GK,
I agree that the kids today "don't get it" but you'd be suprised. My nine year old daughter gets the idea that what is in her medical chart is nobody's business but hers and her doctors (and mommy and daddy for the moment). She and I share a common minor Dx and she doesn't want anyone to know who shouldn't know.
The majority arguement is a weak one at best. So these kids don't get it. Time for all of us to demand that our school districts require Orwell and 1984 in the Junior HS then. As you said we should "shape the discussion".... Well we are. Teach and spread the word thru your daily interactions with your patients. There is another way, but we all must stand up and say; "I'm mad as hell and I'm not gonna take it anymore" (1000 points for any new member who can properly tell us who this is a quote of and from where, NOT YOU BERT!)Instead of just going along, fight my man, fight. Stand up for your rights as an American no less to defend your poor over worked unpaid, under apperciated wife and all her fellow docs.
And we practive what we preach. We are no longer giving out Vaccinations not because Nancy is doesn't want to or care to, but because the state wants to mandate that we violate our patients' civil rights and liberties and put each and everyone of them under the age of 19 in their stupid and invassive vaccine registry. We don't want own kids in there no less anybody else's. ZIG HEIL! No less the fact that as always the didn't put a dime in the budget to pay us a darn cent for all the extra paperwork and data entry, right Vinny??? You get a brand new 16 year old patient and give her one flu vaccine, if her previous provider hadn't entered her data because he saw her before the law took effect, guess who has to BY LAW and Penalty enter and compile all of that patient's shots for the brave new order??? That's right us who just saw her for the first time because her mom felt is was time for her to have a "real doctor".
Yes portability is a lofty goal and if implimented in a non-spy on the doctor and patient way it just might be worth considering. But why the manditory back-door spy portal for the carriers and there for the government, the largest and probably to be larger still provider of healthcare. What is in mine or your medical chart is nobody's business even if they are picking up the freight. Why are Americans always so willing to throw out the bill of rights?
I came from a different industry, one with lots of standards. Theater and TV as an audio and lighting tech, stagehand. 525 lines of interlaced resolution, 29.97 frames per second (drop-frame), no questions asked. Great idea, now all TV's, tapes and discs can work and play anywhere in the country. Who is this brave new world is gonna pick and choose how much data is enough and what style of charting will be approved. Trust me and everybody else here, their idea of a CCHIT system won't look and work on a day to day basic ANYTHING like this lovely little program we all have here.... It will be some NextGen enterprise monster that only you, Bert and Vinny will be able to run and take care of without half an IT team. And just like the vaccine regisitry, they won't pay us nearly enough to make it worth while...
What does protablity got to do with interconnected servers run and accessed by law by the courts, the carriers and the government? Picture this, if patients can't trust the privacy of their health records, how long until your wife or mine mistreats any number of them because they don't tell part or the whole truth? Who's butt is on the line when that patient crashes? I just posted something to another guy who was stalking Vinny here, about what we in Psych refer to as the Bogus Pipeline. It was a body of experiments and research to try and finally get people to more accurately self-report. It is tough enough to get patients to finally trust a doc, now we have to add them being concerned that their health insurance company and the government is watching them and that at any time the courts could access their stuff as well.... Please. The line in the sand must be drawn here. (Jean Luke Piccard)
I have a totally different idea. Instead of medical records stored in centeralized servers with a few million healthcare professionals and their related staff, having total log on access to, why not have "E" medic alert tags and braclets much like the pay at the pump or a usb zip drive. You could have en entire families health records on a single little drive. And now if I loose my drive it is only me and mine that has had a security breach, not half the east coast. We already have assumed consent laws on the books, so the lie that we need a national system so just in case you have a car accident 500 miles from home is bogus. We could cover ER docs and EMT's and the like with the same assumed consent we have right now. It is assumed that if you were so bad off that you couldn't speak for yourself, that you would like someone to attempt to save your life, so they would be covered for accessing your little drive to get at your health record in a true emergency... No more national health record needed. Just flushed away in one swoop.
But if you are a greedy carrier who cares not about healthcare or outcomes and simply wants to find a way to deny care or take back payments, or attack a decent hard working doc, then yes a national health record sure makes sense. So too if you are part of the majority of the morons on both sides of the isle who want to destroy the bill of rights with warrentless searches and kangaroo courts. If you are a good man of integrity, all of us, I'm not just call you out, you actually seem sincere here, but you really need to think this thru some more, then question and fight and come up with viable alternatives to these people's invassive and self serve horseCCHIT.
I mean honestly imagine the security nightmare alone. Billing clerks, front desk people, nurses and MA's, mid-levels and docs, managers and all the folks at each and every insurance carrier in the country! It is just insane. Can we really lock this thing down that tight in such a pervassive and over populated system? Hell no, and everyone with half a brain knows that, and you are smart enought too, I know you are, you know it too.
I posted a while back about these vaccine registries and the possible coming of a nation centeralized health record. Recently we were all up in arms because a few folks, contractors at the State dept, yes the State Dept, acessed all three of the remaining Presidental candidates passport records, and goodness knows what they did with the information or who they shared it with no less. Well imagine in 20 years from now, instead of it being just where they went, in and out of any given country and the basic demographic like data that is in such a file... Instead we will be talking about Senator "X's" abortion she had when she was a scared teen of 16 years old, or Congressman "Y's" previous history of treatment for moderate depression and mild substance abuse in college... To me that is a place I never want to ever let this country get to, we have already gotten way to close to it already and it is time for all people of good conscience to push back and say a firm "NO". The great RIT needs to be returned to its rightful place of honor. To be defended at all costs.
I would rather see an EMR that is contained within the walls of the practice and unless the patient or their legal guardian says otherwise, it never leaves that place, just like a paper record does today... Who is this record for, the carriers, the gov't, NO, it's for the continued good care of the patient and for that doc who is trying to provide such, nothing more, and nothing less.
Sorry I got so over the top... I lost myself and forgot you were on our side and not just some software developer like that other guy who was stalking Vinny here just the other day. My mistake and I am embaressed. But if you really are your wife's defender and assistant in this insane business, then please for both your sakes, put on your paraniod practice manager's thinking cap (even if you are just tech support) and question what these idiots send down the shute at us. It is never what is apppears and they always have a well dsigned cover story. Never, please, never take what these A-holes say at face value or you and your wife will be had for sure... Watch both your backs.
And now I will: "you have to go sit in zah little box, you can not do zat, it is bery bery bad, you go to box, everyone stare at you, it is bery bad" (Slap Shot, Opening Interveiw with the Chief's Goaltender) I must under the rules of fair play give myself a 2 minute minor and a 10 misconduct for Unsportsman Like Conduct, how embaressing is that??? So I will go sit in the corner now getting our new tower ready to take over the main data folder duty for our little P2P network for being a rude, bad boy.....
Have a great night,
Paul
