Just curious–do they have an off-the-shelf, prototype people can see online? Why am I thinking, “No.” Cost information? Estimates of user time needed to maintain records? File sizes? etc. Any people with systems up and running docs etc can visit or call or online videos or anything like people do these days? Companies to install and/or maintain? Or software reps giving docs vacations in Aruba…whoops, uh…Vegas, if they buy a system? Or real world stuff. No? Ok. Just thought I’d ask. NancyO
Not many Vegas vacations for docs, usually “user group” meetings for staff. Working meetings.
Do I detect a hint of sarcasm?
There are lots of plenty of prototypes, lots of different systems and lots of anxious vendors. Lots of advertising. Plenty of up-and-running systems to look at. There is plenty of cost data, some reliable some not.
Biggest complaints.
Cost Complexity Clumsy input devices Conversion costs and difficulties Training and staffing costs Compatability with other providers (this is why a push for EHR and not just EMR) Ridiculous bureaucratic rules Conflicting bureaucratic rules
up until recently i could be reasonably sure that anything my doctor said about me stayed in his office file. now may favorite FBI agent, or political enemies, can just go on line.
i seem to have forgotten all the advantages of this.
but my own experience and that of some friends in real business suggests that computer systems are not all that reliable.
most of you children don’t remember what a #2 pencil could do, but it’s how we tamed the west.
up until recently i could be reasonably sure that anything my doctor said about me stayed in his office file. now my favorite FBI agent, or political enemies, can just go on line.
i seem to have forgotten all the advantages of this.
but my own experience and that of some friends in real businesses suggests that computer systems are not all that reliable.
most of you children don’t remember what a #2 pencil could do, but it’s how we tamed the west.
Who are you trying to kid? There are medical conventions around the country on a more than regular basis and specialists at least travel all the time.
My brother is a specialty surgeon with a case-load that would boggle anyone’s mind. But he still manages to get out to the West Coast, and in intervals between grueling convention sessions, still see his (and my) Mom and take her and his wife out to San Francisco area fine dining venues. Which is some pretty fricking good dining, which since before he went back to medical school he was a professional chef.
Those of us who follow this stuff on a semi-regular basis know that the life of many,maybe most, Family Practice and Primary Care doctors ain’t a total bed of roses: lots of hours for what is in context not that much pay.
But let’s get real,being a doc doesn’t just mean getting unlimited promotional pens from drug reps, you don’t have to be that much on the ball to promote all the paid Vegas trips,or Miami trips, you would ever need. They just may not, and probably will not pick up your gambling and bar bills. But your hotel room and wine dinners? In Vegas? Unless your name is Saint Doctor Marcus Welby and your practice confined to the inner city chances are pretty good that you have seen some resort somewhere on someone’s dime.
As you know I am currently bouncing around the country, in part or mostly buffeted by economic winds. Story for another time and another forum. But one anchor for me is the VA (Veterans Administration) medical system. Since last June no matter where the leaf blower of life temporarily deposits me, my medical care and my medical records are just as close as the nearest VA Clinic. Or in a pinch I can go on-line and have refills of my meds mailed where I need them. And if I have to go to the doctor I don’t have to review my medical history or that of my family from memory before getting treated. Because it is all there.
So forgive me if I don’t have nostalgic recollections of my own incarnation of Marcus Welby, a medical chart, and a number 2 pencil. Even if the FBI and NCIS have theoretical access. Beats a questionnaire on the gurney in the hall outside the emergency room when you are having heart palpitations.
Although the rules are readily available in PDF, there are reports the rules may not be published in the Federal REgister soon, which means they would not yet have force of law.
Well, geewhiz, Bruce, I think that Vegas is low class. But, a lot of other people in the professional world don’t. SSA meets in glamorous spots like Modesto and Temecula. It’s a true test of one’s professional zeal to get up enthusiasm for a meeting at a Ramada Conference Center ($65 dollar rooms) off I-5 on the way to Stockton, believe me. But, hey! Doctors are human beings and SSA soldiers just don’t rate. NancyO
Bruce–Agreed. Same in SSA for beneficiaries’ records. Now even claimants’ medical records are being digitally stored. But, I was wondering about competing systems in doctors/providers’ offices outside the VA and/or federal govt. agency files. Strikes me as a big impediment to implementation of any such scheme. NancyO
Wouldn’t be the first time the contractor sent in a deliverable in the form of a long prose set of instructions and systems requirements with zero actual working prototypes. And, not a trace of any real regulatory muscle. Happened a lot in the Reagan administration. SSA paid for a lot of wonderful stuff that never saw the light of day. NancyO
STR–In the old days, agencies’ or Congress’s staffers wrote regulations. Now, contractors who are hired by the affected agency or Congressional committees write them. So, it may be that a contractor’s employees did the writing and the DHHS just reviewed the proposed language. Wouldn’t surprise me. I read (but can’t cite the source) that Heritage and AEI actually wrote the President’s budget. So, kind of like ALEC doing canned legislation and flogging it to state legislators or Congressional committees. NancyO
I will continue to ask you the say question. How many pages has your current insurance plan. Rusty, you know as well as I do, it is more than 1 page, more the two dozen pages, and problem many pages long. What they miss, they make up along the way. Rusty, who are you kidding?
I will continue to ask you the same question. How many pages has your current insurance plan. Rusty, you know as well as I do, it is more than 1 page, more the two dozen pages, and problem many pages long. What they miss, they make up along the way. Rusty, who are you kidding?
a very good post, thanks! It’s the first time I come to your site, just found it in Bing. I’ve been going around and there’s a lot of top quality work. But I tried to add it to my RSS Reader and can’t. Perhaps it’s a only something going on with me. It is really a very good source.
The Obama administration has now published about 1300 pages explaining how hospitals and physicians should use electronic health records systems.
“Experts” are wondering why independent physician practices are not jumping into the stimulus EHR program.
Duh.
Bad bureaucrats, poor results.
The 1300 is in two batches, the first 850 published a couple of years ago.
Just curious–do they have an off-the-shelf, prototype people can see online? Why am I thinking, “No.” Cost information? Estimates of user time needed to maintain records? File sizes? etc. Any people with systems up and running docs etc can visit or call or online videos or anything like people do these days? Companies to install and/or maintain? Or software reps giving docs vacations in Aruba…whoops, uh…Vegas, if they buy a system? Or real world stuff. No? Ok. Just thought I’d ask. NancyO
Not many Vegas vacations for docs, usually “user group” meetings for staff. Working meetings.
Do I detect a hint of sarcasm?
There are lots of plenty of prototypes, lots of different systems and lots of anxious vendors. Lots of advertising. Plenty of up-and-running systems to look at. There is plenty of cost data, some reliable some not.
Biggest complaints.
Cost
Complexity
Clumsy input devices
Conversion costs and difficulties
Training and staffing costs
Compatability with other providers (this is why a push for EHR and not just EMR)
Ridiculous bureaucratic rules
Conflicting bureaucratic rules
just a thought from my worried mind:
patient privacy?
big brother?
up until recently i could be reasonably sure that anything my doctor said about me stayed in his office file.
now may favorite FBI agent, or political enemies, can just go on line.
i seem to have forgotten all the advantages of this.
but my own experience and that of some friends in real business suggests that computer systems are not all that reliable.
most of you children don’t remember what a #2 pencil could do, but it’s how we tamed the west.
just a thought from my worried mind:
patient privacy?
big brother?
up until recently i could be reasonably sure that anything my doctor said about me stayed in his office file.
now my favorite FBI agent, or political enemies, can just go on line.
i seem to have forgotten all the advantages of this.
but my own experience and that of some friends in real businesses suggests that computer systems are not all that reliable.
most of you children don’t remember what a #2 pencil could do, but it’s how we tamed the west.
The feds want two somewhat conflicting goals:
1. easier interchange of data
2. better privacy protection
Not many “Vegas Vacations” for Docs?
Who are you trying to kid? There are medical conventions around the country on a more than regular basis and specialists at least travel all the time.
My brother is a specialty surgeon with a case-load that would boggle anyone’s mind. But he still manages to get out to the West Coast, and in intervals between grueling convention sessions, still see his (and my) Mom and take her and his wife out to San Francisco area fine dining venues. Which is some pretty fricking good dining, which since before he went back to medical school he was a professional chef.
Those of us who follow this stuff on a semi-regular basis know that the life of many,maybe most, Family Practice and Primary Care doctors ain’t a total bed of roses: lots of hours for what is in context not that much pay.
But let’s get real,being a doc doesn’t just mean getting unlimited promotional pens from drug reps, you don’t have to be that much on the ball to promote all the paid Vegas trips,or Miami trips, you would ever need. They just may not, and probably will not pick up your gambling and bar bills. But your hotel room and wine dinners? In Vegas? Unless your name is Saint Doctor Marcus Welby and your practice confined to the inner city chances are pretty good that you have seen some resort somewhere on someone’s dime.
Dale. “all the advantages of this”
As you know I am currently bouncing around the country, in part or mostly buffeted by economic winds. Story for another time and another forum. But one anchor for me is the VA (Veterans Administration) medical system. Since last June no matter where the leaf blower of life temporarily deposits me, my medical care and my medical records are just as close as the nearest VA Clinic. Or in a pinch I can go on-line and have refills of my meds mailed where I need them. And if I have to go to the doctor I don’t have to review my medical history or that of my family from memory before getting treated. Because it is all there.
So forgive me if I don’t have nostalgic recollections of my own incarnation of Marcus Welby, a medical chart, and a number 2 pencil. Even if the FBI and NCIS have theoretical access. Beats a questionnaire on the gurney in the hall outside the emergency room when you are having heart palpitations.
Most of the medical conventions are association meetings with docs paying their own way.
Most docs i know think Vegas is low class.
Although the rules are readily available in PDF, there are reports the rules may not be published in the Federal REgister soon, which means they would not yet have force of law.
Now what?
Well, geewhiz, Bruce, I think that Vegas is low class. But, a lot of other people in the professional world don’t. SSA meets in glamorous spots like Modesto and Temecula. It’s a true test of one’s professional zeal to get up enthusiasm for a meeting at a Ramada Conference Center ($65 dollar rooms) off I-5 on the way to Stockton, believe me. But, hey! Doctors are human beings and SSA soldiers just don’t rate. NancyO
Sorry, Bruce. I meant to direct my remarkstarting with “Well” to STR. NancyO
Bruce–Agreed. Same in SSA for beneficiaries’ records. Now even claimants’ medical records are being digitally stored. But, I was wondering about competing systems in doctors/providers’ offices outside the VA and/or federal govt. agency files. Strikes me as a big impediment to implementation of any such scheme. NancyO
Wouldn’t be the first time the contractor sent in a deliverable in the form of a long prose set of instructions and systems requirements with zero actual working prototypes. And, not a trace of any real regulatory muscle. Happened a lot in the Reagan administration. SSA paid for a lot of wonderful stuff that never saw the light of day. NancyO
Bruce
i’ll take your word for it. i have never had a medical condition that required more than one visit for the dr to tell me it was all in my head.
nevertheless i think i would worry about that privacy thing.
I like Vegas, cause it isn;’t the midwest. Docs usually go more upscale, at their own expense.
When i stay at someone else’s expense I stay as cheap as i can.
No tears for government bureaucrats please.
And hey, they can get even better deals in Flint Michigan.
What contractor? Huh?
STR–In the old days, agencies’ or Congress’s staffers wrote regulations. Now, contractors who are hired by the affected agency or Congressional committees write them. So, it may be that a contractor’s employees did the writing and the DHHS just reviewed the proposed language. Wouldn’t surprise me. I read (but can’t cite the source) that Heritage and AEI actually wrote the President’s budget. So, kind of like ALEC doing canned legislation and flogging it to state legislators or Congressional committees. NancyO
STRB:
I will continue to ask you the say question. How many pages has your current insurance plan. Rusty, you know as well as I do, it is more than 1 page, more the two dozen pages, and problem many pages long. What they miss, they make up along the way. Rusty, who are you kidding?
Str
I will continue to ask you the same question. How many pages has your current insurance plan. Rusty, you know as well as I do, it is more than 1 page, more the two dozen pages, and problem many pages long. What they miss, they make up along the way. Rusty, who are you kidding?
a very good post, thanks! It’s the first time I come to your site, just found it in Bing. I’ve been going around and there’s a lot of top quality work. But I tried to add it to my RSS Reader and can’t. Perhaps it’s a only something going on with me. It is really a very good source.