose your job?
3) What reason do we have to believe that our new Government overlords will be anymore benevolent than our existing insurance company overlords? I don't see how arguing with a Government bureaucrat over treatment is any preferable to arguing with a private sector bureaucrat. Who would you rather deal with: DMV or your auto-insurance company?
4) Will there be a way for me to opt-out if I don't see the benefits in having my health record instantly accessible from anywhere in the United States?
5) Will Government involvement in health care be used as an excuse to further erode the doctor-patient privilege? Go read the laws around credit reporting sometime -- the Government wrote in nice little exceptions for itself for all of the privacy laws related to credit reports. Will it do the same thing for medical records?
Just are just off the top of my head. I'd have to say that #2 is probably my biggest concern. I'm sick of the nanny state and the war on vice. And I see no signs that it's going to get any better. In fact I see the exact opposite......
I want peace on earth and goodwill toward man.
We are the United States Government! We don't do that sort of thing.
A standard isn't software; it's how to exchange information. That includes data formats, but also includes protocols and an awful lot of context. The standards work is a big job, and people have been working on it for years (see HL7). As eln points out below, it's boring as hell, but that doesn't make it unimportant. The industry has been in the process of moving from HL7 v.2 to v.3 for about a decade now.
If you want to get into the software part of the solution, have a look at the OHF Project. There are others, but that's a starting place.
I agree with tnk on the benign reason; the system as a whole will save money, but which individual players will save how much? Hospitals already spend very little on IT compared with other businesses, so spending a big whack that may end saving money for some insurance company isn't going to happen.
You want one big reason for doing this? If it can free up nurses from doing secretarial work chasing down documents in the mail and phoning around, it just might keep enough staff at the hospitals to serve the public. The U.S. department of health and human services prepared this report on the subject. It's worth reading.