Home Forums Discussions General Discussion Down with CCHIT

Roy,

That's a FANTASTIC idea! Post the resolution on the board.

Jon has said that this is an open, public forum. Not EVERY topic has to be directly related to AC. (heck, this one isn't!)

V.

I agree, Roy. I do not belong to any of the medical societies anymore...who can afford their ridiculous dues? But, I will be glad to sign your resolution and forward a copy to as many of my colleagues as possible.

Leslie

Guys,
I agree with you in principle, but Vinny our MSSNY has already bought into the CCHIT, $hit. They are in bed with the state and federal gov'ts, the major software vendors and the carriers already!!! They are the grant handers out of the CCHIT only assistance for us poor struggling small practices for get corporate wellfare for those Major players, to line their pockets as they assist small practices getting "hooked" into the CCHIT, $hit. I as Nancy's practice manager was one of the most active members they had here in our county and they don't give a darn about us. They blew us off and didn't care to incorporate our concerns or our perspective on these vital issues... Oh those PCP's again. And that is with Nancy as one of only about a dozen or so other docs in the entire county, volunteering at the MSSNY booth doing BP checks for 3 summers in a row, representing the society in the sticky hot Aug. weather here at the state fair. The heck with them.

Think about it. Your malpractice rates are probably not too far off from ours being in a similar part of the same state. Why is the medical society using a large part of our resources fighting malpractice rates, not for us primary offices, our rates although not great really are not so bad. $1.3-3.9 coverage in case of a suit with tail coverage at under $8K a year really is pretty good deal in terms of what you get at todays prices. They are fighting it for all the morgage sized premiums that their better off and better paid specialist members who have more clout have to pay. Now I do think that malpractice is an issue, but it certainly is not my main issue.

If we only got paid, with RVU's that show respect for all that care managed you so properly mentioned, not .40 but like .70 or .80 RVU's, so that a 99213 or 99214 would actually sort of pay for all the work you guys do each and every day, that is my issue, but that means finally devaluing the over inflated RVU's of their better heeled members that they do really represent. Really why are the RVU's on a simply skin biopsy or non malignant cryo removal more than those for all that multiple issue management of care for BP, cholesterol, DM and the like??? It is so @$$ backwards. We talk about care as something we value but when it comes time to actually put the rubber to the road, we pay the Marines who get in and get out a whole lot better then the PCP grunts who slug it out in the trenches every day.

I think that PCP's of all three major groups need a real Medical Society type organization that puts them and their patients needs first. Those specialists that you properly railed against do not share our concerns nor do they give a hoot about our day to day survival. If you don't believe me, pretend to be a staff member on a day your office is closed for paperwork one morning. See how even the stafff and practice managers at other offices treat you and your staff as they call looking for the all important referals that we have to do for Free so they can make more money on our patients than we do. Nancy answers the phones here no and again and she doesn't always let on right away the she is the "Doctor". These people treat he like regular crap until they ask something about or to speak with the doctor. They she says, "oh I am Dr Blake..." They start falling all over themselves as they try to pull back from the arrogant better then you attitudes. BullCCHIT!

Anyway, you know we love the heck out of you, Roy and the rest of the gang, but these folks no longer represent us, if they even every really did. They are a bunch selfish fools that are trying to maitain the status quo for the better paid specialties. They certainly don't speak for me whether as a doctor's office or a patient.

I think you know that after asking for their help from the legal dept at MSSNY central, Lake Success who blew me off on women's wellcare and the inappropriate bundling of CPE's and GYN Paps performed on the same day I didn't give up and kept going on my own anyway. Well I, as in me, myself and I, by my self with a little help from our IPO, won that fight with one of the largest S-CHIPS carriers here in our state, Fidelis. Now you can bill and get paid for a 99395,6,7 and G & Q on the same DOS for the same patient with this carrier because I refused to give in and made a valid argument that stuck. How many women patients, PCP's and GYN's did I just help??? How many dollars of lost revenue did I win back for all our members across the state who treat these women??? Meanwhile, we can not even afford tickets to the annual black tie dinner here. Hell Nancy and I should be one of the guests of honor getting an award for goodness sake. How about a life time membership for fighting it and winning it alone for everyone? Not even a simple thank you from anyone, not one single member. No less any real recognition of what this little solo PCP's office accomplished on it's own.

Heck MSSNY paid lots of money for this really good lawyer speaker to come here and talk about not letting the carriers have any records requests that they are not entitled to with suggestions and laws on how to fight them. And then almost in the same breath they are in bed with CCHIT and the SOB's that support it, so the carriers can back door spy on all docs and patients any time they want??? What kind of split personality kind of leadership and advice is this???

I for one an very pissed off and have lost just about all respect for our state medical society. They owe this office a big thank you and an appology. Give my wife a free membership after what we did on our own, then we'll talk about getting back involved.

The EULA is fine. I love the EULA. Let's leave the EULA alone. It's Jon's program, he can write whatever EULA he wants. We don't have to buy it.

I'm sorry. I don't mean to offend anyone. But, I think we need to let this EULA thing go. When we get new updates, if we don't like the EULA, we can either not use the update or email Jon with our concern. I don't think Jon has any intention of taking anyone's program nor could he. He could stop you from renewing your annual program support. But, I don't think that's why he went to all this trouble to make AC and market it to then turn around and destroy it.

Well, I must admit that's interesting.

Hey, MSSNY may have, but I was in RARE form, and told off my friend Rick Abrams - in front of our CCHIT preferred vendor and a room of 100 or so doctors, at a presentation they did in Albany a month or so back.. I felt bad about it after.. Rick is a friend of mine.. but I go to the meetings and I'm LOUD.. and I CALL 'EM LIKE I'S SEES 'EM. If more people did then the buy-in wouldn't be there.

V.

Out of curiosity, Is anybody participating or planning to participate in the PQRI?

What is PQRI.

Medicare P4P -- voluntary, at this point...


http://www.cms.hhs.gov/pqri/

I'm no expert on this. No, I have no plans to participate.

Folks,
Personally I suggest that nobody does. We all need to resist. I hope nobody submits anything. Otherwise we are just feeding into this misconcieved idea of we the providers have the ultimate control over patient outcomes, when in reality we are but tutors and guides. There are numerous other factors that affect outcomes way before we get involved. Diet, food availible or not avialable at Supermarkets and restuarants, choice of activity level, use of recreational things (tobacco, Booze, ect...), work type and OT, enviornmental things be they chemical or psycho-social and the like, Family history, personality and cooperation with ones own care.

P4P is BullCCHIT. Since when did I become your mother??? And since when did emancipated adults, supposedly free citizens in a supposedly free society, suddenly become minors who can not care for or be responsible themselves and for their own healthcare; there by requiring that we become their "Health Guardian", who have been unwillingly appointed for them as such, so that we are now legally and otherwise responsible for their care and the managment there of??? We can advise, we can suggest, we can educate, but in the end, in the final analysis we are but tour guides.

"You can lead a horse to water, but you can't make him drink." We just got chart requests from a Managed Medicare plan for this husband and wife's charts for quality purposes. This couple is classic. He brings his fairly frail and sick wife in all the time, but now matter how much we bug, poke or prod him, we just can not get him to give us a visit and get some labs done so we can take care of the caregiver. How much is this male resistance to medical care, his feeling overwhelmed, or what I don't know, but we just can not get this guy to let Nancy have half a shot at him.... Even though he is coming in anyway with his wife and we would gladly see them back to back, at the very same time so he doesn't have to worry about her or even make a separate trip. He just won't do it and we are powerless to change that until something inside of him changes. And they both adore Nancy and apperciate this office so the doc is probably not the issue either.

We do not live in a totalitarian state were like big brother we have the power and the means to follow free citizens around, taking away their cigarettes, picking the food for their shopping carts, make them put on a condom. I don't see big brother like TV screens and cameras in peoples cars and homes, at least not yet. Although Gonzo and Bush certainly did try and Bush seems to be continuing to do so. There is the wonderful, free thinking, unpredictable, erect walking, tool using animal in the middle of all this and he/she tends to screw things up to hell, just as he/she should and hopefully always will.

P4P is but a new twist on the old game of developing new bullcchit programs and cover stories to take away money from provders and instead keep it in the insurance industries pockets for their greedy selves. Goodness only knows what their next well thought out scam will be... But I'm sure there will be others to come. There always are, right???

Happy and Health to one and all, Catch ya Next Year...
Paul

I tried to do this during the second half of 2007. I made a special Medicare Superbill. I found that it's not worth the 1.5% to report the BP, blood glucose, HbA1c, Lipid panel with their special codes. You use a newly designated Q code only for Medicare patients. If this was mandated, I will quit seeing all Medicare patients.

Appears that our Federal Government is devising all sorts of way to force smaller practices out of business. This is the message that needs to get to our medical societies.

I also refuse to play the game. And, I am becoming increasingly more vocal with patients about their insurance company's intrusion into their health care. I had a patient call in today complaining of cold symptoms. He wanted me to call in an antibiotic because he was "afraid it would go into his lungs and cause pneumonia". I refused to call anything in and had my staff tell him if he is sick enough to warrant an antibiotic, he is sick enough to warrant a diagnosis, which means a visit to his physician. He got mad and told the staff he thought it was a bunch of crap that he should have to come in the office for a "cold". He told them "all she wants is to rack up another office charge."
Well, that did it. I got on the phone and explained to him that his insurnace company is one of the very worst about mailing me crap about apparent patient non-compliance with medicines, junk about whether or not I was aware of potential drug interactions (such as ASA and Plavix in a recent coronary artery stent patient..."Are you certain you want this patient on these medicines?") and burdening me and my staff with requests for office notes to assess whether I am managing THEIR patients appropriately. I told him I was not about to incur the wrath of his insurance company for prescribing inappropriately nor was I going to risk being put in a court room just because I failed to properly see and evaluate a patient prior to the prescribing of potentially dangerous medicines. By the time I was finished ranting, he was apologizing profusely. I told him it sounded like a common cold, to treat himself conservatively and if he failed to improve after 7 days or worsened at any time then he could make an appointment and I would then evaluate the need for antibiotics. He said he was not aware of the serious issues I had and thanked me for my time. Once again, we docs MUST make the patients understand why we do the things we do and more and more it is because of insurance companies, the federal government or the fear of legal retribution.

Leslie

Leslie, you made my day. I, too, get SO tired of patients who tell me they're "too sick to come in" and ask me to just "phone something in".

One of my former patients - who is now living in Myrtle Beach - called to BEG me to write all of her narcotic and benzo Rx's. She was told three months ago that I would do this for ONE MONTH while she finds a new doctor. She called my office manager and asked her to BEG me to write them.. but not to have me call her back because I would yell at her. Her parting comment as to why she didn't find a doctor where she is living now was "Well, doctors HERE expect to be PAID! NOT like Dr. Vinny ! ". I was LIVID.

The 1.5% that Medicare is offering is insulting. You want the data? Come in and read the chart. Can't do that? Then leave me and my patients alone.

If we don't educate them, patients will continue to think that ANYBODY can do what we do, that we're both stupid and greedy, that we're just evil shills for Big Pharma, etc. BTW.. though, the ones who can't or won't learn that my services require skill and have value are invited to leave. It's AMAZING the shocked looks on their faces as I throw them out of the practice.

Keep fighting the good fight, folks, and Happy New Year,

With warmest regards,

Vinny

I now, everything that sounds like P4P creates a lot of controversy.
The PQRI stands for Physician Quality Reporting Initiative.
It is not pay for performance. It is actually pay for reporting.
I agree with Vinny about the 1.5% bonus, it is ridiculous and the main reason I would vote for not to do it.
I believe that the Reporting Initiave Goal is not focused on the care of the patient but to the "supervision" of the doctors, kinda like an early stage of pay for performance.
However, My partner wants to participate. He see it,at least for now, as a more specific way to communicate the state of our patients to the payor (Medicare). He believes that Medicare and other insurance companies could easy ask for this without offering a payment or bonus at all.
Since my partner is determinated to participate, and reporting is actually easy, still voluntary and not related to pay for performance, We will participate in 2008 and hope for the best.

Happy 2008 to all AC Family

Keep your AC family up to date on developments, Romel!

We wish you the very best for 2008 also.

The Best for you in 2008 !! Salud (cheers)

Happy 2008! It's been great so far- lots of cold and flu, and folks throwing up all over the place... lots of easy 99213s... what more can us docs want? It's going to be a great year indeed!

Anyhow, on Friday I found out that one of my patients, a lawyer that served in the past on one of the Congressional oversight committees came through and took my 65 page dissertation on what's wrong with HIT in the USA (http://www.box.net/shared/static/ceebmf946k.ppt) and made hard copies and distributed it to all involved legistators of both parties with a note that "this could increase the cost of Medicare!". This was one reason why they defunded P4P and held the EHR tie-in provision at the last moment. Gosh, I wish I could have been a fly on the wall!

Anyhow, she warned me that they could easily refund it by the time they take up the measure again in June.

It's great working in the Washington, D.C. area!

Al,
Honestly, is there a way you could use this "connection" to get a bunch of us small practices out in front of the proper committee(s) in charge of all this??? You are the link we need to get ahead of this stupid thing. Perhaps you could even get your presentation entered in the way they do down there as part of the larger record.

Even better at some point Bert, Roy, Leslie, myself and a few others really wanted to start a new small practice, mostly primary care (but a great guy like you would obviously be well too) based advocacy group to stand up for ourselves in ways the large AAFP's, AMA's, Med Society's and the rest just can't and don't. We toyed with this idea for quite some time here, but never really pulled the trigger on it. But I would love to put together a small group of active and concerned docs from here at AC to go lobby and give testimony as to what the real conditions of small practice and primary care is like. I'm just affraid that I will get drafted to run and head the darn thing.... There could be worse things in life I guess... lol

Are ya game???

Al,
Just a thought.
Do you have a lecture on CCHIT?
Do you go out and give presentations on this issue with your powerpoint presentation?
This is something I could bring forward to the Washington State Medical Association to see if they would be interested in having you at the Leadership Conference we have in Chelan, WA in May.

Hi Roy/hockeyref:

I would love to give a lecture on CCHIT, Roy! I did a Sermo poll to see how many docs there knew about the HIT tie-in to the repair of the 10% Medicare pay cut. A full 38% didn't know anything about it! (URL: https://md.sermo.com/medical/ticket/details?nav=on&id=14378 )

The PPT presentation was done on a hunch that I had written over 70 letters and other postings on emrupdate, but I felt that the information was scattered all over the place. I wanted to make one solid repository of information where one can pick up on the salient points of the reality of the situation in the areas of CCHIT, P4P, and ePrescribing.

My patient advocate was astounded at how dumb politicians seem to be on these issues- one told her courier that "anything with computers must be good". What was neat was that the PPT presentation was finished 1 week before the vote on HIT by chance- I didn't know how important and how quickly it would serve our cause. It was just dumb luck. It's like a game of chess- HIMSS and its Congressional minions with all its money thought that they had a check mate and we then suddenly stole their queen. I'm sure that they are pissed!

This patient is very secretive because as a member of the Congressional oversight committee she once got mugged (hit over the head and left unconscious in her room) forcing her to retire from her position. She was instrumental in bringing computers to Congress some 15 years ago. She currently works with a group of lawyers close to where I live. She still has a lot of connections and I was surprised in the manner that she went out of her way to help us. In fact, at this point she is trying to "follow the money" to see if anyone in Congress took a bribe to get the HIT legislation passed, which as you know is a criminal act. All she would have to do is to report it... and the game would be over. She just knows which buttons to push. Heck, I tried to contact some of these Congressmen and their walls seemed impenetrable.

If it comes down to a round 2, it would great to have a team of us docs go there to testify how screwed we're getting by this legislation. I hope that they allow us to- not AMA/aafp/ACP eggheads, but real docs, the ones in the trenches.

Al,
As we all know and are extremely appreciative of all your leadership and hard work as it relates to all this CCHITT-CCHITT, I still really want to put together some sort of larger group. One that talks to all the issues that small and solo practices face and how we are getting the healthcare that we deserve because it is the healthcare that we have legislated via the Congress, the states, the FTC and CMS. We now have crumby, expensive, larger and larger group factories that perform 7 1/2 minute drive by visits because that is the only way to make office visits and primary care pay. All while big pharma, the carriers and the large supply manufacturers are rolling in green.

I still really want to hit my favorite topics like we have discussed here over the past few months, CCHITT and other gov't invasions of privacy included, but we do not have an insider to help us get estblished so as to be able to "get thru" the road blocks and other interferance to that inside track. I feel that your cause (our cause obviously) would be extremely well served if it were to be incorporated into some larger regional and national group that we might form to rebel against the entrenched supposed representitives of providers such as the AMA's, AAFP's APA's and the like.

Now I totally understand and respect your aquaintances need to protect herself and her family, goodness knows how ugly that must have been. Send her all our best for taking such risks and abuse for all of us, she must be a real patriot and we all own her a debt of graditude. But might there be a way to have her simply turn you on to other friendly and receptive folks who could take it from there??? That's sort of how I started this business for Nancy. One or two friends gave me a few names and numbers of other intelligent folks who could be helpful, and with there stamp of approval ("Hi so and so told me to reach out to you...") a number of doors opened up from there, and now the rest is history.

My biggest pet peeve besides CCHITT and it's Orwellian spy portal, is that we all talk about what we value like quality care, but then we have the lowest RVU's assigned to the OV's that are where the care is truly done. We would not need any P4 if we simply paid hard working docs what they need and deserve for the disrespected, underpaid office visit where most of the care goes down. Henry Ford has been speeding up the assembly line all these years, and now he has the gall to turn around and wonder where the quality has gone??? Screw that. It's likw all this talk about family values while those same moron politicos support a ton of policies that hurt the average person everyday... What values for crying out loud???

It is time for people to put their money where their mouths are. People tend to pay for what they value and they tend to not pay for what they don't.... It's time for America and it's gov't to, "piss or get off the pot", as my dad would say. We'll pay some Marine like specialist thousands of dollars to perform one procedure, but we can't seem to find the money or the will to pay a PCP a living wage for managing his sick old mother or to care for your new born kid. Medicare fee schedule for an est pt level 4 in upstate NY is $86 and change. And that was a blessing from the sky as it wasn't even $80 until 2007!!! Now that is pure horseCCHITT. And there are carriers who are trying to get away with not even paying Medicare fee schedule while they roll around in our money like pigs in a pen.

Anyway, yes let's keep you friend safe and secure. But if she could just point us in the right direction to others who could assist us, with that combined with a banner of our own to give us an air of legitimacy, I think we just might stand a fighting chance....

Bert, Gang are you listening??? Are you ready for the fight of your lives??? "gadeszuks Martha, I've been drafted!!!"

Good Night and Good Luck,
Paul

>>> I feel that your cause (our cause obviously) would be extremely well served if it were to be incorporated into some larger regional and national group that we might form to rebel against the entrenched supposed representitives of providers such as the AMA's, AAFP's APA's and the like.

I agree Paul. We have to educate our politicians about HIT and how it is good for medicine but should not be abused by politicians. It should not be an unfounded mandate where physicians are forced to pay for it. It should not be used against physicians in an effort to cut back their pay in an effort to balance the budget.

Case in point- check out what socialist Clinton and her archenemy but co-socialist Obama want-

Clinton presses for electronic medical records
Healthcare IT News, By Diana Manos, Senior Editor, 01/04/08

URL: http://www.healthcareitnews.com/story.cms?id=8359#

>>> Anyway, yes let's keep you friend safe and secure. But if she could just point us in the right direction to others who could assist us, with that combined with a banner of our own to give us an air of legitimacy, I think we just might stand a fighting chance....

I'll work on her slowly, I promise you. I have to first buy her a dinner for her and her husband to the best restaurant in town! I'm glad that she has so much energy and empathy for us.

I just wish that we had such energy and good will in our medical societies who likewise seem to be in bed with the HIT lobbyists.

BTW, here's another article about our WIN (I can't read about this enough)-

I.T. Mandate Out of Medicare Bill
December 21, 2007

URL: http://www.healthdatamanagement.com/news/mandate_legislation_Medicare25383-1.html

Cheers,
Al

I just updated the EMR slideshow on CCHIT/P4P/eprescibing ("HIT_in_the_USA14") including such stuff s.a. taking out Guiliani's picture and quote to add quote from McCain, and adding 2 slides on the 12/21/2007 "win" in Congress. I also updated several slides, splitting a couple and making others more readable. It's located here: http://www.box.net/shared/static/prwi2ne688.ppt .

Thanks for sharing this, Al.

This slide show is a great resource for anyone who is trying to understand the issues of CCHIT and P4P.

If CCHIT is ever able to make their recommendations mandatory for all EMRs, Amazing Charts (as we know it) would cease to exist.

They have apparently been set back, but there are hordes of know-nothing "do-gooders" out there, still trying to enact their agenda. They'll try again.

I hope you will continue to keep us informed of developments on these important subjects!

I missed this awhile back. But, I do need to comment on it. Again, I wish these thread would default to the opt out rather than the opt in.

Leslie, you handled this beautifully, so I hope you don't think I am suggesting that you handled it incorrectly.

But, I picked and choose what patients to tell this too, but I am often right up front about the office charge. I will sometimes tell them, "yes it is about the money. We are not a pharmacy. We not only make any money by calling in medications and practicing medicine over the phone, it is bad medicine. The pharmacy will still get paid as they should, but we do not."

Bert,
As I posted a long time ago. We tell our patients that it is inappropriate and bad medicine attempting to Dx and or treat them over the phone. Furthermore, if they are still testy about it, I explain to them that there are codes that we could use to phone consults and the like, but that almost no insurance plan in the country pays for them, because of their own stupid reasoning. We could use such codes, but in the end they the end customer would almost certainly end up being responsible for such charges; SO, we are actually trying to do you a favor by having an office visit with you so at least your insurance will hopefully pay what they should for a standard office visit. That last part usually gets them re-adjusted if the first part didn't.

Al and Committee,
What about the idea of having Al give his CCHITT presentation at the ACAC??? And perhaps we could have this with Jon and one or two of his development team at least on panel for a post presentation conversation as to what is means to us and to AC as our Vendor? Roy are you listening out there??? I think this is an issue that has generated a lot of interest (be it mostly negative) here on the board. I for one would love to hear AC's perspective on it and what their short, mid, and long terms plans and thoughts are on it. I say keep your friends close and your enemies even closer, right?

What say all of you? Roy I think you must be part of something like this please. Al?

Hi guys:

I take it that the "ACAC" is the win-ding at that fancy resort? We could have a round table discussion on the impact of these HIT forces and how to defeat them. For a conference, the slideshow can be condensed to half the slide volume, especially the 22 slide history part which can be all placed on ONE slide. CCHIT/P4P/eprescribing can together go into 18 slides and the beginning and ending parts into about 6 slides... or less.

Brian was nice enough to help redo the redo slideshow significantly, especially in the concluding remarks. Here is how I summarized the changes for him in an email-

1) I put in a Leavitt joke! (tasteful, of course)
2) Almost took out Mitt Romney (and his views on HIT) now that he's out. I left him in as he could be the next VP and it's nice to have a 2-Dem slide and a 2-Rep slide (i.e. "balance").
3) Deleted a repeat slide about Stark regulations.
4) Really, really condensed and improved the concluding remarks as suggested.
5) Changed the color of the index tabbed topics from yellow to dark gray.
6) Added a 7/17/2006 Market Watch slide stating that CCHIT certified EHRs increase costs.
7) Put Brian's name on the last slide.

Title: HIT_in_the_USA18.ppt
URL: http://www.box.net/shared/static/cwejp2yo0k.ppt

BTW, tonight I'm sending a bouquet of flowers to our "spy" in Congress. According to her, the air of inevitability concerning CCHIT/P4P/e-prescribing is starting to thin out and crumble. In the last HHS meeting they stated that they will push in the first part of the year one last time [presumably on behalf of those that gave donations to Bush, like HIMSS], then give up and turn the paton over to the next president. She'll be emailing me more detailed information in the near future as things evolve.

Cheers!
Al

Al-
Could you please repost your files to www.box.net? For some reason, both the links above are coming up as not found on their server.

thanks

Here it is (the HIT_in_the_USA19.ppt version):

http://www.box.net/shared/static/mvwvacmck4.ppt

Happy reading!

Al

Al and Brian,
Thanks very much for a great little slide show. Even as tired as I was staying late last night, I just had to see the whole thing.

Al,
Is this link and the server it is one fairly stable? I know you were sort of kicked off EMR Update a while back. I ask because I really would like to pass this link around for others to see all the meat and facts you have put together.

Also, one interesting question that came to mind while reading it last night. There was a slide where "Both" Leavitts were standing side by side at the podium. Are these guys related as in family and not just industry??? Sure seems even more insider, nepatistic if they are. Might they be brothers, cousins, or what? Or do they really just happen to share the same last name and nothing else. As we all know as much as one should "follow the money" one should also "follow the friends and family" too, if you catch my drift.

Well be well to one and all. I'll catch ya on the other side...
Paul

Hi Paul:

Everything at emrupdate is relatively peaceful again. Nick suddenly called me and ended the foolish "banishment" that only served to fuel the fires. What gets me is how everyone is so *nice* there at this time... I actually talk with Nick, Robert, and Barbara Duck at least on an every other day basis. I was kind of let down by the banishment, but many, many, many good things happened that ended up being an overall good experience:

1) Although the number of emrupdate new members grew by about 2%, the average user time spent on the site for the banishment month dropped by 20% and the post content died.
2) A mini-second flareup preceded my sudden unbanishment; I'm very thankful to all of those that stood up for me. It warms the heart to see one's friends in action.
3) I got a lot done that needed to be done! Programming, family, Panama vacation, etc. Just after the first blowup I spent 4 days under the warm Panamanian sun and water cooling off...
4) The 6 month extension of the Medicare physician wages were extended and the HIT-tie-in was defunded. It's nice to *win*.
5) One of the 2 emrupdate moderators had to renounce his post; the other is keeping a very low profile.
6) I was offered an IT-related job which was enticing to say the least! I don't think that I'll ever leave my medical practice, though- it's still a lot of fun.
7) I didn't get killed when the stock market declined.


(possible website "look")

I am now keeping my own download site that emrupdate's download site references and which soon my own website will reference too. The URL that I've posted here is a direct link to the download site, so it's more than stable. Occasionally the URL will change as I upgrade the presentation, but this will be preceded by another posting. Never again will I have someone maintain a website for me that is critical to survival of my files!

Maybe the 2 Leavitts were adopted by an Al Queda terrorist family so as to torture physicians and bring havoc onto the USA medical system? We could now refer to them as "IHDs" (for improvised hot air deviates).

Cheers,
Al

Thought you guys would like this one. I just received an e-newsletter from Physicians Practice magazine. They discuss "Fearlessy buying an EMR" There 1st recommendation: Buy one certified by CCHIT.

Oh no.

Wayne- is there a URL for that reference? It would be nice if we can all respond to that one, bombarding their letters-to-the-editor department with our throughts, from the trenches.

In the meantime, let's all bear witness to the 10 Commandments of HIT:















































Al