Butterflies

It is late September and the Monarch Butterflies are in the air, migrating through my town. It seems like a time to republish my piece on chaos theory and the  'Butterfly  Effec"

By some chance here it is several years later and the Affordable Care Act will commence in several weeks.

Where is my butterfly net when I need it?

Health Care Reform is here, or is it? Frankly the whole thing is so complex that no one really knows how this is going to work, if it does. True to form our government is telling us we are going to save so much money by spending more money now. 17,000 IRS workers to keep track of who has purchased insurance, and who has not. There will be a new check box on your 1040 asking you to swear that you have purchased insurance. Insurers will undoubtedly issue 'stickers' to place on your 1040 forms.

Welcome to Democracy .

On Thursday, the California Occupational Safety and Health Standards Board voted to set up a committee to examine whether condoms should be required on all pornographic film shoots within the Golden State.

California has run out of money, but it hasn’t yet run out of things to regulate.

That's a great point. Does the government have the power to force you to buy something simply because you are alive? If that is true, what prevents the government from mandating that everyone must also buy a casket, funeral plot or urn for your ashes.

MORE B.S.

Health Care BS

I wrote this piece three years ago, and it is time to expose it to the light of day again. Most of it still rings true.

Cleaning the Augean Stables of the Health Care Debate

About Catron

Health Care Dues:
Twenty years on the front lines of health care finance, doing battle with the forces of darkness (i.e. CMS and the managed care companies).
Imaginable analysis of the current B.S.  we are all subject to on a daily basis.
A  worthwhile blog to add to my blog links.
Reenbean posted a very good summary of what is wrong with our patients. on SERMO.   The Patient Owns The Disease, in the  Emergency Medicine Categoy.
You will have to log in or join.  It is free and worthwhile.
******************************************************

Richard Reece of Medinnovation

del.icio.us Tags: health train express,medinnovation,Catron

today comments,
“The Affordable Care Act will start to roll out between 2010-2014. Given the volatile political scene, no one knows what this portends for physicians and patients. The only certainty in the new term is higher costs for all. But the uncertainty doesn’t dissuade a quasi-futurist like me.Whatever happens, the practice landscape will never be quite the same again.
For a piece of writing to be effective, you should choose a a suitable design and hold to it. For today, my design is 11 mindsets outlined in John Naisbitt’s book Mind Set!

Accountable Care Organization:  Ready, set, go…..

Accountable Care ???

1. While many things change, most things remain constant - I do not expect things to change radically or rapidly for physicians. Medicare and Medicaid will continue to be the big payer. Medicare will still pay 20% less and Medicaid 40% less than private payers. More doctors will stop accepting new Medicare patient/ Government will not come to grips with the Sustainable……..
For the remaining commentary, go here..

Solar Flare and Health Care

Catchy title ? I always wanted to be a poet (not what you think, click to see)  and it is obvious my poetry is at the second grade level (that’s pushing it a bit).

I awoke this AM, as usual, much to my surprise. Believing the apocalyptic prediction about last night’s stream of cosmic energy I donned my radiation suit and wore my dosimeter to bed.

During the night I had bad dreams about the electromagnetic storm and what it would do to your EMR, the Nation’s non-existent HIEs, my  own PC and hard drive as well as the electrical grid. And that says nothing about the billons of chips, ROMs, RAMs and the ability to fly drones over my home.  I pictures 747s, F 35s falling out of the sky, cruise ships floating (hopefully) dead in the water, the complete shut down of the government, and the cell phone network down.

 

Like many ‘facts’ that are passed along on ‘open source’ transparent communication on the internet where is the evidence for this statement that an EMF will destroy your ‘chips’, and erase data.
This says nothing about the negative effects on social media for health care, and advertising.
My messenger is still streaming, Google + is still there. I don’t know about Facebook or twitter, I only use them to feed my main squeeze G+ and hangouts.

I awoke this morning hoping to not be able to post this blog. A day off due to a solar storm does not seem that outrageous, and I would lose no income from a day off. I write this blog out of love, not that I couldn’t use the money during retirement.

Is there a CPT code for social media ? Will it be part of meaningful use? Are your outcomes improved by using social media.  How can we measure it.  Let’s form a committee to measure it.  I am applying for a ten million dollar grant from HHS to create a ‘pilot project’.  That is probably a better idea than most of the ‘pilot demonstration projects’ from HHS and CMS. 

Hmmm, maybe I should ask for $100 million USD so it will show up as a line item in the budget.  Ten million is chump change in the discretionary budget (for drones, seal team expeditions, and Obama’s campaign.

Monetize my blog?  Probably better chance of being hit by a meteor
.

Technorati Tags: monetize,blog,solar flare,cpt code,social media,pilot demonstration,hhs,cms,g+,hangout

Medical State of Mind

I read many blogs from medical students or doctors-in-training. I realized that some of us totally ignore medical education and what the future portends for our younger brethren.

Especially if you are retired, we owe it to them to "Pay it Backwards" and continue as champions for patient advocacy and care.

The alliance between patients and physicians grows stronger as the threats of the health insurance-government industrial complex grows stronger as well.

For those retired, disabled or who have migrated to non-clinical work, we owe it to ourselves to look back and kick the villains hard.

Indoctrination, automation, subjugation, must be curtailed in a subject as humane as health care.

There are many trainee blogs

Medical State of Mind

The Nuclear Option.

State of California Beneficiary Identification Card

   California Governor Jerry Brown and President Barak Obama
Despite California’s challenge with debt Governor Jerry Brown has a very experienced hand on the rudder..He is no stranger to adversity, and seems to be quietly picking away at the trash left behind by several recent governor’s.
Brown seems intent on accelerating California’s Health Insurance Exchange and preparing Medi-Cal’s planned expansion for the newly ‘insured mandate.  There is serious concern about Medi-Cal’s readiness to accept more ‘insured’.  Financially it will be a challenge even with Federal matching funds.
Surrounding the increase in eligible will involve careful examination of an eligibility process that is seriously flawed. Depending on that for a foundation will doom the effort to failure and offer an empty promise to hopeful patients who may be rejoicing prematurely
As a former provider (physician), how I hate that new classification of my intellectual ability, and also as a recipient during hard times on disability, the process is not consumer friendly.  Want that our government would become patient centric and consumer friendly as well as accountable as in the PPACA.
Medi-Cal in it’s present form is not insurance !  It is not even a ‘safety net.  It is more like a trampoline with large holes that let patients fall through or if they are fortunate to hit something solid….they bounce around quite a bit before obtaining benefits.
If Medi-cal want to provide insurance coverage then they should pony up and act like a regulated insurer, not some special government agency that completely misses the point …
In it’s present rendition medi-cal rules are complex, much more than I could address in a short bl og.  The rules and regulations are nicely detailed here.   Eligibility requirements are a maximum asset value of 2,000-4,000 dollars depending on family size. Does this mean to obtain guaranteed insurance one must also be destitute in addition to being previously uninsured? In addition one’s income must meet a threshold below `125% of the poverty line, indexed according to family size.  None of this has a familiar sound in the world of ‘real insurance.’  Medi-Cal’s mantra is if you aren’t poor when you apply, wait, when you start getting <Medi-Cal benefits…you will be destitute or worse.
Furthermore medi-cal benefits have a unique term called “Share of Cost’  The accounting of how income and expense are determined is subject to a strange algorithm of which no one can explain, and neither can the clerks and administrators of the system. Plainly or not so plainly the numbers are crunched several time using differing indices to derive ‘real numbers’ from a byzantine matrix of adjustments,  factors indexed my more unknown guidelines. And finally all the regulations are set forth in llllll.

It is an outrageous system , designed to limit benefits, and somehow save the state.  The fee for service is antiquated and should be completely abandoned without a doubt.
The hope for Medi-cal/caid is the managed care option which truly is managed with case workers and some indication of attempts to be a consumer friendly system.  One serious flaw is that one must have no share of cost to qualify for the managed care option/ Losing one family member increases your share of cost by over 1200 dollars (per month), and terminates your physician arrangement since one is cast back to FFS Medicaid, whose providers are different than managed care Medicaid.
I very much doubt these facts have ever faced the scrutiny of voters….I doubt if legislators are even aware of how bureaucrats have usurped what they think is a ‘generous safety net’.
The Medicaid Expansion proposed under the PPACA is the subject of much discussion:
Most government systems need an injection of sound business practices, and I am not talking about venture capital or profits. Systemic errors seem to go on and on unchecked simply by the sheer size of government agencies. Mistakes are buried…few are terminated for incompetence, they are shuffled to other positions in the civil service system. Good management in health care goes far beyond short term financial savings. In fact Medi-cal often creates worse situations for patients.
Rather than list more of my observations in my next several blogs I will outline measures to correct Med-cal’s shortcomings before it’s dysfunction is spread by PPACA.
This is a system ruled by the “Lowest Common Denominator” invented by committee and administered by uncreative people unwilling or unable to step out of the box, blindly following rules, with the over-riding fear of “fraud and abuse’.  Abuse, yes…by the very system set up to protect and serve, fraud…maybe some but often due to the sheer volume and complexity of the system itself.
As an indicator of the coming melt-down:
President Barack Obama thinks his health care law makes states an offer they can't refuse.
 
Whether to expand Medicaid, the federal-state program for the poor and disabled, could be the most important decision facing governors and legislatures this year. The repercussions go beyond their budgets, directly affecting the well-being of residents and the finances of critical hospitals.
The health care law will go into full effect next Jan. 1, and states are scrambling to crunch the numbers and understand the Medicaid trade-offs. Louisiana's health secretary, Bruce D. Greenstein, is concerned that the Medicaid expansion could replace private insurance for many low-wage workers in his state, dragging down quality throughout the health care system because the program pays doctors and hospitals far less than private insurance. He says the Obama administration and Congress missed a chance to overhaul Medicaid and give states a bigger say in running the program.
"Decisions are made by fiat," he said. "There is not any sense of a federal-state partnership, what this program was founded on. I don't feel in any way that I am a partner." The Obama administration says it is doing its best to meet state demands for flexibility..
As an indicator of the coming melt-down:
President Barack Obama thinks his health care law makes states an offer they can't refuse.
USA NEWS
Is Medicaid Expansion Good for the States?
Money fears vs. real benefits in Medicaid choice
Medicaid—the joint state-federal government health insurance program for lower-income Americans—would be expanded to cover those making 133 percent of the poverty level. States that refused to participate in this expansion would risk losing federal funding for their current Medicaid programs. However, the Supreme Court ruled the federal government could not withdraw existing Medicaid funding to punish states for not expanding their programs, thus giving states the choice to opt out of the expansion. More than a few states have expressed intentions of doing so.
Rather than fixing the underlying deficits (an not just financial) the Feds wanted to force states into their plan without relief. Fortunately the SCOTUS ruled otherwise.
Studies have shown that Medicaid patients fare worse in many cases than the uninsured. In many states, Medicaid pays doctors so little, recipients can't find a private physician to see them so they must wait, sometimes for hours, in hospital emergency rooms to get care. They deserve the dignity of private insurance, which states could provide if they were freed from Medicaid's mountains of red tape.
Empty Promise offered by PPACA
Further, the Medicaid expansion will harm the poorest and most vulnerable patients already on the program as they are forced to compete with millions of new patients seeking care from this limited pool of providers.
Many governors are rightly resisting adding another 16 million more people to Medicaid and are demanding that Washington give them more flexibility to improve the program.

Is this a system we want to expand to cover the uninsured?  Empty mandates again.
 

Technorati Tags: ppaca,medicaid,hix,health insurance exchange,california,jerry brown

Don't talk to a Navigator !! Use your Insurance Agent that you Know or Trust

When Obamacare 'Navigators' Ask If You're Qualified, You Should Ask Them About Identity Theft

I agree with Grace-Marie-Turner's op-ed in Forbes Magazine today.

"Starting October 1, armies of “Navigators” will begin asking Americans very personal questions to learn if they qualify for taxpayer-subsidized insurance under ObamaCare.

Thirteen attorneys general have expressed deep concerns about what the Navigators are going to do with the information. They are rightly worried about identity theft and fraud as consumers reveal Social Security numbers, addresses, employer information, income, home addresses, children’s names, health habits, and much more."

The Navigator program has serious systemic flaws, including HIPAA which requires significant training alone.

Congress through it's usual way of contracting via non profit groups has granted 104 organizations the $67 million in grants.

While in some areas there may be a paucity of qualified insurance agents, and Navigators may fill the void we  have internet and 800 telephone numbers which will accomplish the same goals.

Congress is now asking the relevant questions obviously ignored in the unread Affordable Care Act.

"For example, the committee asks the organizations receiving the grants to provide a written description of:

• the work that will be performed with the funds obtained via your Navigator grant including a detailed description of how this funding will be utilized
• the training or education employees, volunteers, or representatives must complete
• the processes and procedures in place to monitor, review, or otherwise supervise your employees, volunteers, or representatives
• how your organization will utilize the information obtained during performance of your Navigator grant"

Here is the direct link to Forbes: When Obamacare 'Navigators' Ask If You Are Qualified, You Should Ask Them About Identity Theft

Remember you can get the information and call back later when you questions are answered satisfactorily

Don't be a lemming

Lemmings

• The suicidal lemming
  • Lemmings tend to migrate in large numbers, which can include jumping off cliffs into the water and swimming great distances to the point of exhaustion and even death. However in these cases it's pure accidental and not intentionally trying to kill itself. Lemmings don't even deliberately throw themselves off cliffs. This stereotype was influenced by a Disney documentary, White Wilderness (1958) where the animals were chased off a cliff by the documentary makers, purely for some sensational images.

Health Train De-railed

We have been experiencing technical difficulties with publishing  Health Train and Digital Health Space. Due to the intransigence of Microsoft they without warning discontinued Windows Live programs. No advance notice was given, nor any chance to download our content from almost ten years of publishing.

Their reason was  a 'security issue'. Apparently a  vulnerability in the program. I am puzzled since they often publish updates weekly to close vulnerabilities.  Apparently rather than continue their support for blogger blogs, they have downgraded support for previous versions of Live Writer....along with all of their 'Live' functions.  They no longer provide any Windows Live categories.

Windows Live is a Microsoft program which supports Google's Blogger....My take is that Microsoft is not going to encourage anyone using MSFT software to support a Google product, Blogger or otherwise.

For the next month we will do our best to blog using Blogger's direct platform, which is not very smooth.

Our plan will be to find an alternative 'writer' program  and/or switch our platform to Wordpress

Affordable Care Act in Transition

The world is in transition, and so is health care. It is apparent also that the Affordable Care Act is missing the mark. Even before the ACA becomes effective it is in transition. All of us compulsive professionals who like things to be clean, neat, orderly and predictable are awakening now from a deep REM sleep with a very big headache, vertigo and confusion.
Our feckless quarter-back, Barack Obama and tight-end Sibelius party on as if everything is going well, while they drink the 'kool-aid' the rest of healthcare is in turmoil. There are those who are endlessly optimistic to make it happen while at the same time suppressing any feeling of possible failure. “Failure is not an option”.

Obama and Sibelius take the team back to the locker-room to review the game plan and the score just before the half-time break. The cheerleader section (health insurers, pharma, take a break and march on the refreshment stands
 
The scoreboard statistics don't reflect the QBs pronouncements. At the half there already  have been numerous penalties for “Delay of Game”.. individual mandate and employer mandate. In the third quarter there will likely be a delay of the Health Insurance Exchange.

Even the 'fans” (Congress) may be asking for it's money back and refuse to purchase tickets for a game that may not even be played. It is getting harder and harder for the fans to buy tickets when there is not enough money to pay for 'peace-keeping', the war on terror, and border protection. Things are so bad that the vendors are now accepting SNAP and EBTs cards.

Is Health Insurance Racketeering?

 

I am a firm believer that the Affordable Care Act will be bad for America.  Many others firmly believe that as well. Without going into great detail the facts can easily be found in many places I and others have referenced for the public.

The law insures a stable platform for insurers, and despite being required to spend 85% of the premium dollar on patients it solidifies their positions and markedly reduces competition in the market place.  Lobbyists and organized medicine (AMA) passed this law ignoring most physician’s opinions.  Only about 150,000 MDs belong to the AMA out of over 800,000 MDs in the U.S.A.To add to that many of the members are students and trainees who receive large discounts for membership.

The A.M.A. holds the copyright to  the CPT codes which are mandatory for billing insurers and Medicare/medi-cal actually covered by a copyright held by the American Medical Association, which refuses to allow any free or open distribution of the codes (known as Current Procedural Terminology (CPT)). That's because the AMA makes about $70 million per year "licensing" the codes.

On the other hand,

The ICD-10 is copyrighted by the World Health Organization (WHO), which owns and publishes the classification. WHO has authorized the development of an adaptation of ICD-10 for use in the United States for U.S. government purposes. As agreed, all modifications to the ICD-10 must conform to WHO conventions for the ICD. ICD-10-CM was developed following a thorough evaluation by a Technical Advisory Panel and extensive additional consultation with physician groups, clinical coders, and others to assure clinical accuracy and utility.

While all physicians are highly motivated to care for all, the sad fact is that Obama care will not provide any sort of guarantee.  It is very complex and also fatally flawed financially and administratively. There are other fundamental flaws in the system not addressed by the Affordable Care Act.

American physicians and healthcare providers are not ready to be bull-dozed anymore by insurers, HHS, CMS and other governmental agencies.  We are fast approaching a ‘non-violent’ disruption of the current paradigm in healthcare. No physician is going to self destruct in the short or long term.

Some physicians are reticent to express their strong convictions for fear of alienation and/or reprisal by some other physicians and hospitals or government agencies. For instance in Massachusetts it is mandatory for an MD to accept Medicare to hold a medical license in that state.

Health insurers and Medicare/medical have developed “provider panels” who have agreed to arbitrary one way standards.. Insurers have no inherent legal right to set standards. Those duties are assigned to state medical boards and specialty boards. These boards are qualified to certify and license physicians as specified in state laws.

Insurers have a self interest to their shareholders and themselves to guarantee a profit.

It is redundant for an insurer to repeat the process of “credentialing” providers other than asking for documentation.  Furthermore it is even more ridiculous to attempt to supervise what providers can order or prescribe for diagnosis and/or treatment.  Our confounding event is when the insurance company won’t pay for the required service.  Unfortunately the insurers never speak  directly to their insured to tell them this directly. The message is usually given to the doctor, hospital, lab or imaging facility.  Insurance companies like to pass the buck.

 Available at Amazon

Many patients discover the costs of tests and procedures in non hospital facilities are much less than a hospital. Often 75% less than what is quoted to an insured patient.  There are several reasons for this. First hospitals are subject to  a litany of regulations and requirements which create significant expenses. Hospitals are subject to regulations and standards which may or may not add quality or value to your hospital care.  We all know about the $100.00 aspirin tablet, or a liter of salt water for $ 500.00. Really ?!  The hospital covers it’s fixed overhead much more than it needs to cover the non-reimbursed patients expenses, the losses they suffer at the hands of Medicare and medi-cal, the recapture of overpayments from Medicare years after the fact.

Despite the ACA having been passed and it is the law as some say..Prohibition was also a law that backfired and caused much harm and developed an underground market (black market)

Is  U.S. health care headed in the same direction?

 

Note: This article will be tagged for key words shortly

Google Doc in the Office

 

  (click for locations)

Or is it Doctor Google ?

Either you are a lover or a hater of all things Google.  Google however has some things right. It is a platform of interconnectivity for workflow and also social media use.  The Google Apps cover a wide range of functions

In adopting EMR, HIT workflow becomes a critical component of your day. In the past  year I have gradually adopted Google apps as a central core for my operations. While not perfect it is cheap, runs on the cloud which can be an asset or a liability, and is also available to most of my contacts.

The most useful apps I find are Gmail, Google Search, YouTube videos, Chrome and it’s menu of apps (developed by countless open source programmers) and featured as plug ins. From a  user standpoint this is exceptionally functional for many reasons I will go into a bit later.

You can seek out more details on the Google Apps page.

             

A particularly strong point is the chrome/android OS connection which brings mobile health applications to the same playing field. The variety of functions extends to Google voice, and social media.  Google +, although late to the social media niche has some unique features which include tight integration with mail, video, and maps,

For the future, first it was ‘Big Search’ and now it will be ‘Big Data’  Google has the resources and skills to develop analytics to extract the information that HHS and CMS and others want so badly to manage health care and improve outcomes.

Google even interfaces with mHealth and ph8ysicians as well as hospitals should learn how business uses smartphone technology to serve consumers and patients.

ThinkwithGoogle.com offers knowledge of how mobile is used, much of which applies to mobile health applications

Digital Matters in health choices, where to  find a doctor,

What are the treatment options? 

 

Where are centers of excellence or what hospital has the best outcome,least cost and more.

The strength of all these is that it is open source software and it can be integrated with other open source applications at relatively little expense unlike proprietary systems currently dominating electronic health.

In an era of health reform  focused on  reducing costs it would be foolish to add prohibitively expensive information technology when other means are available. 

Almost all of the above has no cost, other than thin client hardware. It operates in the cloud.

The very agencies and regulatory bodies have done little if anything to allow time and market pressure to develop an efficient and user friendly system. 

Those who make the rules should also follow them.

Technorati Tags: google,google maps,google voice,google plus,youtube,google search,open source,emr,hit,cloud based,chrome,android,affordable care act,aco,social media,big data,gmail

HIPAA Challenges

 

Oh for the day when medical records were on paper. In the blink of an eye, now millions of electronic medical records can be ‘carried off"’ to anywhere. This has become apparent in recent and repetitive reports of privacy and confidentiality breakdowns. Advocate Health reports the second biggest HIPAA breach ever.  Advocate Health System announced that the theft occurred at one of its Advocate Medical Group administrative building in Park Ridge, Ill. on July 15.

In the second biggest HIPAA breach ever reported, one of the nation's largest healthcare systems is notifying more than four million patients that their protected health information and Social Security numbers have been compromised after the theft of four unencrypted company computers.

Patient names, addresses, dates of birth, Social Security numbers and clinical information – including physician, medical diagnoses, medical record numbers and health insurance data — were all contained on the computers, officials say. 

This is the second big HIPAA breach for Advocate Health System. In 2009, company officials notified 812 patients that their protected health information had been compromised following the theft of an employee's unencrypted laptop.

This breach stands as the second biggest HIPAA breach ever reported, according to HHS data – just behind the TRICARE Management Activity breach which impacted more than 4.9 million patients back in 2011. 

Texas HIPAA blunder affects 277K

This time it was not an electronic medium that was breached. Texas Health Harris Methodist Fort Worth is notifying some 277,000 patients that their protected health information has been compromised after several hospital microfilms, which were supposed to be destroyed, were found in various public locations.

Texas Health Fort Worth had contracted with Toronto-based Shred-it to destroy the confidential patient information, but the microfilms were not actually destroyed, as had been agreed upon in the contract, officials say. Instead, a local resident found a portion of the microfiche in a nearby park in May. Additionally, three other sheets of microfiche were found in two other public areas.

The records on the microfiche contained patient names, addresses, dates of birth, medical record numbers, clinical information, health insurance information and in some cases Social Security numbers

These breaches are only two of many inadvertent breakdowns in health information security.

In 2011 a TRICARE Management Activity breach impacted more than 4.9 million patients back in 2011, in which a Lost Military Backup Tapes Results in HIPAA Violation Affecting 4.9 Million. TRICARE, the Defense Department’s healthcare program, reported what may be the largest health information breach documented in HIPAA history since the HITECH Act was established in 2009. Nearly 4.9 million patients of San Antonio area military hospitals and clinics have been affected by the loss of data backup tapes. These tapes contained an archive of sensitive information dating from Sept. 7, 2011, back to 1992.

Vernon Guidry, a spokesman for Science Applications International (SAIC), the organization that reported the breach, has confirmed that it was “not an electronic breach” but “a loss of magnetic storage media.”

The Federal Office of Civil Rights administers HIPAA, and reports its findings here:

The breaches result in fines and penalties as well as civil damages for civil rights violations.

Apparently the federal government has interdepartmental conflict over legalities of sharing protected information.

As yet no one has addressed this issue with the Affordable Care Act in which it is proposed that the IRS administer and enforce the Individual and Employer Mandates .

 

Technorati Tags: civil rights,hipaa,hitech act,hipaa breach Advocate Health,Tricare,Texas Health Harris

HIPAA/HITECH Act Enforcement: 2003-2013

How Far has Health Information Exchange Progressed, or Has IT ?

.

The Indiana Health Information Exchange has what is most probably the longest track record in H.I.E.  If time is of the essence for a product or service to mature, the IHIE certainly fills this space.

Well before the advent of ONCHIT, HITECH, and a garden full of eponyms, acronyms, and glossaries of several pages in length, The Reigenstreff Institute in Indiana provided a nidus of expertise for a brave new world.

IHIE connects more than 25,000 healthcare providers in 17 states delivering services that make patient information available when and where it is needed.

 

IHIE began unceremoniously in the day when no one knew the term HIE. It began and is still a private for profit organization born well before government deemed it necessary to stimulate HIXs with short lived goals and non sustainable business models. (This sounds much like the Affordable Care Act).  The dirty word here according to  HHS is "for profit’. For profits need not apply for HHS grants.  And most will be doomed to fail without strong leadership and vision.

Already the first generation of successful health information exchanges are into HIX 2.0. 2.0 will leverage HIX capacity and interoperability to include the  Accountable Care Organizations which include multi-disparate medical clinics/offices and hospitals.  The diagnostic and treatment outcome paradigms will be measured cross platform transforming data into big data and to feed the giant analytic algorithm.

The task of administering an ACO is formidable, traversing differing specialties,hospitals and  physical space. 

The Health Information Exchange will likely morph into serving another infrastructure for Affordable Care

 

Technorati Tags: affordable care act,hix,hie,emr,reigenstreiff,aco,indiana health information exchange,hie 2.0,onchit,hitech act,interoperability

The Complete Guide To College Students & Healthcare Reform (or the Affordable Care Act…What now?)

 

College is an exciting time in a young adult’s life and many feel that they’re invincible. Besides, who else can stay up until 4am, eat 3 pieces of pizza, and ace

an exam the next morning? However, even though students are young and generally suffer fewer illnesses and accidents than older people, the college environment places them at an increased risk, so health insurance is a necessity.

What if the campus infirmary cannot provide a level of care necessary for the student?  The information here was sourced from ‘Insurance Quotes”.

Thanks to

Desiree Baughman

 

Technorati Tags: college,students,affordable care act,campus,infirmary,health insurance,health,university