Stimulus Avoids Serious Solutions For Health IT

ivaldes3 writes in to note his post up on Linux Medical News, pointing out the severe shortcomings of the Health IT provisions of the just-passed stimulus bill. "The government has authorized enough money to purchase EMR freedom for the nation. Instead the government appears set to double down on proprietary lock-down. The government currently appears poised to purchase serfdom instead of freedom and performance for patients, practitioners and the nation. An intellectual and financial servitude to proprietary EMR companies for little or no gain. A truly bad bargain."

Comments

Opinionated much?

[religious freak]

A little too opinionated in TFS. What news is this post actually trying to tell us?

Re:Opinionated much?

[Nethead]

What news is this post actually trying to tell us?

They didn't get the money sent to them so they are calling the others bad names and getting all pissy about it.

Re:Opinionated much?

[tverbeek]

This article is a poorly written, useless rant. It contains little information about what pisses the writer off, and even less about what should be done instead. I'd love to read a thoughtful, informative article about the subject, since I've recently started an IT job in the health care field, but this isn't it. Any suggestions?

Why Is Health Care even in the Stimulus

[Anonymous Coward]

On top of all the other crap that certainly won't really stimulat the economy.

Here's the bottom line. The problem with the economic crisis today lies with the financial and banking system. Health care wasn't the reason for the collapse, and fixing health care isn't the core issue here.

Its funny how liberals were complaining that invading Iraq had nothing to do the GWOT. This is the liberals version of 9/11, using the crisis as a pretext to remake the US economy and set their agenda.

Re:Why Is Health Care even in the Stimulus

[Captain Splendid]

This is the liberals version of 9/11, using the crisis as a pretext to remake the US economy and set their agenda.

It's tempting to think that, but the truth is McCain would've done pretty much the same thing. Except he would have cried more.

Re:Why Is Health Care even in the Stimulus

[Em Emalb]

This also goes to show that Republicans aren't really the party of small business.

Neither party is the party of small business. They're the party of the party, for the party, by the party.

It's not a democrats versus republican thing, it's an US versus Politicians thing.

Re:Why Is Health Care even in the Stimulus

[cgenman]

Our economy is broken in more ways than just the financial system. Our Car companies have been mismanaged for years, our healthcare system is derided worldwide for being incredibly expensive and backwater, our education system is a joke.

What we need to get out of any economic downturn is higher per-capita productivity. Health Care has been a big drain on our economy for years, and a distributed automated health records system is long overdue. My Mechanic has better records of the work done on my car than My Doctor. I've seen doctors prescribe to my grandmother treatments that had serious interactions with drugs she was already taking, and treatments that she was simply allergic to.

We need growth and efficiencies, and this is one area where a little expenditure would save a lot of lives. And I hate to sound this crass, but saving lives cheaply is good for the economy.

Re:Why Is Health Care even in the Stimulus

[DragonWriter]

The problem with the economic crisis today lies with the financial and banking system.

No, the problem lies with the lack of availability of credit and the lack of consumer demand. The primary direct cause of that may have been actions in and affecting the financial services industry including the banks, but that doesn't mean that the most effective way of dealing with it is exclusively with policies directed at that industry, in the same way that bad diet and inadequate exercise may be the principal cause of a heart attack, but the best response to a heart attack may not be limited to diet and exercise changes.

Its funny how liberals were complaining that invading Iraq had nothing to do the GWOT.

Liberals, in fact, were not generally complaining about that. Liberals were complaining that Iraq (not "invading Iraq") had nothing to do with 9/11 (not "the war on terror") and that invading Iraq was directly counterproductive in (not "had nothing to do with") the war against the people who had actually attacked the United States on 9/11, and that contributed to producing more people who would be more easily recruitable by groups wanting to attack the United States through terrorism.

The first half relates to the justification, the second to utility. Confusing different parts of two distinct-though-related criticisms of the invasion of Iraq misses the point of both criticisms rather completely.

This is the liberals version of 9/11, using the crisis as a pretext to remake the US economy and set their agenda.

That doesn't make sense. The economy is broken. Liberals are proposing a particular way of fixing it that, they argue, apply both to the immediate problem and the longer-term structural problems that make problems like the immediate one both more likely to occur and more damaging to individual citizens when they occur. As you note, what they are doing is directed at the economy, which is where you admit the problem is, not at some unrelated thing. Now, you might argue that the proposals are not directed well to fix the problems in the economy, which would be a legitimate point to debate, but you fail to make that argument, instead making an argument by analogy (though, as noted, a poorly-crafted analogy that reveals poor understanding both of the immediate situation and the one to which an analogy is drawn) that seems to rely on the idea that it is not directed at principal immediate cause of the problem, rather than arguing that it is ineffective at solving the problem. But being effective at addressing a set of undesirable conditions is logically orthogonal to being directed at the events and conditions which contributed to the development of those conditions.

Healthcare is full of closed apps

[joeflies]

Healthcare is dominated by application vendors who each make their own megaplatform for healthcare records. Cerner, Meditech, Siemens, et al. are all trying to keep as much of their system closed as possible, and aren't particularly interested in opening it up to third party systems. They don't particularly want open interfaces, their goal is to keep their customer locked in as much as possible.

So the healthcare IT companies get what they want, i.e. a bigger push for electronic records, selling the software they already have.

The stimulas package isn't going to add an open spec for EMR because nobody in the healthcare industry is bringing it up that they want one.

Re:Criticisms and a Better plan

[Nethead]

I think it was Heinlein that said something like: You only truly own that which you can carry in both arms at a dead run.

Re:Criticisms and a Better plan

[be0wulfe]

You're only half right. The problem is that HIT vendors are generally well behind the times, slow to innovate and closed and proprietary as all get out. You think MS is bad? You haven't seen highyway robbery until you've seen the shit in a box most HIT vendors push. The technical implementation is lacking and the SOLE focus, the SOLE focus of every sale is simply to further ensare the particular customer still deeper into more from the same proprietary stack. Integration is a joke, made challenging by intention rather than accident.

This is a HIGHLY lucrative market. Any given vendor has ZERO interest in open systems and will push to make sure you buy their entire stack.

Thankfully, there are exceptions to the rule and there are many CIOs and CEOs that are wising up to their antics.

This stimulus plan, unfortunately, only makes things WORSE backing proprietary vendors and closed systems over open standards - real standards, not the recommendations AKA HL7.

Thomas Jefferson disagrees with you

[jeko]

Now, the reason, though, that he gives for this is that a private corporation owns his data in the present system, but if the government owned, then, somehow, he'd own it more.

That's the crazy thing. There's no such thing as "public ownership".

I visited Washington DC a while back. I stood on the Mall. I stood on the Lincoln Memorial. I own a piece of it. So do you. I ran my fingers down the names on the black Wall, and I knew that my family had bought a piece of it at the cost of blood. I looked up at the top of that giant obelisk and knew that Washington had given me a piece of it. I walked through Arlington. I for damn sure own a piece of that.

Yes, if the government owns it, you absolutely own it more. You own it more because there's a huge difference between being a citizen and being a customer. I own it more because generations of my kin have stood in uniform and fought and bled for it.

If there's truly no such thing as "public ownership," then why is my family pulling on uniforms and strapping on guns to fight for it?

Re:Thomas Jefferson disagrees with you

[HornWumpus]

You don't own any of it.

If you own something then you can sell it.

Try and sell 'your share' of the Washington memorial.

You family protected the nation. The nation government used to mind its own business (courts, national defense, some infrastructure...nothing else) and mostly leave us alone.

You can say you have a stake in the commons, but that is nothing like ownership.

With businesses you can choose which company you deal with. Government pretty much always grants itself a monopoly.

Re:Thomas Jefferson disagrees with you

[vyrus128]

If you own something then you can sell it.

This right here, ladies and gentlemen. This is the cancer that's killing /b/^H^H^H America.

Re:Please, get the government OUT of healthcare

[Dr_Barnowl]

Isn't it the other way round? Don't Americans by the thousand drive across the border to get their drugs from Canadian pharmacies?

The bureaucracy of the American system is much, much higher than that of the UK NHS (which is no model of streamlined elegance). Just looking at the messaging protocols for the IT systems will tell you that. We don't have to implement half the messages because they relate to billing.

On top of that, the US system is treated as a for-profit endeavour. I'm told that a 15% profit margin is considered to be at the low end.

In the UK we spend only 40% per head what the US does, yet we have universal coverage, flat-rate prescription costs, and no co-pay. Access to treament is based on what is cost effective within the NHS budget, not which loophole your policy manager can use to yank the rug out from under you.

I'd much rather be ill here in the UK, especially if I was poor, than in the USA.

Re:Please, get the government OUT of healthcare

[smoker2]

One question: Where would you like to be if you were a 60+ year old that needed a kidney transplant?

Rich, anywhere. If you are not rich then the UK is better than the US.