They ALL have errors. And omissions. Lots of them. Often important ones. There is even relevent information that is not included with them.
It won't get better with electronic records. It will probably get worse (one universal input format). The (unwilling) doctor will be expected to enter the information into the computer. As a result, the information will be notated on paper or recording device (more errors) and transcribed (yet more errors). Then any information that does not fit into a standardized category will be lost. Wow, what an improvement!
Not to mention the fact that my records will now be public for all intents and purposes. At least with paper records you have to know what doctors I have seen and have to physically find and access them.
"In that case it'd really suck for the hospital if they didn't have the record on file or access to another hospital that did."
Which is the current default. I don't see a huge outcry about this.
"Maybe the patient is severely allergic you're about to give him."
Also the current default. Which is why they make medalert bracelets. If you have a severe medical problem, you already have the info on you. At least if you give a damn. Problem solved.
EHR's are a solution to a problem that patients don't have. It would be great for employers, insurance companies, the government, software companies, etc. But not really for the patient (or the doctors).
"Basically, a pair of professors, one in law and another in computer science (specializing in software testing) are trying to bring the problems with EHR to a wider audience."
And the problems essentially reduce to: do you want easy access or security. The best type of EHR is one that doesn't exist. I can't think of a good system that outweighs the negative. Although I would accept an opt-in system.
"Anti-discrimination legislation is, in general, partially successful."
But only against the extremely stupid or incompetent. Employers discriminate all the time against legally protected classes. They just use a legally protected reason.
"With an EMR, however, the risk of exposure is potentially much higher (e.g., downloading *all* the files instead of swiping or reading just one)."
I prefer the locked cabinent approach. In order for my records to get out, someone has to know where to look. And has to be willing to travel. I have multiple records in multiple states, some of which I couldn't find if I HAD to (legal issues, for instance).
That is far more secure that cracking one little database....
I have a better idea. Don't use electronic records. They benefit almost everyone except the patient.
The paper ones can be transported easily. Anyone can access that information. And anyone who has a truly serious condition should carry documentation of that fact on them.
Unfortunately, electronic records are coming. And unless there are severe penalties for release (long prison terms/fines that destroy companies) they are going to be as secure as your SSN. For all intents and purposes your records will be public including all the errors.....
"Look, a patient's medical record is supposed to be an OBJECTIVE documentation of a patient's health status and treatment."
You are kidding, right?!? It's a record. Generally a crappy one. That has lots of errors in the best case. Hell, some things aren't even written down any longer for legal reasons.
"How, exactly, is a patient qualified to make an objective assessment of their medical problems, diagnostic workups and treatment regimens?"
Some of us know more than most doctors about their specific issues. I have time to research my problems, keep up to date on advances, etc. Most doctors, even specialists, don't have the time or don't bother.
"...altering a patient's medical record is illegal and, at the very least, will result in a physician's suspension of privileges from a hospital... and most likely, a revocation of their medical license."
Yeah, right. I doubt that the complaint would even be looked at by the relevant authorities. Only when litigation is involved does it matter. Doctors routinely (unintentially) kill their patients with no disciplinary actions (medication errors, lack of sanitation, etc)....
Yes, Walmart has different part numbers and slightly different product. Big fucking deal. There is a reason that they can sell it for less.
I have no problem buying a stripped down model if that is what I want. If I don't, then I won't buy it there.
There is no reason for a manufacturer to sell poorer quality products (vs stripped down products) through Walmart. After all, Walmart doesn't have to service them. If they do sell crappy stuff via Walmart, then they don't sell good products, period.
"Not everyone is out to screw everyone for the mighty dollar."
True. But that is the point of capitalism or at least a byproduct.
"Some people actually want to offer a good product at a decent price, while treating their employees well."
And so did Walmart.
"Most companies fall somewhere in the middle."
And see their business go elsewhere.
"I don't think it's the goal of every store to tailor to the lowest common demoninator consumer by offering cheap (read: crappy) stuff at cheap prices, while offering their employees low salaries and even lower benefits."
Welcome to retail. Of course, I can find quality crap at Walmart at cheap prices. If Walmart carries crap you can be certain that others carry it at higher prices....
"Why oh why would you trust your health to somebody who believes your problems are caused by sublexations that divert the flow of "energy" in your spine?"
Because partially dislocated vertebrae can cause pain. Only they call it spondylolisthesis and nerve impingement.
Chiropractors can be just as ineffective as "good" doctors.
"Alternative medicine is quackery which sometimes gets things right by accident."
Unfortunately that also describes regular medicine. In any case doctors routinely prescribe medication for conditions for which there are no non anecdotal evidence. Many treatments have no better data (quantity yes, effectiveness, not really) behind them than chiropractric (see data on back pain treatment....)
"You forgot one important justification for the DTV changeover: ending a massively wasteful use of spectrum."
No he didn't. The "wasted" spectrum really isn't needed.
Desired, yes. Needed, no.
The spectrum is going to be just as "wasted" when it is used by those who bought it.
"Besides, relatively few people even get television from an antenna anymore."
If by few, you mean many millions, then yes.
"that's only because the people who benefited from the analog era had no incentive to move on."
Which is another way to say there was no demand. Most people are perfectly happy with SD quality (see most DVD's and TV). Yes, HD is nice, but it could already be delivered over existing services (cable).
After all, if few people used antennas, then few people need digital transmission. Hell, we could have just gotten rid of over the air TV. Nope, wouldn't be any outcry over that.
And this is coming from a person who does not need over the air TV and likes HD.
"I'd rather eat red-hot nails than shop at an establishment that's destroying America."
Personally, I would blame the shoppers. In any case, aside from the "special" Walmart items, why pay more for the same crappy stuff sold in other stores? Most chains aspire to be Walmart.
"Obviously those bottom 5 guys are a problem and should be fired."
Possibly. Or perhaps they need more training, need to be told they aren't adequately performing (silence = consent), etc. Or maybe you need everyone to meet the production goals. Or maybe their manager sucks.
Automatic cuts are bad. It is a sign of bad management. After all, if you can't hire well and/or assess well as a manager, you shouldn't be one.
"Sorry, but I can't believe the incredible amount of stupid comments posted here on this article. Jobs basically announces he's not dying and Apple's shares jump 4%"
What's even more amazing is that he didn't say he wasn't dying. He said he had a hormone imbalance. Also note the time required to regain the weight...
Press releases are often very important for what they don't say. But most people tend to miss the obvious. Certainly doesn't rule out the dying bit....
"Those same God botherers have been shown in study after study to be far quicker to give a large percentage of their income to charities that directly reach out to the poor and down-trodden than their secular counterparts."
You mean that the people who are expected to tithe as a part of their religion give more money to charity. Wow, what a concept....
Then there is the question of a charity. I don't consider a religious organization to be a charity in the same way as a more secular organization. If you are part of a church, you are expected to support it.
"...the doctor has to do everything while the car is still running."
No they don't. You can stop the heart and replace it, for instance. You can put them to sleep and then do lots of interesting things...
The practice of medicine can be largely duplicated by a flowchart. It is essentially a skilled trade. Of course, in a skilled trade there is still a large difference in abilities.
"So, if your areola is very large and your photo gets banned, I'm sorry. Truely, but rules for the general public sometimes effect a minor group of people...."
So there are no pictures of men with their areola or nipple showing? Somehow I doubt they have banned those. Interesting....
"Legally, female chestal nudity is defined as showing of the nipple and/or the areola."
In some locations. Other places, say Ohio (Columbus), women can be topless legally. Not that they didn't try to make it illegal. Essentially it is considered no differently than a man not wearing a shirt by the courts.
Not that you are likely to see a topless women though. Funny how society didn't collapse.
"Personal preference really, and this is why I prefer not to use MS Word:"
Sure, you don't want to use Word but the publishers will. Word is common in publishing especially in the edit stage (having done it). At some point in time you will probably have to use it. Unless you are self publishing.
Having said that, you can certainly use another program as long as you can get it into Word.
"Which is the reason why Germany doesn't accept them as a religion:"
I doubt that is the reason. There is close cooperation between religion and the state in Germany (religious organizations can be corporations). If you declare yourself to be of a certain religion, the government will happily levy a religious tax you...
Slashdot Mirror
Have you ever read your records?
They ALL have errors. And omissions. Lots of them. Often important ones. There is even relevent information that is not included with them.
It won't get better with electronic records. It will probably get worse (one universal input format). The (unwilling) doctor will be expected to enter the information into the computer. As a result, the information will be notated on paper or recording device (more errors) and transcribed (yet more errors). Then any information that does not fit into a standardized category will be lost. Wow, what an improvement!
Not to mention the fact that my records will now be public for all intents and purposes. At least with paper records you have to know what doctors I have seen and have to physically find and access them.
"In that case it'd really suck for the hospital if they didn't have the record on file or access to another hospital that did."
Which is the current default. I don't see a huge outcry about this.
"Maybe the patient is severely allergic you're about to give him."
Also the current default. Which is why they make medalert bracelets. If you have a severe medical problem, you already have the info on you. At least if you give a damn. Problem solved.
EHR's are a solution to a problem that patients don't have. It would be great for employers, insurance companies, the government, software companies, etc. But not really for the patient (or the doctors).
"Basically, a pair of professors, one in law and another in computer science (specializing in software testing) are trying to bring the problems with EHR to a wider audience."
And the problems essentially reduce to: do you want easy access or security. The best type of EHR is one that doesn't exist. I can't think of a good system that outweighs the negative. Although I would accept an opt-in system.
"Anti-discrimination legislation is, in general, partially successful."
But only against the extremely stupid or incompetent. Employers discriminate all the time against legally protected classes. They just use a legally protected reason.
"With an EMR, however, the risk of exposure is potentially much higher (e.g., downloading *all* the files instead of swiping or reading just one)."
I prefer the locked cabinent approach. In order for my records to get out, someone has to know where to look. And has to be willing to travel. I have multiple records in multiple states, some of which I couldn't find if I HAD to (legal issues, for instance).
That is far more secure that cracking one little database....
I have a better idea. Don't use electronic records. They benefit almost everyone except the patient.
The paper ones can be transported easily. Anyone can access that information. And anyone who has a truly serious condition should carry documentation of that fact on them.
Unfortunately, electronic records are coming. And unless there are severe penalties for release (long prison terms/fines that destroy companies) they are going to be as secure as your SSN. For all intents and purposes your records will be public including all the errors.....
"Look, a patient's medical record is supposed to be an OBJECTIVE documentation of a patient's health status and treatment."
You are kidding, right?!? It's a record. Generally a crappy one. That has lots of errors in the best case. Hell, some things aren't even written down any longer for legal reasons.
"How, exactly, is a patient qualified to make an objective assessment of their medical problems, diagnostic workups and treatment regimens?"
Some of us know more than most doctors about their specific issues. I have time to research my problems, keep up to date on advances, etc. Most doctors, even specialists, don't have the time or don't bother.
"...altering a patient's medical record is illegal and, at the very least, will result in a physician's suspension of privileges from a hospital... and most likely, a revocation of their medical license."
Yeah, right. I doubt that the complaint would even be looked at by the relevant authorities. Only when litigation is involved does it matter. Doctors routinely (unintentially) kill their patients with no disciplinary actions (medication errors, lack of sanitation, etc)....
"What you really mean is 'software running on computers you don't control.'"
Of course, you can have very expensive software that you don't control on computers you do control that could be just as problematic.
As others have said, it comes down to risk management. Unfortunately most companies often don't do it well.
"It sounds more like a familiary issue than anything else."
That's the point. There is a large group of people who don't want to change but do useful work.
And why should they change? What is the compelling reason for the design change? And why can't MS provide a "classic" version?
Some people are power users and can be helped by an interface change. Most aren't. And many of them are in charge....
Yes, Walmart has different part numbers and slightly different product. Big fucking deal. There is a reason that they can sell it for less.
I have no problem buying a stripped down model if that is what I want. If I don't, then I won't buy it there.
There is no reason for a manufacturer to sell poorer quality products (vs stripped down products) through Walmart. After all, Walmart doesn't have to service them. If they do sell crappy stuff via Walmart, then they don't sell good products, period.
"Not everyone is out to screw everyone for the mighty dollar."
True. But that is the point of capitalism or at least a byproduct.
"Some people actually want to offer a good product at a decent price, while treating their employees well."
And so did Walmart.
"Most companies fall somewhere in the middle."
And see their business go elsewhere.
"I don't think it's the goal of every store to tailor to the lowest common demoninator consumer by offering cheap (read: crappy) stuff at cheap prices, while offering their employees low salaries and even lower benefits."
Welcome to retail. Of course, I can find quality crap at Walmart at cheap prices. If Walmart carries crap you can be certain that others carry it at higher prices....
"Why oh why would you trust your health to somebody who believes your problems are caused by sublexations that divert the flow of "energy" in your spine?"
Because partially dislocated vertebrae can cause pain. Only they call it spondylolisthesis and nerve impingement.
Chiropractors can be just as ineffective as "good" doctors.
"Alternative medicine is quackery which sometimes gets things right by accident."
Unfortunately that also describes regular medicine. In any case doctors routinely prescribe medication for conditions for which there are no non anecdotal evidence. Many treatments have no better data (quantity yes, effectiveness, not really) behind them than chiropractric (see data on back pain treatment....)
"You forgot one important justification for the DTV changeover: ending a massively wasteful use of spectrum."
No he didn't. The "wasted" spectrum really isn't needed.
Desired, yes. Needed, no.
The spectrum is going to be just as "wasted" when it is used by those who bought it.
"Besides, relatively few people even get television from an antenna anymore."
If by few, you mean many millions, then yes.
"that's only because the people who benefited from the analog era had no incentive to move on."
Which is another way to say there was no demand. Most people are perfectly happy with SD quality (see most DVD's and TV). Yes, HD is nice, but it could already be delivered over existing services (cable).
After all, if few people used antennas, then few people need digital transmission. Hell, we could have just gotten rid of over the air TV. Nope, wouldn't be any outcry over that.
And this is coming from a person who does not need over the air TV and likes HD.
"I'd rather eat red-hot nails than shop at an establishment that's destroying America."
Personally, I would blame the shoppers. In any case, aside from the "special" Walmart items, why pay more for the same crappy stuff sold in other stores? Most chains aspire to be Walmart.
"Obviously those bottom 5 guys are a problem and should be fired."
Possibly. Or perhaps they need more training, need to be told they aren't adequately performing (silence = consent), etc. Or maybe you need everyone to meet the production goals. Or maybe their manager sucks.
Automatic cuts are bad. It is a sign of bad management. After all, if you can't hire well and/or assess well as a manager, you shouldn't be one.
"If PHB can't tell the difference, then he's not doing his job and *his* manager should notice."
Unless of course, his manager is not doing his job. Etc.
"Sorry, but I can't believe the incredible amount of stupid comments posted here on this article. Jobs basically announces he's not dying and Apple's shares jump 4%"
What's even more amazing is that he didn't say he wasn't dying. He said he had a hormone imbalance. Also note the time required to regain the weight...
Press releases are often very important for what they don't say. But most people tend to miss the obvious. Certainly doesn't rule out the dying bit....
"Those same God botherers have been shown in study after study to be far quicker to give a large percentage of their income to charities that directly reach out to the poor and down-trodden than their secular counterparts."
You mean that the people who are expected to tithe as a part of their religion give more money to charity. Wow, what a concept....
Then there is the question of a charity. I don't consider a religious organization to be a charity in the same way as a more secular organization. If you are part of a church, you are expected to support it.
"...the doctor has to do everything while the car is still running."
No they don't. You can stop the heart and replace it, for instance. You can put them to sleep and then do lots of interesting things...
The practice of medicine can be largely duplicated by a flowchart. It is essentially a skilled trade. Of course, in a skilled trade there is still a large difference in abilities.
"So, if your areola is very large and your photo gets banned, I'm sorry. Truely, but rules for the general public sometimes effect a minor group of people...."
So there are no pictures of men with their areola or nipple showing? Somehow I doubt they have banned those. Interesting....
"Legally, female chestal nudity is defined as showing of the nipple and/or the areola."
In some locations. Other places, say Ohio (Columbus), women can be topless legally. Not that they didn't try to make it illegal. Essentially it is considered no differently than a man not wearing a shirt by the courts.
Not that you are likely to see a topless women though. Funny how society didn't collapse.
"Personal preference really, and this is why I prefer not to use MS Word:"
Sure, you don't want to use Word but the publishers will. Word is common in publishing especially in the edit stage (having done it). At some point in time you will probably have to use it. Unless you are self publishing.
Having said that, you can certainly use another program as long as you can get it into Word.
"Being honest gets you ahead, if only in the long term."
Maybe. Unfortunately a good reputation doesn't pay any bills :)
"Which is the reason why Germany doesn't accept them as a religion:"
I doubt that is the reason. There is close cooperation between religion and the state in Germany (religious organizations can be corporations). If you declare yourself to be of a certain religion, the government will happily levy a religious tax you...
Scientology probably didn't want to play ball....