Feds To Help Train 50,000 Health IT Workers

Lucas123 writes "The US Department of Health and Human Services is spending about $144 million on grant programs at more than 80 colleges and universities to help fill a void of about 50,000 workers for IT jobs in the healthcare industry. The workers are needed to help hospitals, physician practices and other healthcare entities to roll out electronic medical records, which the government is promoting through the use of reimbursement funds for those who implement EMRs and penalties for those who don't. The Health IT courses are set to begin this fall in five regions around the US and are aimed exclusively at workers who have previous IT or healthcare experience."

Comments

yeah, sure is a lack of unemployed IT types

[FuckingNickName]

How often must the government / industry claim there is a lack of qualified workers in some field before people just laugh and wonder who wants to bring down whose salary?

How about giving them loans for training which are paid back as part of their salary once they've secured a job?

Re:yeah, sure is a lack of unemployed IT types

[bsDaemon]

Wouldn't bringing down salaries for IT workers in the health care industry reduce health care costs? Isn't that basically what the whole debate was about with regards to health care "reform" was about for the last 2 years? They need more IT people to support moving everything to computers, but that means they can pay them less at the same time, as there's a larger supply than demand at that point. Makes sense to me, even if it sucks. But not my industry, so meh.

Re:yeah, sure is a lack of unemployed IT types

[Anonymous Coward]

Bringing down health workers' salaries would make health care cheaper, bringing down oil executives' salaries would make gasoline cheaper, bringing down factory workers' pay would make manufactured goods cheaper, and so on.

Everybody needs to eat. Skilled workers also need to pay for their training, and those who devote extra years to studying where they could be earning pay on that time only do so under the promise of a better living. If you don't pay people what they're worth, then of course you are going to end up with a shortage of willing workers - that is exactly the problem we face now. Nobody is going to go through university to live in a studio apartment and take the bus to work.

Re:yeah, sure is a lack of unemployed IT types

[beakerMeep]

Do you have any concept of IT worker salary? This wasn't what the health care debate was about. Your average IT grunt making 50-100k was not the cause of ballooning health care costs. Really there is nothing wrong with the government putting grants towards creating industry efficiencies. EMRs are sorely needed and some seed money to start training programs is not a half bad way to help nudge the industry (and doctors) towards EMRs.

Re:yeah, sure is a lack of unemployed IT types

[Anonymous Coward]

Grunts don't make 50-100k. Hell, I've known managers who don't make that. The only people I've personally known were either important to the company or taking on bigger responsibilities than you are aware of.

The people who handle your servers/routers or run cables are not grunts, the reason they make 50-100k is because maintaining your system services requires major skill and dedication while cabling is tiresome and dangerous work akin to electrical wiring. These are big jobs and if you're offering $35k a year then you have absolutely nobody to blame but yourself if the only applicants are incompetent and dishonest.

Re:yeah, sure is a lack of unemployed IT types

[xmorg]

The market is already flooded with IT. My old boss said when he posted for the job, he got HUNDREDS of resumes, here in solCal. They are just doing this as an excuse to give money to the schools. They don't really care if we have jobs or not. But the schools are colleges are a HUGE lobbyist.

Re:yeah, sure is a lack of unemployed IT types

[Profane MuthaFucka]

Isn't it hilarious that all the people who talk the most about the free market, and the efficient market, and the beauty of the market are the same people who think the market FUCKED UP when it decided that programmers are expensive?

Re:yeah, sure is a lack of unemployed IT types

[Senes]

That's just it. If you don't pay people what they're worth, you don't get them. Instead you get their cheap alternative. You don't want to pay full price for a product? You buy the cheap alternative. But then you notice it's not the same, but you can't blame anyone but yourself because you were the one who chose not to pay for the real thing. You don't think cable TV is worth the price the company charges? Then you don't get it, simple as that. What we have here is spoiled corporate brats who don't want to pay what something costs but then whine when they don't have it.

Re:yeah, sure is a lack of unemployed IT types

[Attila Dimedici]

Why are electronic medical records so sorely needed? So that hackers can access my medical records?

Re:yeah, sure is a lack of unemployed IT types

[pkbarbiedoll]

Case in point.. my job is being replaced by indian programmers.. and I work in healthcare/IT.

I want to be motivated and excited about the news in this article, but I'm not. Sucks when you are in said field and you can't compete with cheaper indian labor.

Re:yeah, sure is a lack of unemployed IT types

[Ex-MislTech]

This is why I refuse to work full time anymore.

My motto as it is for a lot of other ppl tired of Welfare state is ....

"Starve the Beast"

As Ron Paul said, if you subsidize something you get more of it.

We need Co-op healthcare like the way USAA does Insurance, not for profit,
and no government bloated bureaucracy running it like the VA.

As a former veteran I can tell you the VA is often substandard.

The MSM even covered stories of returning injured not getting the care they needed.

Re:yeah, sure is a lack of unemployed IT types

[darkpixel2k]

How often must the government / industry claim there is a lack of qualified workers in some field before people just laugh and wonder who wants to bring down whose salary?

How about giving them loans for training which are paid back as part of their salary once they've secured a job?

Maybe their premise is wrong. There doesn't appear to be a lack of qualified IT workers. (My boss is searching for a go-out-and-replace-this-motherboard technician, and a majority of the applicants are 'big players'--like former Oracle DB developers). I think the correct question is "Why aren't we getting a lot of IT people wanting to work in the medical industry?".

My guess is the horribly insane regulations like HIPAA, SOX, etc... that make the job more 'risky'.

If someone hacks into a windows box at...say...a construction firm, it's not a huge deal. Make sure everything gets fixed/patched and continue on.
If someone hacks into a windows box at...say...a hospital, and you're spending hundreds of thousands of dollars on cleanup, notifying patients, HIPAA fines, credit reports, and possibly getting fired because someone hacked into your system.

As a fun side-note, none of my Linux boxes (~45) have been hacked in the last 30 days, but I've had 5 compromised Windows machines out of approximately 150. (The linux boxes have no antivirus software, all 150 Windows machines are running either Symantec or McAfee).

Re:yeah, sure is a lack of unemployed IT types

[hsthompson69]

Actually, you've got a good point - reducing salaries for IT workers would reduce health care costs. So would reducing salaries for doctors, nurses and all other health care employees. The unintended consequences of such an activity are pretty severe though.

It's sort of like "affordable housing". Everybody is for "affordable housing", but nobody wants more foreclosures. However, foreclosures are exactly the kind of thing that would bring prices down and make things affordable.

The problem here though isn't the theory, it's the practical. Government intervention into markets creates distortions that cannot be sustained. Eventually, the best intentions implode on themselves. In the case of reducing IT salaries, I can only imagine that in the worst case, we have a big bucket of money, but not enough qualified people to take advantage of it, so we lower our standards so we can spend all the money. The resulting poor crop of IT workers ends up replacing more expensive IT workers, who find solace in other industries, and you essentially end up with less quality and less cost.

Of course, if they really wanted to reduce health care costs, they'd reduce disease, and the quickest, cheapest way to do that is to tell people to restrict their carbohydrate intake (contrary to the six servings of cereals and grains recommended by the USDA). Reducing the incidence of chronic disease, including diabetes, obesity, heart disease, cancer and alzehimer's, by recommending a truly healthy diet, would not only reduce health care costs, it would improve health.

Re:yeah, sure is a lack of unemployed IT types

[CAIMLAS]

Yes, and it's a fucking stupid idea. Healthcare IT sallaries are already low compared to other industries. Unlike most for-profit business, hospitals and healthcare in general have yet to learn that IT assets, like any other physical asset, depreciates over time. They replace it when it breaks (or provide you with the funding to do so when it breaks), and the pay for an individual healthcare IT worker is similarly treated. Granted, there are more healthcare IT workers per capita than in most other industries, and most of them are useless sacks of busywork, but the few who actually get things done also get paid less.

Re:yeah, sure is a lack of unemployed IT types

[CAIMLAS]

We've got plenty of EMRs, thanks.

What we need is a decent EMR that isn't horribly expensive that small organizations can use. Unfortunately, unlike other industries where the scale of information in a monolythic application largely relates to the organization's size, this isn't true in healthcare: the 5-doctor clinic needs the same access to EMR as the 1,000 doctor hospital network.

Re:yeah, sure is a lack of unemployed IT types

[drinkypoo]

Maybe their premise is wrong. There doesn't appear to be a lack of qualified IT workers. (My boss is searching for a go-out-and-replace-this-motherboard technician, and a majority of the applicants are 'big players'--like former Oracle DB developers). I think the correct question is "Why aren't we getting a lot of IT people wanting to work in the medical industry?".

My guess is the horribly insane regulations like HIPAA, SOX, etc... that make the job more 'risky'.

Speaking for myself, these jobs aren't in places I want to live, or places I already live. I would take a decent-paying IT job if it didn't require me to move to Bumfuck, AK, where the women are scarce and the seals are scared.

Re:yeah, sure is a lack of unemployed IT types

[BoberFett]

Executive salaries are such a miniscule percentage of the oil industries revenue you could cut them to NOTHING and it would barely make a dent.

Likewise, if you knew what the hell you were talking about you'd know that the health care industries profit margin isn't really all that high. The problem is not profit, it's that top quality healthcare is expensive to provide. Everybody wants the best but nobody wants to pay for it.

Re:yeah, sure is a lack of unemployed IT types

[ultranova]

My motto as it is for a lot of other ppl tired of Welfare state is ....

"Starve the Beast"

[...]

The MSM even covered stories of returning injured not getting the care they needed.

Well, if you dislike the welfare state, then rejoice! The Beast is getting starved, it no longer has resources to take care of all those unable to do soe themselves! You got what you wanted. Enjoy.

You do realize that "welfare state" means a place where injured get taken care of, right? And that in non-welfare states those crippled in wars or by other means tend to end up begging on the streets?

Re:yeah, sure is a lack of unemployed IT types

[jopsen]

How about giving them loans for training which are paid back as part of their salary once they've secured a job?

And then people can't change job... Or they'll have to pay the loan themselves... Who would want it then ?
- I doubt six months training is cheap...

Slightly off-topic but I never understand why you Americans are so willing to take huge loans so early in your life, just to get into college...
I'm fairly happy with my free education and educational support (about 1000 USD / month). I've just finished fourth semester computer science, don't live at home or receive financial support from my parents and haven't got any debt.

Re:yeah, sure is a lack of unemployed IT types

[tivoKlr]

We need them so when you show up in my ER gorked out of your head or unconscious and unable to respond, we:

1, have some sort of freaking idea what preexisting issues you might have and may have caused your gorkedness,
2. so we don't repeat a test you just had in some other ER yesterday, which is where the potential cost savings comes into play.

Problem as you refererred to is the security of this information. It will be stored insecurely and abused, you can bet your ass on that.

Re:yeah, sure is a lack of unemployed IT types

[Attila Dimedici]

We need them so when you show up in my ER gorked out of your head or unconscious and unable to respond, we: 1, have some sort of freaking idea what preexisting issues you might have and may have caused your gorkedness, 2. so we don't repeat a test you just had in some other ER yesterday, which is where the potential cost savings comes into play. Problem as you refererred to is the security of this information. It will be stored insecurely and abused, you can bet your ass on that.

So, how many people would that be each year? According to the stats I can find indicate that there are approximately 400 ER visits for every 1000 people in the U.S.. Based on my experience, I have to believe that the overwhelming majority of those are coherent. Ultimately, I just can't see that the number of people who will be helped by this justifies the costs and risks.

As important as the abuse and fraud that this system will be subject to, is the dangers from the information in this system being corrupted. "I'm sorry, Mr Smith, we can't treat your condition because your EMR says that you have a serious heart condition (some other life threatening condition) and the treatment has unacceptable complications with that."
"But, I don't have a heart condition (other life threatening condition)."
"I'm sorry sir but it says right here that you do. Your EMR would not list if it wasn't so."

I just don't see the advantage of a government mandated system outweighing the problems by enough to justify the expense.

Re:yeah, sure is a lack of unemployed IT types

[flyneye]

Well if the typical Murphys law crap happens, and it does, the job gets outsourced and I wake up in a hospital bed near the Nepal border with a headache and inexplicable surgical scars when I just went in for a prostate exam. Government funded (money taken from your wallet) anything is always a bad idea at some level. They shoulda' read the Constitution and just stuck to the job they were SUPPOSED to do instead. Now nothing works likes it's supposed to and everyone is so dumbed down and Zolofted out no one understands why. It's just like that little ball of sweat that you get on the end of your nose. You know the one that just hangs there swingin' back and forth and you're wondering " hey little ball of sweat, why don't you fall offa' there or someone will think I got snot hangin outa' my nose". Well it's just like my Grandma Hosanna Rattanna Danna said " if it isn't one thing, it's gonna be another".
        Did I mention there were too many sidetracking distractions? Political intrigues, propaganda, payola, car chases, gunfights and other "look a bird "sorta crap. The whole system from World leaders down to the hospital janitor is on the verge of a Hamlets last scene style meltdown because the planet is manned by perpetually distracted drug addicts with delusions of grandeur and a line of credit. We are all medicated enough now that you can just close the pharmacies and pour a glass of tapwater. THAT should reduce health care costs.
Regulating the health industry like they do the communications industry in conjuction with other countries around the world sitting on their evil greedy counterparts, THAT should control health costs. Boards of directors and major stockholders of Medical sector corporations should quit posting so much profit and divert a larger percentage to R&D in a more realistic manner rather than just milking the public for money they don't have. This should lower health costs AND help with the credit crisis.
          It's all just such a tangled mess, the world would be much better off to just have EVERYONE overthrow their governments simultaneous, get together for a beer and get an initial peaceful agreement to interact till we have the world put back together in a more logical beneficial sort of way.
            It's always a bigger picture.

That's 50k unhealthy people...

[aapold]

will they result in more health care than they need?

This is corporate welfare.

[Senes]

Instead of tapping into the underemployed IT labor resources, which would cost more money, businesses have instead successfully lobbied the federal government to spend its own money to solve their problems for them.

Were at Wal-Mart 2.0, now any job can be paid by government instead of the employers themselves.

Re:This is corporate welfare.

[DriedClexler]

Yes and no. It looks like most of these will fund training for technical schools which are, as the /. crowd already knows, basically worthless for actually being productive in IT, and probably won't help you get a job. (The stories of people who went into debt to go to one of these schools, hoping to get an IT job but becoming just as unemployable anyway.

What's worse, as those who get e.g. "Cisco certification" know, it can tell employers that, "This applicant knows enough to destroy your system, but not enough to get anything done."

The best that can happen is that this will just become some "checkoff requirement" -- doesn't help you with your job, but doesn't hurt either, just wastes time.

More money down the shithole. If it's welfare, it's welfare for the worthless colleges that keep rooking the unemployed.

drug testing?

[Internet_Communist]

i've always looked right over health care jobs because they drug test and I refuse to work for a company who does that...end of story. They wonder why they can't find anyone to work for them? hah...

Re:drug testing?

[Lucas123]

And, we all know how much the healthcare industry is hurting from the lack of workers who use recreational drugs.We'd all feel much safer knowing the guy in charge of the EMR database just finished smoking a doobie.

Re:drug testing?

[drsmack1]

I have a friend in I.T. and he regularly smokes pot and will occasionally take other things that mess him up. This *does* make him less reliable and he is less consistently available to work when scheduled.

Knowing him has made me more in favor of the employers right to test for drugs (as part of the employment contract).

I'd really like there to be some sort of disincentive for him being high as a kite (or recovering) whilst he is working on medical equipment that may be keeping someone alive.

Re:drug testing?

[warGod3]

I'm sure if it means a decent paying job with benefits, some people will forego the "I won't work for a company that piss tests people" idea.

Re:drug testing?

[Sponge Bath]

The original poster argues that invasive and unjustified prying into the private lives of employees is a disincentive to potential employees. You respond that anyone who questions those policies does drugs while on the job. You either missed the point or are purposefully ignoring it.

Re:drug testing?

[Anonymous Coward]

How do you know the pot messes him up on a long-term basis? He could just be naturally unreliable.

There is a major difference between being presently intoxicated (which would be grounds for firing anyway) and having had a smoke in the past couple of weeks (which a drug test could yield a positive from.)

Re:drug testing?

[Internet_Communist]

yep that's pretty much the point i'm trying to make - people should be judged by how they perform their jobs, not on what they do outside of their jobs. Some of the commenter's here acting as if someone who smokes pot is an inferior person is just hilarious and goes to show how ignorant the masses can be. Sure too much of anything can be a bad thing, but losing a job cause you smoked some pot at a party 2-4 weeks ago (the amount of time it could potentially show up on a piss test) or something is just retarded and completely unjustified regardless.

Re:drug testing?

[Internet_Communist]

this is anecdotal at best and really speaks out more about your friend as a person than it does the effects of the drugs on him....

Re:drug testing?

[markdavis]

You are an asshole. Did it ever occur to you that there are people (myself included) that have NEVER used illegal drugs and yet refuse to be drug tested because it is a violation of our privacy and almost always with no probable cause?

1) You also have no idea what else they are testing for
2) You have no idea what information is shared and to whom
3) There is a absolute possibility of false positives that could ruin your reputation

Drug testing is evil, period. Legal drugs (such as alcohol and prescription drugs, even over-the-counter meds) can be just as debilitating. Even sleep deprivation can cause severe performance problems. And those that do choose to use a illegal drug on their own time don't necessarily affect their on-the-job performance.

If a company wants to ensure their workforce is not "impaired", then they should test for impairment through some type of coordination, response time, or mental exercise. Or perhaps even through observation of performance.

Re:drug testing?

[Internet_Communist]

well i've got a decent paying job with benefits and they don't drug test, so maybe i am limiting my options, but it hasn't hurt me any. Our employee handbook actually focuses more on addiction and rehab and stuff like that which I actually think is somewhat respectable. I'd much rather work for a company who is realistic than one who decides to violate the employee's privacy right from the start, it doesn't really speak well for the company and it's not the kind of place I'd want to work for...

Re:drug testing?

[Internet_Communist]

Shoulda put a "usually" in there. but all the luck to ya :P

Re:drug testing?

[Internet_Communist]

More and more it seems drug testing is used as a sort of blanket "cover our asses" type of thing for companies which are too lazy to actually monitor the performance of their employees. It's quite sad honestly.

Re:drug testing?

[iamhassi]

" people should be judged by how they perform their jobs, not on what they do outside of their jobs"

From my experiences with drug users the fact that they use drugs does say a lot about how well they perform their jobs.

Plus, it reflects pretty poorly on the company if you ever get publicly busted for drugs. In a large city no one would notice probably, but in smaller towns every little drug bust shows up in the local newspaper.

Re:drug testing?

[Internet_Communist]

maybe, but the fact they are getting busted means they probably aren't being very responsible in the first place....and anecdotal experiences hardly speak for everyone...but even so I'm not sure you're really disagreeing with me - if their job performance is shit then that should speak for itself should it not?

as for company image, i haven't seen too many cases where people getting busted for drugs listed the company they worked for and what not, not unless the person was a high ranking official in the company that people otherwise knew anyway...this is not really something you could predict, and quite honestly if it wasn't for all the broken drug laws this wouldn't even be an issue anyway...in either case I don't think this justifies drug testing one bit.

Re:drug testing?

[drsmack1]

I'd really like there to be some sort of disincentive for him being high as a kite (or recovering) whilst he is working on medical equipment that may be keeping someone alive.

So you'd prefer somebody with a perpetual hangover and a fifth in his lunch box working on that medical equipment? I've found alcoholics tend to congregate at companies that drug test.

Did I say that? Is must be so easy for you to argue your point when you get to make up what you are replying too. Nice strategy there Mr AC.

Re:drug testing?

[drsmack1]

this is anecdotal at best and really speaks out more about your friend as a person than it does the effects of the drugs on him....

Did I really need to take the time to mention that there are times he is not high or recovering and that I can easily tell the difference? I guess I did.

You may be someone who is not heavily affected by whatever you are taking. Maybe it is that you just can't tell. Anecdotal would be that you extrapolate your perception that you can handle it into *everyone* can handle it. It may be that you hold this position purely because you do not want to be inconvenienced by rules which are designed to protect everyone else from the weak or those with poor insight.

On a similar note, I have superior reflexes and situational awareness / judgement that allows me to drive safely in ways that other would consider extremely aggressive.

I am not personally selfish enough to want the laws I regularly break to be stricken from the books - because those laws are there to protect everyone from those who do not have my talents.

It is annoying to be subject to tickets from the authorities, but I am paying for my lack of patience - not being punished for being a better driver than most everyone else.

Re:drug testing?

[ffreeloader]

as for company image, i haven't seen too many cases where people getting busted for drugs listed the company they worked for and what not, not unless the person was a high ranking official in the company that people otherwise knew anyway...

In small towns you don't have to post the name of the company you work for. People know who you work for and if your name gets posted in the newspaper it will get talked about by a lot of people and will reflect on the company you work for if you have a job with a lot of responsibility or one that requires strict integrity. Big city anonymity does not exist in small towns.

I'm not for drug testing, but only because of the personal privacy implications. Someone addicted enough to not be able to stop using long enough for the drugs to get out of their system, or not smart enough to use masking agents, will have a spotty employment record. There will be red flags in their history that will make it very difficult for them to get a job in which drug usage would affect their performance in critical situations. Thus, I don't believe that the loss of privacy involved in pre-employment drug testing is worth the insignificant benefit gained.

Drug testing by employers has had no measurable impact on drug use overall. Drug use has increased right along with drug testing, so drug testing is of no real value. It's just another feel-good "security" measure that does no real world good, but does help create in people more of the "sheeple" effect in which personal independence and liberty is extinguished more every day.

Re:drug testing?

[drsmack1]

Hey, thats a great name. Didn't it make you smile a little? It was the name of a dermatologist I knew in the Army.

Re:drug testing?

[b4dc0d3r]

Traffic rules also let other drivers know what to expect. Your aggressive driving could cause someone else to brake reflexively, getting rear-ended in the process. Your lack of patience is dangerous. I'm not going to waste time finding references because you will probably conclude that you aren't one of those people, but when people think they are good drivers it's usually because they are good at other things and haven't caused an accident yet. You are probably no better than most, and your arrogance, statistically speaking, puts you at higher risk of having a fatal accident when you do something other people don't expect.

As to your friend, the employer should fire someone who is not reliable. That should be the disincentive, not drug testing.

Further, if you are watching him work on equipment that keeps people alive, while he's high, you are an accomplice to any problems he causes. You accept responsibility for letting that person die. Elsewhere you suggest that people with hangovers should not be working on this equipment, to sidestep the argument that drug testing won't solve the problem of unreliable or "messed up" workers. The employer is responsible for monitoring its employees, and drug testing catches only a small percentage of the unreliable workers, which makes it fairly pointless.

Knowing him has made me more in favor of the employers right to test for drugs (as part of the employment contract).

Why go the indirect route? Open-door on the guy, or drop a note in a manager's or executive's box or under their door and get him fired. If you have a problem with it, do something about it. Don't advocate infringing other peoples' right to privacy for something temporary they do off the clock which solves only a small part of the problem just because you're too much of a pussy to do the right thing.

Re:drug testing?

[Internet_Communist]

I never said I was taking anything nor did I claim to be better at "handling my substances" than anyone else as you seem to imply by your driving analogy. It's anecdotal because this is a single personal account a friend and not a scientifically significant subset of the general population or a representation of much of anything at all except for that specific person's issues.

I mean, maybe the laws are there to protect, but quite honestly i don't know what your friends taking, but the laws protecting people from pot are hardly justified given that it's a hell of a lot less dangerous than the legal alternatives like cigarettes or alcohol. Further perpetuating misinformation about the effects of drugs is not going to help this any. I reckon even the "weak or poorly insighted" are not going to be so much more blinded by pot than those with some super-human substance-intaking abilities that you seem to imply exist...Sure you might see the person who's a "n00b" at it act all silly or what not, but the placebo effect is a powerful thing.

Ever seen those scientific studies where they give people "alcohol-free" beer and don't tell them, and then watch as the people proceed to talk louder and act stupid even though no alcohol was actually involved?

Fact is, people are dumb all by themselves, blaming the drugs is just an excuse...and if that person's use of drugs is making then even more dumb, then it's just an extension of that person's inherit stupidity.

Re:drug testing?

[countertrolling]

On a similar note, I have superior reflexes and situational awareness / judgement that allows me to drive safely in ways that other would consider extremely aggressive.

No you don't. You're just lucky... so far

Re:drug testing?

[h4rr4r]

From your experiences with people who you knew used drugs, far more people use drugs and you just don't know it. The average worker who might enjoy recreational drugs is not going to be telling everyone that.

Re:drug testing?

[drsmack1]

Traffic rules also let other drivers know what to expect.

I don't think that most drivers *expect* anything at all. The word "expect" implies forethought and planning ahead at least a little. I see very little evidence that this is a active process in the majority of drivers.

Your aggressive driving could cause someone else to brake reflexively, getting rear-ended in the process.

What kind of aggressive driving did *I* cite that could possibly cause someone to brake reflexively hard enough to cause the person behind them to hit them? *I* did not specify what aspects of my driving that I thought others would consider to be too aggressive. But that didn't stop you from making up a situation that you feel bolsters your point. Seems that your argument is too important to you to bother using it the appropriate situation.

Your lack of patience is dangerous.

Again, in what way? Cite a particular example as it pertains to what I said in my post.

I'm not going to waste time finding references because you will probably conclude that you aren't one of those people,

Probably? And references to what? Something I never said that I did?

but when people think they are good drivers it's usually because they are good at other things and haven't caused an accident yet.

What do YOU mean by "good driver"? And someone answering that question in a polling situation - what does it mean to them? Saying someone is a "good driver" means nothing if "good" is not defined. And what is the percentage on "usually"?

You are probably no better than most, and your arrogance, statistically speaking, puts you at higher risk of having a fatal accident when you do something other people don't expect.

I disagree with you - and between the two of us is only one person who has any direct knowledge on the matter. The other is a windbag who is just trying to win argument points by joining the controversial "Safe Driving Lobby".

As to your friend, the employer should fire someone who is not reliable.

Agreed - and this has happened a few times.

That should be the disincentive, not drug testing.

Ideally, yes. I like the idea of pre-employment testing to weed out the individuals who cannot even get it together for a short time to pass these tests. I don't really like the idea of random screening after employment - but I absolutely feel that testing should be done if there is an incident.

Further, if you are watching him work on equipment that keeps people alive, while he's high, you are an accomplice to any problems he causes. You accept responsibility for letting that person die.

You are like the king of assumptions - at least those that bolster your points. Where did I say I work with him? Where did I say he works on medical equipment? It seems very important to you to establish that I am doing *something* wrong. Why is that?

Elsewhere you suggest that people with hangovers should not be working on this equipment, to sidestep the argument that drug testing won't solve the problem of unreliable or "messed up" workers. The employer is responsible for monitoring its employees, and drug testing catches only a small percentage of the unreliable workers, which makes it fairly pointless.

It would only be pointless if it caught no one or falsely implicated the innocent.

Why go the indirect route? Open-door on the guy, or drop a note in a manager's or executive's box or under their door and get him fired. If you have a problem with it, do something about it. Don't advocate infringing other peoples' right to privacy for something temporary they do off the clock which solves only a small part of the problem ju

Re:drug testing?

[drsmack1]

Citation? How many years of driving without directly or indirectly causing an accident would it take to invalidate your unsubstantiated and context-less opinion? 1 year? 10 years? 40 years?

Re:drug testing?

[drsmack1]

I never said I was taking anything nor did I claim to be better at "handling my substances" than anyone else as you seem to imply by your driving analogy

Quite true, I have no direct knowledge of your personal situation. I should not have made arguments that assumed your reasons for having your position.

That said, *every* person that I have known personally that has espoused similar arguments about employer drug testing has happened to be an active user of illegal drugs. That is about 15 or so in the last 25 years. So my error was to assume you fit in that group.

Fact is, people are dumb all by themselves, blaming the drugs is just an excuse...and if that person's use of drugs is making then even more dumb, then it's just an extension of that person's inherit stupidity.

If you add to that statement that some people are affected by drug use to a greater or lesser degree and that is not necessarily proportional to their abilities or "will" - then we would be in perfect agreement.

Re:drug testing?

[countertrolling]

All of them. You're only as good as your last fuck up. The people around you also contributed to your luck by managing to avoid hitting you while you're playing F! on the highways. Your arrogance is astounding. Save your "talent" for the track, or GTA

Re:drug testing?

[Leebert]

This *does* make him less reliable and he is less consistently available to work when scheduled.

Sounds like a problem which will take care of itself, if the employer is smart. If the employer isn't smart (and quite a few of them softstep around afraid to fire anybody for being useless), serves 'em right.

If the employer doesn't notice any effects of the drugs on the job the employee is doing, then either it's not an issue, or the employer isn't paying enough attention, and thus there's a bigger issue.

Re:drug testing?

[apoc.famine]

From my experiences with drug users the fact that they use drugs does say a lot about how well they perform their jobs.

Great. Then don't do invasive drug testing, and base their employment on how well they perform their jobs. In my experience, most of the drug users I know were indistinguishable at their jobs from non-drug-users.

I lived most of my life in small towns. I must have been in some liberal paradise, because there were lots of local people busted for drugs. And lots of people *everybody* knew were doing drugs outside of work. But by and large, nobody gave too much of a shit. Why? They based that person's respect on how well they did their job, and who they were as citizens. Not whether or not they smoked a bit of weed in the evening to unwind before bed.

Is there a problem if one of your employees does drugs? Most likely not. If they have some serious addiction that requires them to do drugs during work, (cigarettes, cough, cough) that's a problem. But there are plenty of recreational drug users that I know that are able to do them after work, and on the weekends, and be a productive worker and member of society the rest of the time.

...it reflects pretty poorly on the company if you ever get publicly busted for drugs...

It only reflects poorly if your work performance was suffering and the company ignored that.

To be frank, your attitude towards drugs is either horribly misinformed, or you have a very skewed world view. Are you the son of a southern baptist minister by any chance?

Re:drug testing?

[drsmack1]

Can you please write out the argument or position you are replying to? Because I cannot see anything in my statements to which your comments would be appropriate.

Could it be said that making offensive assertions with no evidence would be considered arrogance?

Re:drug testing?

[apoc.famine]

Big city anonymity does not exist in small towns.

In high school, I was dropping my mom off at the doctor's in the nearby city one afternoon, when I broke one of my blinker covers. (Was squeezing into a narrow space, going about 0 mph because I was worried about hitting the bumper of the SUV next to me. Damn thing was *higher* than my bumper, so instead of touching, the SUV bumper cleared mine and took out the plastic covering my blinker.) At 8:30am the next morning, a kid in my school said to me, "so I heard you got into an accident last night..."

I grew up in one of those sorts of towns. And really, nothing reflected poorly on the local companies. Because anything YOU did was tied to YOU. Not to your company. Nobody decided not to go to the store I worked at because their employee had an accident. When a local guy got into an accident and got a DUI, everyone knew the lawyer he was going to hire, because he was one of the three in town. When he got off with a misdemeanor, everyone knew he was a drunk who got into an accident. But nobody boycotted his company. They might go in an harass him, but that was about it.

Big city anonymity does not exist in small towns.

It's true. but I've never seen the sort of "punish the company for bad employees" mentality of you and a couple other people in this thread. Did I just grow up in sensible towns, or is everyone just making up shit that doesn't happen in the real world?

Re:drug testing?

[countertrolling]

Can you please write out the argument or position you are replying to?

"On a similar note, I have superior reflexes and situational awareness / judgement that allows me to drive safely in ways that other would consider extremely aggressive..."

Maybe my sarcasm meter is malfunctioning. Yeah, that must be it... disregard

Re:drug testing?

[drsmack1]

I never said what I was doing *was* dangerous. Only that others may think so. Statistically, there MUST exist a subset of the population that has a greater amount of the skills needed to cope with the maneuvers and judgement required to drive safely - just as there also must be a subset of those with lesser skills. In the absence of actual direct evidence, you are taking a hardened and indefensible position that I am a danger on the roadways.

I understand that it feels good to be on the "right" side of an argument - but what evidence do you point to the leads you to believe that that is where you are?

Re:drug testing?

[countertrolling]

Damn! You're serious! I came to the conclusion, mistakenly it appears, that you were speaking a parable.

...but what evidence do you point to the leads you to believe that that is where you are?

The statistics. The law that is based on them. Do you have any such evidence to prove otherwise? It was written to minimize your behavior for the benefit and safety of others, which apparently you have no regard for. Your luck seems to have destroyed your modesty gene, or maybe it has always been recessive. What you remind me of is the lucky drunk who hasn't wrapped his vehicle around a tree yet. No doubt, if you do ever hit one, you'll be claiming that it jumped out in front of you before your superior "talent" had time to react. You hardly seem to be in a position to decide what is dangerous, unless you possess the credentials to prove you're an expert witness.

Re:drug testing?

[HereIAmJH]

Drug testing is evil, period.

Things are rarely black and white. Once upon a time I used to work in lawn care and some of my co-workers made a habit of having liquid lunches. I made it clear to my supervisor that it was an unacceptable activity for someone who is running a 500 lb machine with high velocity blades. It stopped happening. On the same note, would you want a forklift driver getting stoned on break? How about truck drivers? Airline pilots, police officers, EMTs?

OTOH, years ago when a former employer announced they were implementing a 'random' drug testing program I refused to sign the paperwork that HR sent out saying that I would accept it as a condition of employment. They always had pre-employment drug testing, so it wasn't the testing that I had a problem with. It was the 'random' that allowed supervisors to select you for testing. Blanket testing, testing following a job related accident, no problem. Being targeted by any member of management, unacceptable.

Re:drug testing?

[drsmack1]

It makes your argument quite damming - you know, the whole ignoring my request that you specify what specific behavior that I stated that I exhibit that the statistics should be applied to.

So how about it? What is it that I am doing SPECIFICALLY that you feel makes me dangerous? Extraordinary claims require extraordinary proof - you have made the claim that you can tell that I am dangerous and arrogant despite not being able to cite a single dangerous act that I have performed and having no direct evidence of any character defect I suffer from other than that I have made a *statement* in a posting that I have exceptional driving skills (which you are in no position to prove or disprove).

>>unless you possess the credentials to prove you're an expert witness

What "credentials" are acceptable for use over the internet that would satisfy you?

Re:drug testing?

[DigiShaman]

Fair enough, but do you want to put your life on the line to test this theory? Eh?

Re:drug testing?

[Macrat]

yep that's pretty much the point i'm trying to make - people should be judged by how they perform their jobs, not on what they do outside of their jobs.

You mean the guy who has trouble getting into the office before noon because he is always sleeping off his weed buzz from the evening before?

Re:drug testing?

[ffreeloader]

Big city anonymity does not exist in small towns.

In high school, I was dropping my mom off at the doctor's in the nearby city one afternoon, when I broke one of my blinker covers. (Was squeezing into a narrow space, going about 0 mph because I was worried about hitting the bumper of the SUV next to me. Damn thing was *higher* than my bumper, so instead of touching, the SUV bumper cleared mine and took out the plastic covering my blinker.) At 8:30am the next morning, a kid in my school said to me, "so I heard you got into an accident last night..."

I grew up in one of those sorts of towns. And really, nothing reflected poorly on the local companies. Because anything YOU did was tied to YOU. Not to your company. Nobody decided not to go to the store I worked at because their employee had an accident. When a local guy got into an accident and got a DUI, everyone knew the lawyer he was going to hire, because he was one of the three in town. When he got off with a misdemeanor, everyone knew he was a drunk who got into an accident. But nobody boycotted his company. They might go in an harass him, but that was about it.

Big city anonymity does not exist in small towns.

It's true. but I've never seen the sort of "punish the company for bad employees" mentality of you and a couple other people in this thread. Did I just grow up in sensible towns, or is everyone just making up shit that doesn't happen in the real world?

You're looking at this from an unrealistic point-of-view. You're taking a fender bender and generalizing it to a drug bust. That's not a rational generalization.

Just imagine if you had been the head of IT at a local hospital, a manager at a local bank, a police dispatcher, or any other kind of position of responsibility that directly affects the public, and gotten busted for illegal drugs. The response to both you and your employer would have been a lot different. People would call into the question the ability of your employer to accurately judge the character of the people they hire to put in positions of responsibility, and thus lose faith in that business.

It's not punishing the business, per se, it's losing faith in the business owner's judgment and taking their business elsewhere because of that lost faith. Honor and character are words that still have meaning in small towns, and that's good thing. It means small towns are still reasonable places to live, and you can normally trust your neighbor. However, if you break that trust the small town can be a very uncomfortable place to live. As far as I'm concerned, that's a good thing. People should hold each other accountable. Society benefits when they do.

Re:drug testing?

[markdavis]

No change in my view. Almost any job has the potential for harming people, equipment, property, theft, etc. If a position is that important then they should test employees on PERFORMANCE: Reaction time, mental clarity, focus. It doesn't matter what chemical (or no chemical) that causes the impairment, you are measuring impairment. This can all be done objectively and with a portable computer.

Re:drug testing?

[apoc.famine]

My point was that I grew up in those small towns. And I've not seen the sort of company-shunning mentioned in this thread due to out-of-work employee conduct.

Employees busted/impaired while at work? Maybe.

But I grew up in those sorts of small towns. I never saw any of the "your out of work actions gave the company a bad name" that was mentioned previously. You can say, "Just imagine" all you want. (I have a very good imagination, so I can!!) It doesn't change the fact that I've never seen nor heard of what you or anyone else in this thread is hypothesizing.

Re:drug testing?

[ffreeloader]

I had a long post all written out and somehow it just disappeared when hitting enter for a new paragraph, so the following will just have to do.

I'm not hypothesizing. You are.

I went to school with 2 sisters whose mother lost a restaurant due to them getting busted. A popular place to eat suddenly lost all its customers. That hamburger joint went from being busy all the time to closed within a year, and it was a great hamburger joint. They had good food. BTW, both sisters worked in that restaurant.

A guy I went to school with inherited a well-established, thriving nursery located on a busy 4 lane highway. If you wanted anything from flowers, to seedlings, to mature trees, to mulch, to lawn ornaments of all kinds, they had it. His father had been running the place for 30 years before he inherited it, and he ran it for more than a decade with no slowdown in business until he got busted for drugs. He closed his business and sold the property 2 years later because he had no customers left.

Another guy I went to school with got busted in his mid-twenties a couple of times and his father's dental practice of about 40 years went down the drain within 2 years.

There's three businesses I know of ruined because someone in a small town/rural area got busted for drugs. Any time you have someone in a lead position in a company busted for drugs it definitely affects that business. Now maybe if one of the peons doing manual labor gets busted it won't hurt the company, but anyone who holds a pivotal position in a company getting busted most certainly will affect it.

Re:drug testing?

[Hognoxious]

Are you the son of a southern baptist minister by any chance?

He sounds more like the offspring of a catholic priest.

Re:drug testing?

[Hognoxious]

If he was sleeping off a hangover would it be any different?

Re:drug testing?

[alecto]

I don't use illegal drugs, but would have to have emptied my last can of beans before accepting a job that required a drug test that didn't involve a TS codeword security clearance or was truly a physical safety critical position (e.g. commercial pilot). This is on principle, not because I don't want my employer to know about a weekend crack habit.

Re:drug testing?

[Macrat]

no.

Re:drug testing?

[Hognoxious]

Then why did you specifically mention the "weed buzz"? If he's turning up late, he's turning up late. The reason is irrelevant.

Re:drug testing?

[b4dc0d3r]

Where did I say he works on medical equipment? It seems very important to you to establish that I am doing *something* wrong. Why is that?

Wow you're defensive, but in case you don't remember writing this, here you go:

I'd really like there to be some sort of disincentive for him being high as a kite (or recovering) whilst he is working on medical equipment that may be keeping someone alive.

OK let me rephrase, based on that. If you're concerned, contact his employer. If his drug use kills someone, you're just as responsible. If your quote "whilst he is working on medical equipment" was hypothtical, you did not make that clear, and it is entirely irrelevant to your point. If it is relevant, in any way, he must have a job "working on medical equipment". Yes, king of assumption I am, as long as you're including irrelevant information to bend your argument to make sense. So either he works on medical equipment or you're just making stupid stuff up because of some defensive need to be right. Not sure, only one of us is in a position to know that.

It is annoying to be subject to tickets from the authorities, but I am paying for my lack of patience

You are paying? If so then you broke traffic rules that are in place to prevent overconfident drivers from causing accidents. When I come to a stop light, I expect the guy behind me to stop, there's no forethought or planning involved. When I have the green light I expect that someone else won't sideswipe me because they think they can judge the red-green gap for that intersection. I could spend hours making up any number of scenarios where you could (as I said before, the word "could") cause an accident by doing something unexpected, but you'd say that you didn't mention that scenario and I'm making something up to bolster my argument. Cars move quickly, and there is a limit to other peoples' reaction time, even if you are infinitely responsive.

If "paying" was hypothetical then, again, you're distracting from your argument. If you don't get caught, ever, and have never "paid" either in traffic court, fines, jail time, accidents, or any other way, you're not really breaking

the laws I regularly break

. At least not as much as you think you are. Or you're in an area where your superior skills are irrelevant due to lack of traffic.

Let's go back to your original post here:
http://slashdot.org/comments.pl?sid=1722902&cid=32936784

Someone said they won't work for a company that drug tests. You posted an anecdote in support for drug testing regarding your friend and medical equipment. Surely everyone is for drug testing when people are working on medical equipment, right?

http://slashdot.org/comments.pl?sid=1722902&cid=32937262

It may be that you hold this position purely because you do not want to be inconvenienced by rules which are designed to protect everyone else from the weak or those with poor insight.

I'm not going to interpret that one in any way, but you use your own "talents" and your lack of desire to overturn the laws that crimp your style to suggest that people who are against drug testing are against it because they want to use drugs, not because of any sort of privacy concern or principle. Drug testing is a wide net to protect the population from the small subset of people who think they can handle their drugs but can't. "You may be someone who is not heavily affected by whatever you are taking. Maybe it is that you just can't tell. Anecdotal would be that you extrapolate your perception that you can handle it into *everyone* can handle it." So you are saying that there are people who can't properly judge the effect of drugs on themse

Re:drug testing?

[b4dc0d3r]

We have laws against aggressive driving because of the potential for accidents, and we have laws against being high at work for the same reason. If nothing else, public intoxication would cover it but depending on what you're working with there may be additional laws and/or rules. Mandatory drug testing is one of those rules which an employer may choose to implement, while another more obvious one might be "Don't come to work if you're on drugs".

What we don't have is a ban on driving just because you might drive aggressively, which is the same thing as drug testing just in case you might be "messed up" at work. We're talking about laws/rules against doing something instead of laws/rules against potentially doing something. Your claim of superior reflexes make you a candidate for aggressive driving, so we should revoke your license without even evaluating your claim, nor your driving, based on your logic.

But you say you accept these laws because they protect society against people who do not have superior reflexes, or can't handle their drugs.

with mandatory drug testing, people who are better at handling their drugs, like doing it recreationally when off duty, don't get away with it or pay a fine. They get fired. Laws against aggressive driving prevent accidents, especially when the person is not as skilled as you claim to be. Laws and rules should reality, not probability. Disregarding you, the average person driving aggressively will cause accidents, and the average person using drugs at work will cause problems. So let's focus on the actual problem, not some hypothetical possibility.

The only reason I've ever seen mandatory drug testing used is 1) initial hire, which may be a filter to get rid of people who can't clean up for long enough to pass a test or 2) turning layoffs into firings-for-cause when reduction in force is needed. The only other purpose mandatory testing serves is letting the company say they are anti-drug. If someone is having problems at work, an employer does not need to have a drug testing policy in place to request a drug test on-demand. The employee's performance alone should dictate whether it's needed. It's rare for an employee who has an on-the-job injury to *not* be tested in some way, for insurance purposes. Why would it be different for performance-related concerns? You're acting strangely at work, for the safety of those around you we'd like you to either quit or submit to a drug test at company expense or psychological examination in accordance with your benefits. Seems simple.

I figured I'd try smaller sentences this time.

Re:drug testing?

[drsmack1]

>> OK let me rephrase, based on that. If you're concerned, contact his employer.

Non-applicable because he is out of work due partly to drug use.

>> If his drug use kills someone, you're just as responsible.

Non-applicable (see last answer)

>> If your quote "whilst he is working on medical equipment" was hypothtical,
>>you did not make that clear

I was being imprecise, he does not in general work in the medical field - however I *would* be concerned if he did. I don't know if I would turn him in - would be based on the risk I thought he presented.

>> defensive need to be right. Not sure, only one of us is in a position to know that.

I don't think I was in a argument with you when I was being unclear about this - so it is doubtful it was about winning a argument.

>> You are paying? If so then you broke traffic rules that are in place to
>> prevent overconfident drivers from causing accidents.

I have had a few speeding tickets, that is the "paying" I was referring to.

>> Yes, king of assumption I am, as long as you're including irrelevant information to bend your argument to make sense.

Each time you have made an assumption you have chosen to assume the most extreme circumstances that might paint me in a bad light. You sending me links describing different kinds of cognitive biases is the worst kind of hypocrisy.
>> Since you posted nothing but rhetoric regardling your supposed skills

And the point to that would be what? You have already shown that you seek information and context only to use as fodder for additional attacks - I purposely provided you with no additional ammo for your rhetorical peashooter. By denying you further information I was allowing you to continue to make yourself look like a FOOL by letting you try to bolster your original and unsupportable arguments - arguments which you refuse to back down from due to your apparently over-developed ego and sense of self-importance.

You simply do not have enough information to form an INFORMED opinion and it is just killing you - and just keep going at it. I'm very amused by your completely predictable responses.

>> blah blah wikipedia article blah blah

I am completely aware of the content of each article you pasted in there. I am something of an expert on cognitive bias and I make a study of it. Maybe you could browse through the list again and honestly judge whether your arguments are the result of a mastery of the facts or pure knee-jerk emotion which you are desperately trying to prop up with weak arguments about statistics and probabilities. Do you claim to be free of cognitive biases? If not, then why is it not possible that your are WRONG in this argument?

>> It was the name of a dermatologist I knew in the Army
>>> Ah yes, the meat shield branch.

I know some people who would not appreciate that remark - all of whom (male and female) would totally deliver unto you a life-altering beating.

>> Unless I'm just making the assumption that you were in the Army, as opposed to the dermatologist

Again when faced with incomplete information, you fill in the gaps with whatever fits your distorted world-view. As it happens, the dermatologist was in the Army, I was not.

>>you tend to be unclear and then call people out when they make a reasonable assumption

I was purposely unclear while being completely accurate as a test to see how reliably you could be led into making yet another biased and elitist assumption. People like you are actually really easy to draw out; you as so unaware of yourselves that you can be induced to blunder over and over again.

>> but we folk are civilized here and we have rules.

HA HA HA HA! Just who is this "we" you are projecting your worldview onto? Slashdot? Maybe you should check with them before making su

Re:New Degree

[DWMorse]

I'd pick that up.

there is no shortage...

[snooo53]

I find it extremely hard to believe there is any shortage of IT workers capable of doing healthcare development/implementation. I've actually worked with development for the healthcare IT industry and I could explain to any reasonably intelligent IT person the compliance guidelines they need to follow in a couple hours. This stuff isn't hard if you know your way around a computer; it's requirements like any other project in the world has. This is a government handout, pure and simple.

Re:there is no shortage...

[beakerMeep]

You know, as a fellow developer, I often underestimate the colossal job IT has. It's not just a matter of following a few "compliance guidelines you can learn in a few hours." This sounds to me more like training on how to install, maintain, and support EMR systems. And not only that but how to help the non-technical people (ie doctors) learn them. If you think the job of IT supporting EMR systems is somehow akin to Homer Simpson pressing the "Vent Toxis Gas now" button, you're fooling yourself and insulting the whole of the IT industry to boot. EMRs are supposed to be capable of storing someone's lifetime history of any combination of symptoms and diseases and maintained under strict HIPPA privacy guidelines. And, the number of patients and doctors to support increases the complexity significantly.

I think your label of "government handout" is very presumptuous.

Re:there is no shortage...

[Mumpsman]

"This stuff isn't hard if you know your way around a computer" This is true. What's hard is finding recent grads willing to suck it up and work with 40 year old technology. If you want to submit claims to Medicare directly, you have to do it via ZMODEM on a direct dial 56k line. ATZ...ATDT PHONENUMBER...I do it every day. As for development. Do you know a lot of MUMPS programmers? Do you know a lot of programmers who know what MUMPS even is? This is what 90% of the currently used EMRs use as a backend/DB. VistA, EPIC, Centricity, Meditech...all of these vendor packages use M, and there have always been jobs for people with MUMPS skills. At least there has for the 15 years I've been doing it. With the influx of Government monay, the need will only increase. But try finding classroom instruction in MUMPS - it doesn't exist. You sound really confident though, so you are probably right.

Re:there is no shortage...

[Anonymous Coward]

As someone who as worked in healthcare IT for a grand total of 5 years now I can tell you that we (Americans) and in severe trouble. This entire industry needs to be scrapped and outsourced to private industry asap. The level of incompentency is simply staggering. You have to understand a very large portion of healthcare (beyone the large private HMOs) is delivered by state institutions. That means safety net hospitals, state institutions, and hospitals that operate inside or parellel to higher ed instituions. I work on an applications team of about 80 folks (yeah 80 no shit). Most of these peeps have Analyst in thier title and many came from other areas of the organization (nursing, med techs, etc). I think there are maybe 3 or 4 of us with a realistic IT background that have actual skills to solve problems....e.g., understand relational databases, know a scripting language, undersand basic operational guidelines of managing large complex systems. Basically the modus opandi here is to throw a bunch of money at our prefered vedors and hope that we get a positive result. Combine this with a culture of "never fire anyone for any reason" and you get the worst of the worst case scenarios. This isn't FUD and I am absolutely not blowing this out of propotion. If our education system operates on any of the same principles that I see here (and I think it does), then its starting to become really clear about why thats in the shitter too. On the other hand.....good place to be when there is 15% unemployment....for now.

Re:there is no shortage...

[rsborg]

I find it extremely hard to believe there is any shortage of IT workers...This is a government handout, pure and simple.

Though I'd agree with you, there are many types of "IT worker", and you would be surprised at what an average SAP, Oracle ERP, or BI consultant makes... do you think working with EMR/HIPAA is any easier than CRM, HCM or any of the other enterprise domains?

Re:there is no shortage...

[Attila Dimedici]

I haven't worked in healthcare IT. However, I do work in a related field that must follow the GxP guidelines (there are actually a couple of related guidelines here, the two I'm familiar with are Good Laboratory Practices and Good Manufacturing Practices). These are less stringent than the HIPPA guidelines. The thing is there is a lot of debate about what is necessary to correctly implement GxP regulations. I am quite sure the same is true of the HIPPA guidelines. Not only that but the new health care law contains mandates for a bunch of new regulations to be written, I am quite sure that a significant number of those new regulations will have requirements for the IT department in a health care organization and those regulations have not been written yet (and there is significant evidence that the relevant agency will nto have written them by the time they go into force according to the law itself).

Re:there is no shortage...

[Nerdfest]

So basically, it's like any other government IT department.

Re:there is no shortage...

[Ex-MislTech]

It appears MUMPS programming is about 50 years old.

http://en.wikipedia.org/wiki/MUMPS

If they'd redo it with something a bit more current and open source
they'd save money, time, and sanity.

Re:there is no shortage...

[Ex-MislTech]

Errr, a little over 40 yrs old.

Re:there is no shortage...

[countertrolling]

This is a government handout, pure and simple.

Worse than that, penalizing providers who don't go "electronic" will only hurt the small ones that can't afford such nonsense

Re:there is no shortage...

[CAIMLAS]

Apparently you've never done IT work, because you demonstrate a severe lack of understanding of what's involved.

(Oh wait, you're a developer; everyone's job but your's is easy!)

Altering a couple toggles or switching a few bits is not the half of it. While a developer can release a bug fix at any time they so please (or not at all, as so fucking often appears to be the case) IT tends to suffer directly for a developers' shortsightedness. The people who use a developer's software rely on IT people to make it work and to remain that way. Due to poor development standards (no/poor QC/QA, amateur hour, etc.) this is usually not a terribly fun or easy process. There are often dozens if not hundreds of "gotchas" you won't find anywhere else.

If it were just a matter of HIPAA compliance, I'd agree. But it's never that simple. There is a significant skillset for healthcare IT that the average IT monkey will never touch. Setting aside the need to not only understand the users' work process, but someone at 1st or 2nd level support in healthcare needs to understand medical terms and the roles and obligations of almost everyone in the organization.

Oh, and we've got to deal with doctors and nurses. You thought Chatty Cathy (the man hater in HR who just plays solitaire all day and talks on the phone) was a pleasant phone call...

Re:there is no shortage...

[defaria]

Don't kid yourself. Healthcare is no anymore complex or hard to do than many other businesses. IOW there's nothing really "special" about healthcare. It's a product, a service that can gain from automation. The users of the automation are doctors and as such are probably smarter than your average person to start with. Keeping someone's lifetime history is not difficult to do (perhaps it's difficult for you but not for most people) and HIPPA guidelines are no more difficult than say IRS guidelines yet many software companies handle them with no problem either. Stop thinking your special or that healthcare is special - it's not.

Re:there is no shortage...

[mrmeval]

The original was written on a government grant and is in the public domain.

This is a GPL/LGPL version which works with PostgreSQL http://www.cs.uni.edu/~okane/mumps.html "The Mumps Compiler is distributed under the GNU GPL and GNU LGPL licenses." This is of course not a whole IDE or deployable system as best I can tell and there is still code to be written to implement a system.

Re:there is no shortage...

[skids]

I've worked in a government IT department. Over 50% of the people there could at least write code of some form. The people that couldn't were managers or secretaries or frontline support, and not expected to anyway.

Really, I've worked in basically the exact same environment, one government, one private, and I do not see a difference between the private and public sectors when it comes to bureaucracy or competence. It just does not exist. There are just as many idiots in the corporate sector as in the public. I think it's a case of the grass always being browner on the other side of the fence.

It has more to do with what the government agency or corporation is actually doing than where they hale from. When I was interviewing for jobs in 00s the ONLY times I got the feeling that I was walking into a byzantine hellhole was in two industries: Health Care, and Financials (especially insurance.)

This is for existing IT field people

[syntap]

I always hate to RTFA and burst the naysayer bubbles, but "the training programs are aimed at people who already have health care or IT backgrounds -- not workers from other fields who have no previous experience or training in either discipline." As such I don't think it is dilutive in terms of IT worker salaries... they are taking people would would have been in the IT workforce and steering them to healthcare.

This isn't the old "train the janitor to develop complex systems" move from dot-com era. However the article does not seem to address the possibility of recipients of this training going overseas with the expertise.

Re:This is for existing IT field people

[Sarten-X]

I'm not very certain, since I only work with US healthcare, but it's my understanding that the big overseas job markets (Europe, Asia) have had EMR for a long time already. The US is the only place with a huge demand for EMR experts.

Re:This is for existing IT field people

[NNKK]

The correct answer remains the same: the industry need to offer better compensation.

Hah! You could offer me a million bucks a year and there are still certain fields I WILL NOT work IT in. Health care is one, finance is another. I do not want the stress of the environment, nor the knowledge that someone's life or livelihood may hinge on whether I inverted an 'if' test.

Compensation is not the only thing that keeps smart people out of health care.

Windows != IT

[SgtChaireBourne]

Making it a general programme for people with health care experience will work. Getting even into an entry level medical job entails around 6 years of school plus at least a year or two of work experience. There are exceptions for some specialties, like phlebotomy, where the training period is shorter. Even then it still is not knowledge that can be faked or made up for in a few months of side reading. However, legitimate IT backgrounds, if present in a small ratio, can provide skills and insight not available to those who have spent years getting domain expertise in medicine.

What can kill the project dead, dead, dead is if people with Windowz Skillz are allowed to pose as IT workers. Microsoft products have little to do with IT except that they are placeholders blocking legitimate, functioning protocols, formats, applications, and operating systems. The kind of slug that tries to make a living of of Microsoft products lacks the ability to analyze and solve problems. They're usually either rote memorization monkeys or sales marketeers. The bullshitting and lying that accompanies both the rote monkeys and the marketeers ends up costing lives when it happens in clinics and hospitals, especially when the ongoing Windows disasters collapse the hospital.

In most cases it is easier to add beginner, basic 'IT' skills to people with domain expertise than it is to try to shoehorn people without medical training and experience into the job. That and it's easier to just throw out all closed source rather than waste resources culling just the Microsofters.

Re:Windows != IT

[markdavis]

Unfortunately, healthcare in the USA (and many other countries) is *extremely* entrenched in Microsoft products (trust me, I know) and closed source software. The whole "giving out money for EMR's" has been a disaster. Special interest groups have pretty much ensured that all the money will go only to "approved" or "certified" systems, which are all closed-source, commercial packages (and almost all also running on MS-Windows).

And guess what those companies did? They RAISED THEIR PRICES for that software by the same amount of money that is being pumped into handouts to hospitals and physician groups!

Instead of pumping billions of dollars into closed source, single-platform, commercial products that lock in customers, the Fed should have directed that money into open standards, open source, and multi-platform research and coding. You want to talk about savings? Imagine how much the industry could save if there was at least one robust, flexible, open-source, multi-platform EMR? (And no, that isn't OpenVistA). Let EMR companies make their money off custom (but open) additions, installation, training, support, hosting, etc.

Re:Windows != IT

[bieber]

Surely you jest! Can you imagine the mayhem that would ensue if the terrorists could see the source code to our hospitals? /s

Re:Windows != IT

[Luke has no name]

Why isn't Openvista good?

Re:Windows != IT

[markdavis]

I don't want to slam OpenVistA/EVistA/WorldVistA (or whatever people want to call it)... but from what I know about it:

1) It is an ancient system
2) It is developed in what is now an obscure language (MUMPS)
3) It is barely multiplatform (especially since there is no Linux nor MacOS GUI client)
4) The design is very rigid- for example, it can't really be used in nursing homes nor rehab facilities because it is designed around acute care

Granted, things may have changed over the last few years in ways I am not aware of, but I suspect it is pretty much no different than last I looked.

Re:Windows != IT

[DigiShaman]

What can kill the project dead, dead, dead is if people with Windowz Skillz are allowed to pose as IT workers. Microsoft products have little to do with IT except that they are placeholders blocking legitimate, functioning protocols, formats, applications, and operating systems. The kind of slug that tries to make a living of of Microsoft products lacks the ability to analyze and solve problems. They're usually either rote memorization monkeys or sales marketeers.

You self-righteous bastard!

Let me clue you in on a few things. Most of the corporate worlds runs on Windows, and often in a complicated enterprise environment. Small businesses are either running a Windows SBS server, Google Apps, or stand alone machines in "workgroup" mode. To complicate matters even more, employees use PDA/Phones of all types with Linux servers, VMWare, and Apple computers thrown in the mix. I doubt you even work in IT, because if you did, you would know modern networks are now heterogeneous. The fact getting all this shit to play nice with each other requires a vast knowledge base and skill set. So ya, fuck you and the horse you rode on.

Re:Windows != IT

[SageMusings]

What can kill the project dead, dead, dead is if people with Windowz Skillz are allowed to pose as IT workers. Microsoft products have little to do with IT except that they are placeholders blocking legitimate, functioning protocols, formats, applications, and operating systems. The kind of slug that tries to make a living of of Microsoft products lacks the ability to analyze and solve problems. They're usually either rote memorization monkeys or sales marketeers.

How did this comment get moderated up? The boilerplate "I hate Microsoft" comment?

You appear to be the sort of shrill person that would not even make it past the first telephone interview for most dev shops.

Re:Windows != IT

[SageMusings]

What can kill the project dead, dead, dead is if people with Windowz Skillz are allowed to pose as IT workers. Microsoft products have little to do with IT except that they are placeholders blocking legitimate, functioning protocols, formats, applications, and operating systems. The kind of slug that tries to make a living of of Microsoft products lacks the ability to analyze and solve problems.

Mommy not give enough love when you were little?

Every person I've ever met who sounds like you is also the same type of person that would never even get past the first telephone interview with most dev shops.

Re:Windows != IT

[JoeZeppy]

And guess what those companies did? They RAISED THEIR PRICES for that software by the same amount of money that is being pumped into handouts to hospitals and physician groups!

citation, link or proof substantiating this claim, please?

Re:Windows != IT

[gcharles]

Could not agree with you more - same BS - different day...Will the never learn!!!!!

Re:Windows != IT

[SonnyDog09]

While many of the Healthcare IT front end apps run in Windows, there is a lot of Unix running behind the scenes. The Cloverleaf Interface Engine that I worked on ran on IBM AIX, and it ran like a tank. We had virtually no downtime. The Unix admins begged us to stop the engine so that they could perform maintenance on the box. We told them that if they needed the engines to be taken down, they should call the downtime and let it count against their downtime stats.

Regarding certification, if you do not have a certification requirement, how can you be assured that the product actually performs the functions that an EHR system is required to perform? The cost of certification is the cost of doing business.

Would you be upset if your doctor was using other medical supplies that were not certified?

Re:Windows != IT

[Orestesx]

Come back in 5 years when your system is developed because that's about what it would take to develop your system from scratch, with a hundred people on your development team. You have no idea just how much software is needed to actually run the applications for all the different departments. Prices are getting raised because the vendors are getting bombarded by requests from hospitals that have to implement now because they want their share of the pie in 2011. Not 2015. These vertical markets are closed source and proprietary for a reason: it takes a singled-minded focus to actually get this stuff right.

As for running on Windows, that's just what the customer wants. Our server software runs on Linux as well, but guess what, we don't ship it because customers, because outside of a small minority, they don't want it. Their system administrators are experienced with Windows. It would be trivial to change to Linux on the server. Desktop is a different matter entirely, but that lock in comes from Microsoft themselves (most hospitals rely heavily on Word).

In short, don't blame the health care software companies for giving the customers what they are asking for. We actually our not big fans of the regulation and setting of requirements by the gov't. We appreciate the business it brings in but we were doing just fine for decades without their help. We could actually survive on just our installation and support revenue (albeit as a smaller company), but whose software are we going to support? You want the gov't to step in and write a bunch of software that's already been written? How would we support software that we can't change?

Your points are valid, but only if you disagree with the fundamental concept of an economic stimulus. It's working very well in that respect and has created a lot of jobs.

These opinions do not necessarily reflect those of my employer.

Re:Windows != IT

[markdavis]

Thanks for the info.

It just blows me away that nobody has written a real (not mono crud) Linux/Mac *client* for VistA! Or perhaps even a multiplatform Java client or [true] web based client. But even if they had, I can't see VistA being useful for any of ICF/SNF/RH/AL/HHA facilities, which is a HUGE chunk of the healthcare market (and growing far faster than any other segment). :(

As an IT worker in the healthcare industry...

[WiglyWorm]

... I say "bring it on". The IT department at the hospital I work at is bloated, inefficient, and ineffective. A lot of it has to do with our leadership and lax corporate culture, but a lot of it also has to do with the fact that 25% of our IT department is made of nurses who have not a clue about technology, and the other 75% of it is made of technology people who know nothing about medicine/hospital work. I can honestly say that some of the wacky decisions the IT department has made out of ignorance have negatively affected our patient care. I doubt it's killed anyone, but it has caused unnecessary delays and confusion.

Re:As an IT worker in the healthcare industry...

[SonnyDog09]

My experience is that Healthcare IT is almost as conservative as healthcare. They are using systems and methodologies that are old. The deployment of EHR and HIEs will create jobs for IT to do things like network administration, database admin, backup/recovery, etc. There is going to be more work than the talent that is available. I, for one, will be happy for all the help that I can get. If I don't have to explain the basics of encounters and the importance of security to the newbies, I will be a happy man.

Re:As an IT worker in the healthcare industry...

[user_moniker]

Agreed with the circus part. I work as the sole IT person for a small company who decided to build their own EMR. First, using a consultant. Now, I make the changes to the software. The owner and the managers have created a very reactive environment, where the business processes change almost daily. They tell me what they want, and I have to implement it. I don't think the thing is nearly as compliant as it should be. The entire system is custom made, the company processes are built around the software. The management decided to flush out all the long-running employees, and now I am constantly running around answering questions. The people we have know "what" to click on, but don't know why. My project completion time has ballooned from hours to weeks. My manager said if they bought an EMR, it would be easy for the vendor to convert all of our data (250 tables, and 1M records). The pickiness of the owner, managers, and the industry make it almost impossible to implement a sane design, a vendor would have no hope of meeting their "requirements." They seem to have no idea what a nightmare hole they have dug. I have been holding things together, but the hole gets a little deeper every day. It's the healthcare people who need IT training. Even some rudimentary logical training would help. Your computer cannot read your mind; it cannot think. If it tells you to do something, it doesn't mean you have to do it. It means it was programmed to pop up the dialog box. You still have to know what you are doing. Yes, you have to use the note format provided. No, you cannot have a special note just for yourself. Yes, you have to have internet access to access the internet. When you print something, the words on the paper cannot change when the data is updated?! Just because you took grandma's blood pressure, doesn't make you God. Just type it in the box labeled "blood pressure" so we can all get on with our day.

Re:As an IT worker in the healthcare industry...

[hsthompson69]

The problem I think you describe isn't one of the lowly IT worker, it's one of the clueless IT manager. Leadership counts, and even a group of the best people aren't going to be able to accomplish much when hampered by the management-idea-du-jour. They'd probably be better off by offering subsidies to MBA programs for clued in IT workers, so that you can get better blood in the ranks that matter.

About every 16 months, we have another reorg. The new boss of course decides that anything done before was wrong, so they've got to change it. As a consequence, any IT project that takes > 16 months (and most reasonable sized ones do) ends up switching gears to the detriment of the end product. In the kind of IT environment where leadership is transitory, top down change is done without thinking about the consequences, and where it is not unrealistic for a project manager to spend 5 years working and never ship a single damn system, even the best IT developer is screwed.

This isn't even bothering to take into account the sheer amount of process health care IT has as overhead - no kidding, even the best IT developer in health care probably spends, on average, less than an hour programming per day.

Re:As an IT worker in the healthcare industry...

[oldhack]

"I doubt it's killed anyone, but it has caused unnecessary delays and confusion."

I doubt that statement.

You think your typical corporate setup is messed up, you have not encountered big hospitals, run by for-profit "health care systems" battling and colluding with unions, doctors, ungodly regulatory regimes, MediCare/Medicaid bureacracy, drug companies, medical schools, insurance outfits, and, of course, lawyers. Throw in a pervasive ethical ambiguities, too.

Medicine seems to be one of the few sectors still expanding, but seriously, it's not much better than finance bubble. Can't build economy by treating diseases.

Re:As an IT worker in the healthcare industry...

[DoofusOfDeath]

25% of our IT department is made of nurses who have not a clue about technology, and the other 75% of it is made of technology people who know nothing about medicine/hospital work.

That's 100% total. Which group are you in?

Re:Works out to $30000 per worker

[ferd_farkle]

"Take that $150M, divide it by the 50K workers, and come up with a bill of $30000 per worker."

You may have left your sliderule out in the rain.

This is just the rise of evil diploma mills

[rsilvergun]

It's been going on for some time. A bunch of wealth asshats bought out a ton of regionally accredited schools and turned them into diploma mills for soaking up taxpayer money in exchange for fake educations. IT is really popular with these bastards because it's cheap as hell to train and the rubes these 'schools' prey on think there's lots of easy money in computers because they find them hard to understand.

There's a movement in the Obama admin to take away these pseudo-school's eligibility for gov't if they can't show 80% of their graduates get jobs in their field and actually enforcing it. Right now they're skirting around these regulations by claiming stuff like call center work is 'IT'.

Anyway, if the gov't really gave a flying fsck they'd stop the H1-B Visa program dead. At any rate this is just more free money for the rich. Yea America.

Re:This is just the rise of evil diploma mills

[rainmayun]

I doubt any accredited four year college or university could show that 80% of their graduates got jobs in their field. There's no mechanism for requiring that graduates stick to their field of study, and many find happiness doing other things, even if their income over time is reduced.

Re:This is just the rise of evil diploma mills

[b4dc0d3r]

http://www.google.com/search?q=crack+down+on+diploma+mills

Lots of state and federal movement to do exactly the opposite of what you're saying - too many to list, so read up a bit.

Re:This is just the rise of evil diploma mills

[Required Snark]

Very true. I have a friend who teaches Computer Animation for visual effects, and he has literally lost jobs because he actually tried to teach useful skills to the students. That made it management unhappy, since it showed that most of the students did not have the basic academic qualifications to do the work. What the schools wanted was to teach by rote, so that almost anyone could learn to punch the right buttons to and do the tutorials supplied by the software vendors. A lot of the kids had done poorly in high school, or failed in other post high school settings, so the idea was to make them "computer artists" who could get high paying cool jobs working on games or for Pixar. Just like it said in all the TV adds. Granted, some of the students had talent and a good working attitude, but they were also being short changed by the low standards. Although not 4 year accredited institutions, these are still diploma mills.

The government focus on healthcare is troubling

[Average_Joe_Sixpack]

Healthcare is a service that has evolved to benefit productive societies. It is mostly unexportable and can not sustainably drive GDP anymore than government spending can. Thus the government's push to expand the sector while the rest of the productive economy is contracting is nothing more than a malinvestment which will result in a weaker economy overall.

Re:The government focus on healthcare is troubling

[shaitand]

A cut in healthcare expenses puts just as much capital in consumer pockets as a tax cut. Arguably, unlike the tax cut, it puts the capital in the consumer pockets that are likely to need it.

Consumers then spend that money, into the productive economy but without screwing up a budget surplus.

Re:The government focus on healthcare is troubling

[Sarten-X]

Better healthcare leads to more healthy people, which leads to more productive people, which leads to a better GDP. That's one angle.

Another is that American healthcare is a huge industry, and the processes that are effective there can be expected to migrate into other industries easily, having passed the test of scale. It's hospital EMR today, leading to the fabled paperless office down the road.

Re:The government focus on healthcare is troubling

[Overzeetop]

I'd argue that it is partly exportable, as some people come to the US for medical procedures, but your point stands that it is primarily local.

Of particular importance, and as mentioned by some sibling posts, is that the federal government spends an inordinate amount of money on healthcare. This could have cost implications which would potentially lower (albeit a small amount) the cost per procedure in overhead and administrative expenses. Will that be reflected in the bills we pay or in the size of the house the head of Radiology can build on Water Island?

The other factor here is that the world is a closed system which is getting more efficient over time, so there is a limit to exports to bail us out.

Re:The government focus on healthcare is troubling

[alphaseven]

Here's a chart showing a very strong correlation between health care costs and wages. For a period in the 90s health care costs grew very slowly and wages shot up, and when health care costs started rising more sharply during the 00s wages became stagnant. It makes sense that an employer would spend less on an employees wages as the cost of their benefits go up.

Re:The government focus on healthcare is troubling

[Attila Dimedici]

A cut in healthcare expenses puts just as much capital in consumer pockets as a tax cut. Arguably, unlike the tax cut, it puts the capital in the consumer pockets that are likely to need it.

Consumers then spend that money, into the productive economy but without screwing up a budget surplus.

That's great. Now when is somebody going to do something to reduce healthcare expenses?

Re:The government focus on healthcare is troubling

[hsthompson69]

Better healthcare leads to more healthy people, which leads to more productive people, which leads to a better GDP. That's one angle.

But that's patently not true. Getting healthcare does not necessarily make you more healthy, and even when it does it does not necessarily mean a more productive person -> take your average stroke victim, who racks up a bill of hundreds of thousands of dollars in surgery and rehab. This person is never going to be productive again. Yes, we've kept them breathing, and yes, one day they may be able to walk with a stroller, but they'll never add to the GDP again.

The real problem with healthcare, of course, is that we've set it up primarily to treat the *symptoms* of chronic disease while not addressing the *causes*. Diabetes, heart disease, obesity, cancer and other chronic diseases are all "treatable" in a myriad number of ways, but the cause, excessive carbohydrate intake, is actually encouraged by our USDA food guidelines.

Ironic, our government subsidizes the industries that create carbs and cause poor health (HFCS being ultra cheap because of corn subsidies), and now our government is going to subsidize the industry that treats the symptoms caused by these subsidized carbohydrates. If they'd just stop fucking with the levers on the machine, maybe the machine could take care of itself.

Re:The government focus on healthcare is troubling

[Sarten-X]

Things like strokes are a very small percentage of what hospitals actually deal with. Instead, they deal with a lot of broken bones and other "normal" things like complicated pregnancies.

What's a hospital supposed to do to fix the diet problem, anyway? Send scalpel-armed surgeons into the street to stab anyone eating a cheeseburger? By the time a hospital sees the patient, they've already screwed up their body to the point where treating the cause is practically impossible. Most healthcare systems I've ever been involved in also already run giant public-education campaigns pushing for better diets. They usually are ignored.

Healthcare takes sick people and (usually) makes them healthy again, enough that they can go back to their normal lives. Polio has practically been eliminated. Diseases that were a death sentence a few decades ago are now just minor inconveniences, and those people can go on leading full (and productive) lives.

Re:The government focus on healthcare is troubling

[hsthompson69]

Instead, they deal with a lot of broken bones and other "normal" things like complicated pregnancies.

Actually, as a percentage of cost, chronic disease treatment, such as that for diabetes, heart disease, cancer, etc, is much more than the broken bones or pregnancy category.

Most healthcare systems I've ever been involved in also already run giant public-education campaigns pushing for better diets. They usually are ignored.

It would be better off if they were ignored, but unfortunately, they're not. The problem with the giant public-education campaigns is that they prescribe the wrong diet. They say stay away from saturated fat, eat low fat in general, and bulk up on cereals and grains. The common wisdom on "healthy diet" from our government and healthcare providers is actually the cause of most poor health.

Polio has practically been eliminated.

Which is my point - polio hasn't been eliminated because we've gotten better and better at treating symptoms (which we currently do for chronic diseases), polio was eliminated because we attacked the cause. Over the past 30 years, health care has gone from acute care to chronic care, less about making us healthy again, and more about treating symptoms with more and more expensive and often useless methods.

Diseases that were a death sentence a few decades ago are now just minor inconveniences

And the sad part is that our current dietary guidelines promote these chronic diseases. Whether or not the inconvenience is "minor" or not aside, we currently run a health care industry that causes most of the diseases that they treat the symptoms of. It's as if nobody bothered to find a vaccine for polio, but instead developed drugs, surgeries and other treatments to mitigate the symptoms, while at the same time suggesting to the general public behaviors that would increase the incidence of polio.

those people can go on leading full (and productive) lives.

This is generally true for acute care (fixing the broken bone, fighting the infection or virus caught by accident, etc), but for a lot of chronic care I think the evidence is pretty clear that while we keep people alive longer, we don't necessarily keep their lives productive or full, Darth Cheney being the obvious exception.

Re:The government focus on healthcare is troubling

[Sarten-X]

The original comment was regarding GDP and the general productivity of patients after being treated. Regardless of heart disease's cost, it's now possible and normal for a heart attack victim to return to a productive life. Diabetes no longer means a "short, disgusting, and painful" life, but one of manageable testing and treatment. If indeed these chronic diseases make up the biggest cost in healthcare, then it's certainly offset by the return to productivity.

Even if the American diet is the cause of American health problems, that doesn't change the fact that there are people sick now, in hospitals and clinics, trying to get back to a normal life. Curing the cause works wonderfully in the long run, but how far off is that for diabetes or cancer? Ten years? Fifty? Two hundred? Until then, treating the symptoms of the disease is equally important, and it's the relief of symptoms that results in the majority of patients returning to productive lives. This isn't the 17th century anymore. Leaving a hospital usually means you're as capable as any other person, even if you do have to take a few pills to maintain that status.

Re:The government focus on healthcare is troubling

[hsthompson69]

Diabetes no longer means a "short, disgusting, and painful" [wikipedia.org] life, but one of manageable testing and treatment.

Ironic, of course, that the dietary guidelines put forth by our government actually creates Type 2 diabetes, which we then cheerfully treat. Or perhaps you were just talking about Type 1 diabetes.

Curing the cause works wonderfully in the long run, but how far off is that for diabetes or cancer? Ten years? Fifty? Two hundred?

The answer to that question has more to do with political inertia and the inability of government to admit error than any scientific or technological hurdle. Type 2 diabetes, and the vast majority of cancers, can be laid at the feet of the high-carbohydrate dietary guidelines we've been given. You could change the world in a year if we just were willing to admit our error for the past 30 years.

My personal bet, we've got 20 years before it becomes common knowledge, once again, that bacon is healthy for you, and bagels are sugar-death-bombs.

treating the symptoms of the disease is equally important, and it's the relief of symptoms that results in the majority of patients returning to productive lives

I'll just have to disagree with you on that one. It may be important, but it simply cannot be seen as equally important. And I think the big problem with the "productive lives" argument is that the costs associated with the chronic disease care really should be counted against any productivity. So if your average 100k salary senior programmer gets to work another ten years thanks to 2 million dollars worth of medical interventions, you're lost the game.

I think that the past 30 years of increasing medical expenditures vastly outpacing inflation shows just how important it is to get to the causes of disease, rather than the symptoms. We keep kicking the can down the road, focusing on what is immediately underfoot, and our shortsightedness ruins us in the long run.

Re:$3k/worker

[Sarten-X]

EMR is absolutely awesome, and with regards to the government push for it: it's about time.

I'm assuming your "unconstitutional" comment is with regards to privacy. I'm also assuming you have no idea how things currently work.

The concept behind EMR (Electronic Medical Records) is simply taking your medical data, previously filed on paper, and instead storing it on a computer. All the previous privacy regulation (mostly HIPAA) applies, as well as extra regulations (HITECH). The information is still behind firewalls and physical locked doors. The biggest operational difference is that now third parties (like insurance providers, pharmacies, specialists, labs, researchers, etc.) can get access to your data much faster, once they have enough credentials.

In the days of paper, a third-party representative would have to come into the hospital, go to a big room full of paper, stand there making copies of the records they need, then go back and have someone transcribe them all into a computer. For a while, all your data would be carried in a briefcase down the street, easily available for theft. Among the data the third party needs is a lot of other information they don't, but since it's on the same form, they see it anyway.

Now with EMR, the third-party computer system can just connect to the hospital, and supply their credentials to gain access. At the hospital I work with, that means two rounds of username/passwords, plus a physical token. That's far more secure than simply needing a hospital badge and a good excuse. The records are pulled by request, so there's no extra information given. If the third party (like a pharmacy) doesn't need to know about your religious preference (kept by the hospital in case they have to call for last rites), they simply don't get it. Once the electronic medical data's in transit, it's also more secure. There's no briefcases to grab here. Instead, there's an encrypted connection inside an encrypted VPN. When the data arrives at the third party's office, it's easily formatted for their system, with no extra people staring at it.

All in all, EMR is far better than old processes. It's faster, more reliable (think of the stereotypical doctor's handwriting), and more secure.

Digital records are NOT a good thing

[shaitand]

I've been in hospitals with digitized systems. The nurses simply don't have the time to do data entry on top of their jobs.

It's hard enough grabbing the pills and running room to room without having to stop after each one, scan the cup into the system, fix the system when it doesn't log the cup correctly or the patient opt'd not to take the drugs yet or has a script that gives a different number of pills at night vs day or spit the pills out and she needs to get more.

Now you have nurses with several cups of pills they have to hold because the digital system already has them checked out. Patients who can't get medication because the nurse can't just go get more pills to replace the ones she knows weren't taken. People who aren't attended to at all because the nurse has to spend an extra 15 minutes per patient per room stop to handle data entry overhead.

Re:Digital records are NOT a good thing

[Excelcior]

Working in the medical field myself, I can tell you that digitizing makes things faster, not slower. Back when it was all paper, you still had to take just as many notes and chart just as much stuff... you simply had to do it with a pen, and if you made a mistake, you had to cross it out in red, file it anyway, and go get a blank chart to copy it all onto. Then there was also the travel time aspect; when patient C was issued a new RX, you had to physically walk down to records to get the medication history and allergies report for the doctor. Now you just pull it up on the console in the operatory. All notes that are required now have always been required; the only difference is that now people can enter them with a keyboard, instead of needing good penmanship. Trust me, getting a records transfer from another clinic that does not use electronic records is always a pain; do you have any idea how poorly some nurses & assistants can write?!

Re:Digital records are NOT a good thing

[FlyingGuy]

Well is it really better? When my son goes to the doctor for his annual checkup ( a 9 year old ) the doctor spends most of the time logging into ( if it works ) some windows box, then getting to the screen to lookup my son's medical records, then typing in why he is there. That takes about 1/3 of the scheduled slot. Then the exam followed by more intermediate typing, followed by more questions from him, answers by my son, me and his mother ( if we can both be there ) followed by yet more typing.

All in all about 50% of the scheduled visit is just the doctor fucking around with the computer.

bad in the old ways the doctor made a few salient notes here and there and 90% of the time was used to address issues and or questions about my sons health instead of dicking around with a computer.

Sometimes automation is good other times it just gets in the way of what you are trying to do.

Re:Digital records are NOT a good thing

[FlyingGuy]

Pls see the post above.

Re:Digital records are NOT a good thing

[FlyingGuy]

Sorry I was replying to the other post below.

Re:Digital records are NOT a good thing

[Sarten-X]

So what happens to those notes? Are they copied into a permanent record? Are they made available to anyone who needs them? Or are they ignored, as in the case of my father, who suffered an allergic reaction to a surgical disinfectant, because his allergy information was compared (by a human, mind you) against the list of materials to be used, and they missed that one note?

Paper records are great for recording notes that the doctor never wants to see again. Anything that might be useful in the future should be put into electronic form, and kept ready for use in an emergency.

It sounds like your doctor is just following the normal computer-using routine: using Windows, logging out when leaving the room, hunt-and-peck typing, et cetera. If you want to complain about something, go complain to the people who recommend those kind of systems. The doctor could carry around an always-logged-in laptop and take some typing lessons, and you'd see a huge improvement in the time usage. EMR isn't the problem.

Re:Digital records are NOT a good thing

[b4dc0d3r]

Your doctor needs a medical transcriptionist, which would raise costs, and have the staff open the patients' charts before you are called back. If you have a complaint, this person is providing a service and you are free to share your concerns or find a new doctor. I'd share my concerns because it will benefit all of the doc's patients in addition to yourself.

Blaming technology for its incompetent users requires you to distinguish which is the cause of the problems. A child services applciation that automatically closes abuse cases after inactivity, requiring users to falsify records in order to keep them open, and makes support payment processing impossible is a failure of technology (UK govt vs. EDS). Your doctor dicking around is a failure of training, and a failure of you to complain.

Re:Digital records are NOT a good thing

[SonnyDog09]

bad in the old ways the doctor made a few salient notes here and there and 90% of the time was used to address issues and or questions about my sons health instead of dicking around with a computer.

The problem with the "bad old ways" was that no-one could read the doctor's writing. If the data is entered into the EHR, not only can all of the other care providers that see your son understand what your doctor entered, but if the entries are coded correctly using one of the standardized medical vocabularies like SNOMED-CT, for example, then the computerized decision support systems can look at your son's condition and alert the provider before the inject him with something that will kill him. Being able to see your son's complete medical history, including medications, conditions and allergies will go a long way to prevent medical errors. If I cannot read your doctor's hand written notes, there is no medical history. One doctor described having to prescribe medications without being able to see the patient's current medications and medical history as "prescribing blind."

Re:Digital records are NOT a good thing

[khallow]

I've been in hospitals with digitized systems. The nurses simply don't have the time to do data entry on top of their jobs.

Sounds like those nurses didn't have time to do whatever the digital system replaces either.

People who aren't attended to at all because the nurse has to spend an extra 15 minutes per patient per room stop to handle data entry overhead.

Then hire more nurses so they can do their jobs. What you're tell me is that a 1000 bed hospital which I guestimate to require 12,000 bed visits (assuming a full hospital and one visit per two hours on average over the course of a day) would require roughly 125 years of solid labor per year in order to keep up with the alleged data entry overhead. That's somewhere around 350 nurses just devoted to data entry. I doubt hospitals that have digital entry require that much manpower for the purpose.

Re:Digital records are NOT a good thing

[HereIAmJH]

The problem with the "bad old ways" was that no-one could read the doctor's writing.

A while back I changed doctors and had my medical records transferred from the old clinic to the new one. On my next appointment the nurse was going through them to make sure they had all the important facts from my history. The notes from one visit were perfectly detailed, but unfortunately the previous doctor failed to write the date of the visit, which made all the notes nearly worthless because they couldn't be used along with other visits to determine any kind of trend.

Re:Digital records are NOT a good thing

[Dr_Barnowl]

When I was still practising I worked out I was spending around 3 hours a week just transcribing prescription cards from full ones to fresh ones because the card served as the nurses administration record as well - a total waste of my time as a qualified doctor, but legally it had to be me because they were prescriptions.

Re:Digital records are NOT a good thing

[shaitand]

"That's somewhere around 350 nurses just devoted to data entry. I doubt hospitals that have digital entry require that much manpower for the purpose."

You are right they don't dedicate the manpower they just don't keep up or cut corners to keep up.

"Then hire more nurses so they can do their jobs."

What purpose does the system serve if you need MORE staff to use it? Are we just going digital for its own sake? The point of the system is to reduce errors and cut labor requirements.

Re:Digital records are NOT a good thing

[Hognoxious]

Computers are just a fad. Businesses will soon wise up and go back to employing armies of clerks all scribbling away with a dead duck's wing dipped in soot.

On second thoughts, scrub that. I'm not convinced by this here new-fangled paper. Clay tablets are where it's at.

Re:Digital records are NOT a good thing

[shaitand]

I think the problem isn't so much the hospital as the FDA. It's like copyright holders in the digital world. Digital lets them enforce more restrictions, so naturally if you go digital they require them.

Re:Digital records are NOT a good thing

[khallow]

You are right they don't dedicate the manpower they just don't keep up or cut corners to keep up.

Then they aren't spending 15 extra minutes per visit. I merely noted that your assertion implied a significant increase in labor which didn't appear to be true.

What purpose does the system serve if you need MORE staff to use it? Are we just going digital for its own sake? The point of the system is to reduce errors and cut labor requirements.

If it significantly reduces errors, then that in itself is a vast improvement over older systems even if it does need more staff. For example, a recent report claimed that almost 200,000 people die a year in the US (the news story implies that there was somewhere around 75 million hospitalizations over the time period of three years, meaning we have more than half a percent death rate from medical error in hospital stays for the data in question). That same report indicates that there is massive error in the system (roughly 3% of all the hospitalization records had some sort of "patient-safety incident" in them). In comparison, auto deaths are somewhere less than 20% of that number.

Re:Digital records are NOT a good thing

[khallow]

With a paper system, this would consist of drawing a line through a word and initialing the correction. It would take about ten seconds. In the electronic system, correction of the error took over three and a half minutes.

[...]

Additionally, there is a rudeness with a pure electronic system. Instead of glancing at a paper chart and taking notes while looking patients in the face, I have to turn away from them and log into a computer, wait for programs to load, and enter data while talking to them. It is just plain tacky.

Sounds like a terrible interface. I didn't take the original poster seriously, but this really is a serious problem that I think will kill people and drive costs up.

Re:Works out to $30000 per worker

[PolygamousRanchKid]

Actually, that's the way government math works. The representative wrings out $3000 from Congress. He returns to his constituency and yells, "Y'all gettin' $30000!"

Being off by an order of magnitude is "compliant with government levels of computational accuracy."

Federally supported open source alternative

[rainmayun]

You might be interested to know that the federal government (under the guidance of HHS) is funding and fostering community support for development of an open source health information exchange framework. This includes the software to run the system that health care providers (think hospitals, insurance, HMOs, etc) can install and run, and administration of the network backbone to connect them (also known as the NHIN).

http://www.connectopensource.org/about/what-is-CONNECT

Outsource?

[flyingfsck]

This won't work, since it cannot be outsourced to India.

Bizzarro World - health IT closed, oil IT open

[dbIII]

The really bizzare thing is that while the oil industry has had open standards for file formats and other elements for decades the health industry has been steadily closing things off.

Re:Bizzarro World - health IT closed, oil IT open

[countertrolling]

Who cares about open formats if the records are just going to be falsified anyway?

Re:Bizzarro World - health IT closed, oil IT open

[dbIII]

Nice article BTW, unfortunately a similar one could have also been written about the electricity generation and chemical industries since the early 1990s. What clueless MBAs consider "acceptable risk" engineers see as the criminal negligence it actually is, and there's plenty in that article.
A bit offtopic though, hence the previous post.

Re:Bizzarro World - health IT closed, oil IT open

[Orestesx]

Open standards for information exchange is not even close to the same thing as open software.

Re:Bizzarro World - health IT closed, oil IT open

[Orestesx]

And, they already exist in the health care world. Look up HL7.

Helps me out anyway

[Tailor]

In Albany, NY there are a few job openings as a result of this. I saw a very simple technology specialist position open up that is paying $50,000 + government benefits for kids straight out of college. The economy is fine as long as you are in the right field.

Uh, that's a GOOD thing.

[AnonymousClown]

Most of these peeps have Analyst in thier title and many came from other areas of the organization (nursing, med techs, etc). I think there are maybe 3 or 4 of us with a realistic IT background that have actual skills to solve problems..

My wife is currently using this iPhone/iTouch medical app for her NP program. Long story short, the UI and the selections make absolutely no sense from a practitioner's standpoint. Once, after swearing at it, she asked what the fuck they were thinking. I answered, "Honey, it was probably designed and developed by programmers that have no clue what a practitioner needs or uses in a system." I know, I've worked on some medical systems for a very large medical software company that everyone in the business would know who they are and I've had to rework a few things myself because they didn't work from a practitioner's perspective.

So, it's a good thing that at least some of the practitioners are involved.

Healthcare IS exportable, and becoming more so

[pkbarbiedoll]

There is a huge push for telemedicine right now. Lots of money is going into developing systems where docs can perform consultations via internet.

An objective of all of this is to further reduce healthcare costs by offshoring many routine examinations to Bangkok or other third world physicians. Your tax dollars at work.

Re:Healthcare IS exportable, and becoming more so

[h4rr4r]

So my tax dollars are being used to make this market more efficient? Sounds great to me.

Shortage Or Willing?

[codepunk]

I think it has more do with finding IT workers willing to work in the field then it does a actual shortage. I can only speak for myself but I just don't see many positive aspects to working in health IT.

Insource

[pkbarbiedoll]

No, it's easier to insource indian workers with H1-b's.

If ALL the big hospital/healthcare companies..

[Paracelcus]

would stop discriminating against older IT workers (over 40) there would be no shortage!

Re:If ALL the big hospital/healthcare companies..

[SonnyDog09]

Actually, I see lots of "old IT" folks working in Healthcare IT. At the hospital system that I worked for, there were many folks who had been working there for over twenty years. Also since the life span of systems in healthcare is quite long, you tend to need older IT folks to maintain a system that is over ten years old, as they don't teach kids that technology in school any more. There is a lot of cruddy, old Healthcare IT written in MUMPS, and very few who are under the age of 40 know MUMPS.

Re:Works out to $30000 per worker

[h4rr4r]

1. your math is wrong
2. 30,000 would pay for 1 maybe 2 years. Perhaps went you went to college this was not the case, grandpa.

MUMPS

[HereIAmJH]

If they'd redo it with something a bit more current and open source
they'd save money, time, and sanity.

Make a .NET version, it could be the new C#.

Of course, they could just pay me to finish the conversion to Delphi. (VistA already utilizes Delphi and Java along with MUMPS) Maybe then we could build a large enough market to re-launch Kylix.

I said there was a movement

[rsilvergun]

I didn't say there was a successful one. The owners of these 'schools' are buying off legislatures left and right with the money they get from said legislatures.

I wish they were doing this in San Francisco

[FoolishOwl]

I just spent three semesters at a community college in San Francisco, studying system administration. High on my list of places I'd like to work is the healthcare industry, given that I want to find work that actually helps people, and that the healthcare industry is one of the places they're taking personal privacy most seriously. Had this program been available at the school where I studied, it would have helped me enormously. I'd gladly spend more time in school if the financing were available.

Re:$3k/worker

[JoeZeppy]

Your real world experiences are no match for my preconceived notions. (sticks fingers in ears) La la la la la la la!!!!

Re:$3k/worker

[Sarten-X]

That's odd... I thought the primary problem with healthcare is people getting sick/injured/pregnant. I suppose insurance companies could be the problem, though. I mean, who would want to pay a lower constant rate to cover everyone's rarely-high costs? That's far too cooperative! It's like communism!

Re:$3k/worker

[Sarten-X]

The big reason physicians are less productive with EMR systems is that they need to learn how to use a computer properly. This means using password-protected screen savers instead of fully logging out, and spending $35 a month on a network connection faster than dial-up. It means taking some typing lessons, and getting used to the feeling of a keyboard rather than a pen.

I also note that you very carefully mention only private practice, rather than doctors in any large organization. That reminds me an awful lot of the "get off my lawn" mentality held by most private practices. They have THEIR way, and God forbid anybody try to recommend changing it. Never mind that it would decrease errors, which would make malpractice insurance cheaper, which would bring more profit, but I digress.

Regarding EMR and insurance, your point is moot. Insurance claims are ALREADY required to be filed electronically as part of HIPAA. Now the records will just be stored in a computer in the hospital, reducing the error rate introduced by transcriptionists. If there's going to be any change, it's more likely to be positive. The insurance company can, in one request, see that tests were run that indicated a specific treatment, rather than ask ten times for the results of each test.

Since you seem to appreciate studies, here's a few nice ones (found by searching on Google for "study emr effectiveness":

• The Effect of Organizational Factors on the Effectiveness of EMR System Implementation"For practitioners considering or about to begin an EMR system implementation, these results highlight the importance of considering organizational factors before, during and after EMR system implementation"... In other words, if it doesn't help, you're probably doing it wrong.
• Can Electronic Medical Record Systems Transform Health Care? - A rather comprehensive examination of costs and savings. Here's a spoiler: EMR costs far less than non-EMR.
• EMR Reminder Improves Osteoporosis Management: Discussion - "EMR reminder intervention resulted in 51.5% of patients receiving a BMD measurement or an osteoporosis medication, compared with 5.9% in usual care."

Looking at those listed credentials, it seems the research is being funded by drug companies. I know from personal experience that drug companies love EMR for the same reason I do: hospitals using EMR are easier to work with for exchanging medical data. Again, the insurance companies don't care, because they've enjoyed electronic records since 2003.

Air Force streamlines cybersecurity hiring for 680

[antdude]

Also, security people for Air Force: http://www.networkworld.com/community/node/63783 from http://www.bluesnews.com/s/112262/safety-dance ...

NoSQL

[SgtChaireBourne]

Since you bring up VistA, there are three items to fill in the gaps in the list you show:

1. "Ancient" can be two kinds, ancient like old cabbage or ancient like a shark is an ancient design. With M, aka MUMPS, it is more of a case of being ancient like a shark. The style is a little different, but it is really powerful. With the resurgance of interest in NoSQL databases, it should be top on your list to at least look at for larger projects. Like with anything else, it's a matter of choosing the right tool for the job and in some cases a hierachical database, as opposed to an object database or an SQL database, is just what the doctor ordered. (Pun intended.)

2: MUMPS (aka "M") is a very powerful and, in the health sector, rather widely used hierarchical database standard and language. It's ISO/IEC 11756 (2005) and has several engines that support it. GT.M, MDH, ANSI MUMPS. There are situations where a hierarchical database like M is more appropriate than the more widely used database standard, SQL aka ISO/IEC 9075(1-4,9-11,13,14):2008.

3: AFAIK the only example of a cross-platform GUI for VistA is Ovid. The most widely used client is still CRPS which is still dependent on Delphi (pascal) and kind of works with WINE or might do ok with tweaking on Lazarus. It's possible to write one, there are bindings for Python and Java. However, getting up to speed means at least one experienced clinician spending a lot of time with the system and at least two programmers (real ones, without Windows) with some clinical experience getting up to speed with VistA. R

4. The design is quite modular, but since all kinds of shysters and carpetbaggers are wanting a piece of the Brewster's Millions spent on electronic health care, there is all kinds of external politics interfering with development and deployment. For example, it is common for some shysters to peddle solutions built around M$ imitation of Java rather than sticking with actual Java for their extensions.

That said, there are also a good dozen open source health care systems designed around various types of clinics and demographics. Some are very good. Good luck finding them though. Wikipedia won't show them, being the playground of marketing corporations and lobbyists. Google won't find them unless you already know the name. Even then there is a good chance a competitor has been jamming the search engines with chaff.

can't count

[SgtChaireBourne]

should read 'four' items or something...

Re:Air Force streamlines cybersecurity hiring for

[mjwalshe]

the thing that takes the time for thease sort of roles is the Vetting - I trust that teh USA is not skimping on this!

How does this work?

[walterbyrd]

Let's suppose I'm interested in the program. What do I do? Just go to some college and see if they offer courses? How is this any different from before? Who gets the money? Me? The college? If the college gets the money, then isn't that just a government handout to colleges?