This is a U.S. law only. The U.S. Federal government has to make laws on DST covering the entire country or else states and local governments make their own laws. Three states currently get away with staying on standard time. We had a patchwork of DST laws across the country until President Johnson signed the Uniform Time Act of 1966. The public rallied behind it when it learned that you would drive through seven time changes in the 35 miles of road between Steubenville, Ohio and Moundsville, WV.
Yes, Kaiser is implementing the Epic solution in all their clinics and the IBM application is being replaced by Epic. The data from the IBM application will live on as read-only e-documents because the Colorado clinics had gone to paperless charts.
Epic will be the first nationwide electronic health record system at Kaiser where before each region could have its own system. And yes, Kaiser is spending a lot of money to implement Epic - a $1.8B budget is what I read in the papers.
I've read all the posts on this topic but it seems like many important questions and comments haven't been made about the implications of having national health care records.
Why would doctors and HMOs put money into a national system if it makes it easier for patients to jump to another provider? Maybe that's why it takes national leadership to make this happen.
How would updates to your health record get disseminated to other hospitals and clinics? How often? You have to assume there will be multiple data stores, not just one central one. And, remember, bad data could kill you.
Shouldn't patients be able to carry their records with them for emergency rooms or new doctors? What's the best way to carry that record because don't I already have to carry my health insurance card whereever I go?
How do you authorize certain people to see your medical record but not others?
In an emergency room situation, a portable record (on the patient) with drug allergies, current prescriptions and medical history could save your life. Isn't that worth it to make it part of the standard then? How does an unconscious patient grant authorization or does she have to? Can EMTs unlock an on-person record if needed?
Exactly how does a national health record improve the quality of patient care, instead of just enriching or giving more control to third parties such as government and insurance? Is improved care the #1 goal of this initiative?
Controls and standards aren't just needed at the data level (think database) to ensure security and privacy. Aren't they needed at the "view" level also? What if a doctor is on one terminal in a hospital and they walk to a different one? How fast should the view lock up? Should the first view of your record close if the doctor opens a second view of that record on a second terminal?
How can we guarentee that patient records are made sufficiently anonymous when researchers are using records en masse for statistical analysis?
Who gets the money for usage of the records for research... or are they free?
Should you get a royalty if your record is used as part of a study? Do you have a right to know which studies your record was used in?
I could go on but I won't. As you can see, this isn't just about data, like the HL7 standard. It's about a heckuva lot more.
It is interesting that these IT companies have only recently entered the health IT field as more than hardware or generic software vendors
IBM started working with a large HMO in the early 1990's and delivered an
Electronic Health Record system in 1997 that was deployed across all the HMO's clinics in Colorado. As the application matured, those patient records became completely paperless except for high-res images (xrays) and ekg strips, AFAIK. Health providers could view EKGs online, dictate through the app, submit prescriptions electronically using a formulary, receive results from labs and radiology, etc.
Early 1990's doesn't seem that recent. Many of these companies have been involved at the application level for a long time.
After zooming in to incredible detail in this picture, I suddenly had the realization that this is pretty damn close to what Deckard was doing in the movie Blade Runner. I'd say the detail here is as good or better as the photo in Blade Runner. If memory serves me, Deckard could "turn around" corners in the photo though. That capability would require a vastly larger number of photos from different angles to be stitched together, and more sophisticated "Zoomify" software.
Agree... the gigapixel photo of Bryce canyon that others posted about is frankly, kind of boring. But, instead of buildings an a few scattered cyclists, I think a gigapixel photo of a large sporting event or the beach at Rio de Janeiro would be more interesting to search through.
Before tax credits for using U.S. workers, we need to close the tax loopholes for multinational corporations that are encouraging them to offshore work. Profits earned overseas are taxed if invested back in the U.S., but they are tax-free if invested back overseas. There is a U.S. Senate bill offering amnesty for these overseas profits. This is one of many examples of American workers getting outmaneuvered and not even knowing it.
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The United States uses 20 million barrels of oil a day, so these 10,000 barrels a day would save .05% (.0005)
This is a U.S. law only. The U.S. Federal government has to make laws on DST covering the entire country or else states and local governments make their own laws. Three states currently get away with staying on standard time. We had a patchwork of DST laws across the country until President Johnson signed the Uniform Time Act of 1966. The public rallied behind it when it learned that you would drive through seven time changes in the 35 miles of road between Steubenville, Ohio and Moundsville, WV.
Yes, Kaiser is implementing the Epic solution in all their clinics and the IBM application is being replaced by Epic. The data from the IBM application will live on as read-only e-documents because the Colorado clinics had gone to paperless charts. Epic will be the first nationwide electronic health record system at Kaiser where before each region could have its own system. And yes, Kaiser is spending a lot of money to implement Epic - a $1.8B budget is what I read in the papers.
I've read all the posts on this topic but it seems like many important questions and comments haven't been made about the implications of having national health care records.
I could go on but I won't. As you can see, this isn't just about data, like the HL7 standard. It's about a heckuva lot more.
IBM started working with a large HMO in the early 1990's and delivered an Electronic Health Record system in 1997 that was deployed across all the HMO's clinics in Colorado. As the application matured, those patient records became completely paperless except for high-res images (xrays) and ekg strips, AFAIK. Health providers could view EKGs online, dictate through the app, submit prescriptions electronically using a formulary, receive results from labs and radiology, etc.
Early 1990's doesn't seem that recent. Many of these companies have been involved at the application level for a long time.
After zooming in to incredible detail in this picture, I suddenly had the realization that this is pretty damn close to what Deckard was doing in the movie Blade Runner. I'd say the detail here is as good or better as the photo in Blade Runner. If memory serves me, Deckard could "turn around" corners in the photo though. That capability would require a vastly larger number of photos from different angles to be stitched together, and more sophisticated "Zoomify" software.
Agree ... the gigapixel photo of Bryce canyon that others posted about is frankly, kind of boring. But, instead of buildings an a few scattered cyclists, I think a gigapixel photo of a large sporting event or the beach at Rio de Janeiro would be more interesting to search through.
Before tax credits for using U.S. workers, we need to close the tax loopholes for multinational corporations that are encouraging them to offshore work. Profits earned overseas are taxed if invested back in the U.S., but they are tax-free if invested back overseas. There is a U.S. Senate bill offering amnesty for these overseas profits. This is one of many examples of American workers getting outmaneuvered and not even knowing it.