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Similar to what we read daily in regarding to health care I found this tidbit regarding another unintelligible, inexplicable and mysterious document dated back to the 15th century, long before Medicare, HMOs, and ACOs
We are not unique !! Someone from a far distant and unknown galaxy comes this story !!
Don Berwick MD must have been on call last night. His testimony at the Senate Ways and Means Committee was a good thing for those wanting to repeal the Health Reform Law.
When faced with specific questions regarding the costs of reform, and it’s impact upon availabilty of care providers he failed to deliver answers, stating that was not his area of expertise. It’s obvious Dr. Berwick never ran his own medical practice. He seemed more bent on the propaganda and rhetoric of the Obama administration, Nancy Pelosi and Harry Reid..
It unfortunately does confirm that some doctors know bupkas about finances. and not just those in private practice.
He even went so far as to tell the committee that they would like the system once it was in place for several years. Most of the changes will not occur in 2011 and only begin to create an impact in 2013. I agree with some of the utopian ideals that Dr Berwick espouses, however it is obvious that neither side has drilled down on the impact of true costs to patients, employers, or care providers The bureaucracy will be stultify everyone concerned.
Even Berwick states that early predictions are way off.
The healthcare reform law, beating the Medicare actuary's predictions, has so far strengthened the privately-run Medicare Advantage program, Medicare chief Don Berwick testified on Thursday. Enrollment is up six percent while premiums are down six percent, Berwick told the House Ways and Means Committee.
The Centers for Medicare and Medicaid Services actuary had predicted that Medicare Advantage enrollment would drop 7.4 million over the next few years - starting this year - and that premiums would rise. Berwick said the initial results show that the prediction was incorrect. "I have the facts on the ground before me now," Berwick said. "The facts are that Medicare Advantage is looking stronger and stronger."
Can it keep up?: Berwick said he doesn’t know how long Medicare Advantage plans will continue to grow. “It looks like the industry thinks there’s a good future for Medicare Advantage,” he said, adding that he hopes it will keep expanding or at least stabilize.
So how can anyone predict where this will be in 2020 ?
High-risk enrollment low: If Medicare Advantage was the good news for the Department of Health and Human Services on Thursday, then high-risk insurance pool enrollment was the bad. Enrollment over the past three months is up 50 percent to 12,000 - well short of the 375,000 originally predicted by the end of 2010. HHS said the low enrollment is consisent with the experience of the Children's Health Insurance Program, and they unveiled new tools on Thursday to help boost the high-risk program's visibility.
Technorati Tags: Berwick,testimony,Senate,Ways,Means,Committee,Health,Reform,impact,area,expertise,propaganda,rhetoric,Obama,administration,Nancy,Pelosi,Harry,Reid,doctors,system,Most,ideals,bureaucracy,Medicare,Advantage,Enrollment,House,Medicaid,Services,results,prediction,plans,industry,High,news,Department,Human,insurance,Children,Program,tools,providers,employers,predictions,actuary,strongerA live web video from the hearing on Health Reform Repeal Legislation.
You listen, you decide, but a must view for everyone.
See all those ‘blue letters’ they don’t print.
In the hope that someday it might save me or my family some time (or maybe my life) I have been entering medical data into GH the past year or so.
Yesterday my wife has a doctor appointment and I went to health.google.com and logged in. I reviewed the data. It was easy to read online. I decided to print it and take it with us to the appointment.
As usual when going to the doctor one is rushed, so I clicked on the pdf tab and print and walked off. As I was running out the door and driving to the doctor I glanced at the print out. Much of it was blank, and'/or unreadable.
Now you may ask why. Why? Because Google was intent on making a ‘pretty display’ of basically boring data. So a great deal of it was in color, blue to be exact, which does not print at all on B&W printers (which many people have if they use a laser printer, or more likely a deskjet of MFP which has an empty color cartridge (which mine did ). I will bet you a buckwheat that most people have an empty color cartridge (because they are too expensive, and not really needed 95% of the time.
So Google if you are listening and not busy searching, please fix your Health web site so it is not useless for many people.
That old saying you don’t have to be a rocket scientist is just not true when it comes to your EMR and the ‘certification stamp’ on it.
You show me yours, and I’ll show you mine.
Each year, just scrape off the old label, and apply the new one…..there will be a new national committee with new rules…..
The ‘stamp’ must be approved by a collection of agencies and committees in a pyramidal structure which is constantly shifting every several years or so, and makes the Bernie Madoff or Enron scandal look benign.
Here is how it begins
The Office of the National Coordinator for Health IT has opened a 30-day window to accept applications for organizations seeking to be the approved accreditor of certification bodies under the permanent health IT certification program, according to a Federal Register notice published Tuesday, Modern Healthcare reports.
Health care providers seeking to meet meaningful use requirements can use electronic health record systems approved by ONC's authorized testing and certification bodies. Under the 2009 economic stimulus package, health care providers who demonstrate meaningful of certified EHRs can qualify for Medicaid and Medicare incentive payments (Conn, Modern Healthcare, 2/8).
Now listen up !!
Distinction Between Temporary, Permanent Certification Programs
ONC issued the final rule on the temporary testing and certification program in June 2010 (iHealthBeat, 7/2/10).
Under the temporary program, vendors can receive certification for products designed to help health care providers meet Stage 1 requirements of the meaningful use program (iHealthBeat, 9/7/10). ONC has selected six ATCBs for this purpose (Mosquera, Government Health IT, 2/8).
In January, ONC issued a final rule to establish a permanent health IT certification program for EHR systems and modules. The permanent program separates the testing and certifying of health IT products.
The final rule stipulates that ONC will choose one organization -- the ONC-approved accreditor -- to accredit groups aiming to become a health IT certification body (iHealthBeat, 1/4).
After an entity is accredited by the ONC-AA, it can apply to become an ONC-authorized certification body (Goedert, Health Data Management, 2/8).
Are you still with me?
Application Details
Applicants looking to become the ONC-AA must provide details that include:
The selected ONC-AA will serve in that role for three years and can be re-selected after a competitive process (Health Data Management, 2/8).
Let me slow down a bit for this next one. Raise your hand if I need to repeat any of this.
I hope to be publishing my blog more regularly. The past week I had a major malfunction of my computer. Always the one to make things better by adding dual monitors (for more screen real estate) I managed to corrupt several drivers, then my hard drive. (at least I had a good backup). After recovering the system (and having one full day of Window Updates (150 or thereabouts) I am considering upgrading to Windows 7. It can’t be any worse than what I went through this past weekend. My blogging platform has been Windows Live Writer. It’s much faster than posting on the blogger platform, and the bonus was getting all the new plug-ins.
So stay tuned for more blogs from The Health Train Express
Paul Levy, formerly the CEO of a large hospital writes in today’s The Health Care Blog’ about conspiracy theories Here are some excerpts for clarity on my comments which are also posted at the original blog post.
He mentions excerpts from a writing of George Bernard Shaw, and I am not entirely certain which part of his post is the quote or if the entire article is from Shaw’s “The Doctor’s Dilemma, Preface on Doctors”
Quotes, to follow
“The truth is, there would never be any public agreement among doctors if they did not agree to agree on the main point of the doctor being always in the right
But for this very reason no doctor dare accuse another of malpractice
That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. But that is precisely what we have done. And the more appalling the mutilation, the more the mutilator is paid. He who corrects the ingrowing toe-nail receives a few shillings: he who cuts your inside out receives hundreds of guineas, except when he does it to a poor person for practice.
But the effect of this state of things is to make the medical profession a conspiracy to hide its own shortcomings.
Public ignorance of the laws of evidence and of statistics can hardly be exaggerated.
If I attribute these comments to the wrong person, I apologize.
It seems to me GBS was wrong about many things.
Health is not the only space being driven by information. It has received the lion’s share of exposure, however we should not forget the rest of the spaces, government, military, financial, industry, and technology. The amount of recorded data multiplies almost exponentially for each industry, much like a nuclear fission reaction., and there is significant fallout.
Our ability to understand and incorporate into a useful knowledge base overwhelms our capacity to understand the information to frame it into useful form.
The federal government IT efforts, and others have and are continuing to build software to extract and display this deta into images understandable at first glance. Without this the data is useless.
The same limitations apply to medicine, and medical research. Who has not read a journal article that quotes ad nauseum statistics which only a statistician can interpret? How many of us skip to the conclusions to ferret out what the article is all about? That’s me!!
The web site data.gov is a not so secret open source for information ranging from The Open Government Initiative to an almost infinite number of data sets, including open data sets from all the major US Government Departments
The best way to find out what is in there is to explore the site. It is pretty amazing !
The California Health Foundation sends a daily eletter ( iHealthBeat)about topics of interest to medical professionals
There are a number of remarkable items in today’s publication.
We are going to be reporting on developments on HIT progress that are important news. Our sources reveal that HIT in healthcare is making progress. There are differing opinions on the rate of growth depending on which side of the argument you lie. Most physicians are still skeptical that the huge investment will pay the dividend claimed by vendors, CMS, insurers and the pundits, while some who have adopted EMR in their practices say they would never go back. Well, I think not if I had invested between 50 K and 100K USD and managed to persist through the adoption process successfully, or not I would be happy unless the EMR was a ‘pig in a poke’, reduced my income, and consumed more of my time being a data entry clerk.
EMRs are only going to make it easier for those who read our reports, clerks, utilization reviewers, and audits.
80 % of Internet Users Seek Health Care Information Online
Study Suggests Some Health Providers Lag in New Coding Transition
Report Finds Doctors and Public Agree on Many Health IT priorities
VA seeking advice to Upgrade Health IT to Open Source Software to Upgrade Legacy Systems
States Line Up for Grants from ONC’s Health Information Exchange Challenge Program
Disruptive Women in Health Care Health Care Roundup features Hope Ditto and the state of the world…disruption seems to be the key word for 2011 thus far. Health care is not alone. It is a good read!
Are you waiting for Health Train Express on the train platform? Have a seat and call 911.
If you are at all wondering if your doctor will be there next time you call, you are operating in reality. In a recent survey sponsored by a well known EMR vendor the results are stunning. Practice Fusion’s independent consultants found the following:
Key findings:
* 41 percent of doctors report that their practice is doing worse this year compared to last year. Compared to 26 percent who report their practice doing better and 31 percent report no change.
* 59 percent report that new technology has made things easier for their medical practice.
* 73 percent report that the computers in their practice are over three years old on average (21 percent in the five to six-year-old range).
* 69 percent of doctors report being satisfied to extremely satisfied with their career despite these challenges.
* Doctors were also asked to report their practice's top negative pressures and positive trends in a series of open ended questions.
* Issues relating to practice administration (31 percent), insurance and reimbursement (26 percent) and difficult patients (11 percent) are the top negative pressures on the practices.
* Positive trends are led by advancements in medicine (22 percent), patient quality (19 percent) and improvement in the healthcare workforce (15 percent).
* 80% of US physicians practice in groups of 9 or less according to the AMA.
View Practice Fusion's 2011 State of the Small Practice info graphic. Raw data from the survey is available free upon request. Practice Fusion is also offering physician sources across the country to talk about their own experiences managing a small practice.
Survey Methodology
The Practice Fusion State of the Small Practice study was conducted by internet survey in December 2010 with MDLinx. Responses to 10 questions were collected from a national sample of 100 physicians. The majority of respondents were primary care providers in practices with fewer than six providers.
Admittedly this was not a very scientific study, nor was their any indication of the demographic of the study group, not taking into account the geographic location, age of the physician, or medical practice. The statistic lumped all small practices from 1-9 physicians. That is quite a spread. The resources of a one or two man group are far different than three or more individual practitioners.
"Small primary care medical practices are the backbone of the US healthcare system," said Ryan Howard, CEO of Practice Fusion. "These are family doctors on the front lines, they're passionate about caring for their patients and our survey indicates that they're struggling. “
EMR vendors as part of their service will evaluate a medical practice for implementing a system. This includes a thorough analysis of costs and return on investment. They know the financials within which physicians operate. If anything they are biased toward selling their system,, and having a client be able to purchase and pay for it.
This survey by Practice Fusion (which offers a totally free EMR which operates in the cloud) points out that even with a ‘free EMR” practices cannot afford the down time or the cost of minimal hardware investment.
Most small practices, and larger ones are operated with less than optimal physician/staff ratios. The staff has to be multi-tasking in their job description. This is not always possible.
How many times do you receive an answering machine when you call the doctor’s office? My observation is it occurs a great deal of the time. The message is ‘if it is a medical emergency to call 911 or go to the emergency room.”
How about that for improved quality of care? Government studies do not measure that metric, “the first mile to the health care system”.
Let me have your thoughts on this matter.
You can tweet me @anophthalmus, or leave a message on facebook/garylevin
And here is the top of the blogosphere news for Monday, January 31, 2011
Dr Val 5 million dollar fine for Doctors asking questions about Guns in the home
The Health Care Blog A Medical Student’s Dilemma
Dr Wes Carding Doctors?
Dr A Social Media to Traditional Media, or why you should participate
Health Policy and Communications Blog Rise of the Tea Party Machine
Life as a Healthcare CIO Cool Technology of the Week
Medinnovation Health Reform and Pay-for Performance,Not So Fast, Macduff !
Wall Street Journal Health Blog Six Health-Care IPOs Planned For This Week
Disruptive Women in Health Care Who’s a Medical Doctor?
Kevin MD Marcus Welby and the relentless growth of specialization
Edwin Leap The Physician Exodus
iHealthbeat Report Says Health IT Has Potential To Advance Personalized Medicine (report from the Brookings Institute
