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healthcare related......but a little different.

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Reb Cpl View Drop Down
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    Posted: 22 November 2009 at 9:00am
The IT company I work for is actually part  of a larger company, a Medical billing company out of Albany NY. They're actually the largest in the capital region by far. I know I've mentioned that, but its a good intro to what I'm going to rant about.

Most of our clients are in the medical field, doctors, dentists, etc...everything from family practice to urgent care centers and so on. There has been talk for some time now that the government is planning on having all medical records done electronically. What does this mean? It means that all of your medical records would be available to any medical practice, anywhere, immediately, which is great if you happen to be on vacation in Juneau and break both your legs in a slip and fall accident while going to the outhouse.

The government is even offering early sign up incentives for medical practices who jump on board sooner rather than later....Everyone is supposed to be up and running by 2011 I think, and the closer to the deadline you get, the smaller the incentive package.

There are hundreds of software programs out there that would do the job of putting these records out there.....and they're all different....and very, very expensive to implement- which is why the incentives are nice, they'll cover a large portion of the expense involved in getting these programs up and running.

The issue is, that neither the state or federal government has standardized the regulations for what they would like these programs to do...so people are hesitant to purchase these programs for tens of thousands of dollars because once the standards are finalized, they might be left with a program that's out of compliance.....but in the meantime, the incentives are getting smaller and smaller. They either have to gamble on a program, or pay for the finalized version out of pocket when the powers that be get off the pot and make a call on it.

Not only that, there are upgrades to a system of delivery for payment (and I'm a little bit fuzzy on the details on this one, but I think it has to do with HIPPA) that is coming out soon that requires one of these programs to run.

So again, there is financial push to get into one of these programs, as well as a near requirement for one of these pieces of software to be put up quick, fast, and in a hurry......but aside from the general "Put your records online" claim, the government hasn't got a clue on what they want each of these programs to actually DO in the meantime.

.....This system that they're proposing has been in place with the VA for a long time, and even Mexico has it in place nationwide. I don't know why we've dragged our feet for this long, or why the practices are being screwed to the wall with a lack of standardized requirements. Its  interesting.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Reb Cpl Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 11:08am
Also, this thread doesn't have a real point other than my expressing a little consternation over something that doesn't make sense. 


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Linus Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 11:10am
BOO GOVERNMENT!



PS--- While it is a great thing they are wanting to do, some agencies don't want to get on board, because doing any part of their billing electronically means they have to be compliant with HIPPA.

Edited by Linus - 22 November 2009 at 11:11am

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Reb Cpl Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 11:23am
Originally posted by Linus Linus wrote:

BOO GOVERNMENT!



PS--- While it is a great thing they are wanting to do, some agencies don't want to get on board, because doing any part of their billing electronically means they have to be compliant with HIPPA.


I'm not saying 'boo government' I'm just a little irritated that something thats supposed to be a huge deal hasn't been standardized yet, and may end up costing millions out of pocket for these practices.

And electronic billing is only one piece of the puzzle....the main part of the pie is the migration of records to electronic systems.


Edited by Reb Cpl - 22 November 2009 at 11:24am


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ben Grimm Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 12:09pm
I've been reading about this - many of the US practices/hospitals that have gone electronic haven't seen any particular savings for exactly the reasons you describe.  Great, we have electronic records - now what?
 
It is somewhat silly.
 
I suspect the theory here is that the good old free market will figure it out.  Once enough records have been electronified, money-saving software will pop up - including software to help bridge temporary incompatibilities.
 
The gubmint could of course mandate standards and procedures which would get us there faster, but at the presumed cost eventual free market savings.
 
To me this is like the early adopters for digital cameras.  When we got our first digital camera there was no meaningful way to get physical prints, and people thought we were silly.  Now there are services, good printers, etc. - all because enough people got the cameras.  We just need the critical mass installed.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tallen702 Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 4:08pm
Ben, I still don't see the cost saving initiative being as cost-saving as people believe. The redundancy of records almost demands that there be a paper backup in case the system in a particular hospital goes down. That means charts, prescription orders, care directions, etc will still need to be printed on a daily, if not hourly basis.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote God Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 4:20pm
You dont have to print every hour, there are numerous backup electronic solutions. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DaveEllis Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 4:20pm
My ER uses something called http://www.poseidongroup.com/ Poseidon.  Its an electronic patient charting system, its pretty neat, all the pt visits are neatly listed if they've been there under the Poseidon system so you can easily find past allergies and in the case of some of the frequent fliers you can find out what drug they're seeking.  It also has a status board and what not.

But one of the ironic things is that even with "paperless charting" you still use a large quantity of paper.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote impulse!! Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 4:21pm
Not a fan.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote God Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 4:26pm
Plus, i dont think the huge amounts of paper created at individual hospitals is the biggest issue that is trying to be addressed. 
I believe they are trying to make it easier from patients to take their records from place to place and not have to wait for their records to be faxed back and forth, when an email or data stick would be easier.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DaveEllis Quote  Post ReplyReply Direct Link To This Post Posted: 22 November 2009 at 4:37pm
Agreed, this is one of those things that there is so many caveats to, with the obvious huge issue being data security. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ben Grimm Quote  Post ReplyReply Direct Link To This Post Posted: 23 November 2009 at 11:58am
Originally posted by tallen702 tallen702 wrote:

Ben, I still don't see the cost saving initiative being as cost-saving as people believe. The redundancy of records almost demands that there be a paper backup in case the system in a particular hospital goes down. That means charts, prescription orders, care directions, etc will still need to be printed on a daily, if not hourly basis.
 
Why would there be paper backup?  The entire business world functions without paper backup.  Local redundancy combined with offsite backup is far superior.  Forget hourly - backup is realtime.
 
I have seen what going from paper to electronic has done for business, and I find it difficult to believe that there aren't tremendous savings and service improvements to be found for the practice of medicine as well.
 
Actually, I can offer up a couple of personal observations:  I just relocated, and as part of that I had to find new doctors.  That's enough of a pain, but then getting records transferred is more pain.  And then sitting in the doctor's office waiting while the new doc is trying to interpret a crappy fax of the old doc's crappy handwritten notes was really painful.  As a result I was probably prescribed some incompatible drugs that will kill me.
 
Second, there is consulting and outsourcing.  Radiologists already email scans around for review, and that's great - but what if a consulting physician would like to compare the scan to the patient's record?  Oops - not so easy.  Thus proper consults (which are important to proper medical care) are either limited to physically proximate doctors or limited to limited review without full information.  Neither are good.
 
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