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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."
I read the article.
The guy's central point is that corporate systems are bad, and open, federally funded systems are good, with the further implication that government is good, and corporations are bad.
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". You own as much of something that is public as you do a car by walking past a Ford factory. Ownership at its most practical is, who controls it, and you really don't have any control over the daily disposition of property managed by the government. In effect, when you argue for publicly owned health care, or publicly owned anything, what you are really arguing for is to pay your own taxes to buy something for some administrator either elected or appointed or a lifelong civil servant. In any case, its not you.
There's a lot of good reasons to adopt open source in health care. For one, the creation of a single standard document for representing a medical history would go a long way towards enabling applications across the medical spectrum to coexist.
This will be easier said than done.
A good example is that there were some efforts to do this in insuring property for catastrophic losses - a build is remarkably complex for insurance purposes, but that specification has essentially died by its own complexity. The industry largely and thankfully essentially resorted to using SQL Server copies of the leading vendor of property and casualty software for CAT. Is it proprietary? Yes. But, it allows all the insurers to exchange books in a way that is relatively practical and easy to use.
The moral here is that its not good enough to say that a standard is open for data interoperability. Ease of use and ease of transportability becomes paramount and if open source wants to drive health insurance, it stands to reason that there needs to be a pervasive application that goes along with it.
This is my sig.
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.
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.
Linux, you magnificent bastard, I read the fucking manual!
The National Institutes of Health just announced the NIH Challenge Grants that is used for doling out stimulus money to small projects. In it they identified several high-priority topics, which if you look through, you will find includes Information Technology for Processing Health Care Data.
So there certainly is money available for this type of work. And for those not familiar with grant funding by the US government, the NIH is the single largest grant provider for the life science in the US.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
At least down here in Texas, any grant money funded through DSHS as well as HRSA at the federal level have specific sections that state that any system proposed that makes use of the VistA system will receive higher consideration to getting funded above any proprietary solution. Unfortunately the available solutions are still very high risk and many hospitals and other healthcare entities really don't like the look and feel when compared against proprietary browser-based systems.
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.
Sent from your iPad.
I use the proprietary systems and had attempts at open systems (there are always "shoot outs" at the medical conferences) and I can say that the proprietary systems suck much less.
It's all about workflow. The open systems fail to understand this concept.
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?
http://alternatives.rzero.com/
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?
He put his boots up on the table and made a face. "The sig," he smirked. "You can waste your life in search of the sig."
He has the same rant about proprietary applications without interchangeable data formats in the medical field that people have with MS Office. Health Systems are just as bad if not worse than the other closed proprietary systems that people here constantly rail about. It's very likely that you'll have to buy a special program to read the medical information that you get from your doctor. It's a closed silo system that won't get any better based on the new funding.
With some extra cash, maybe the proprietary system vendors could widen that gap. Or at least hire some lobbyists to explain why they'll need more money next year. Failure seems to be our new economic engine.
The cost of that cleanup, of course, will be borne by taxpayers, not industry.
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.
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.
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.