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EPIC FAIL:Digitizing America's medical records

laska

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Digitizing hospital records is a great idea but spending 28 billion so far and we have a system without interoperability of working together with different networks, devices, and operating systems. Somehow I think a great system could have been done at a fraction of the cost, but of course I'm an IT idiot so maybe I'm naive.

"Within five years, all of America's medical records are computerized," he announced in January 2009, when visiting Virginia's George Mason University to unveil his stimulus plan. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests."
Unfortunately, in some ways, our medical records aren't in any better shape today than they were before.We've Spent Billions to Fix Our Medical Records, and They're Still a Mess. Here's Why. | Mother Jones
 
Digitizing hospital records is a great idea but spending 28 billion so far and we have a system without interoperability of working together with different networks, devices, and operating systems. Somehow I think a great system could have been done at a fraction of the cost, but of course I'm an IT idiot so maybe I'm naive.

"Within five years, all of America's medical records are computerized," he announced in January 2009, when visiting Virginia's George Mason University to unveil his stimulus plan. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests."
Unfortunately, in some ways, our medical records aren't in any better shape today than they were before.We've Spent Billions to Fix Our Medical Records, and They're Still a Mess. Here's Why. | Mother Jones

Yeah - I wish they hadn't bothered to start. Twice this year my son's doctor has lost track of his medication history. "What medication did i prescribe your son?" Is NOT something you ever want to HEAR.
 
Digitizing hospital records is a great idea but spending 28 billion so far and we have a system without interoperability of working together with different networks, devices, and operating systems. Somehow I think a great system could have been done at a fraction of the cost, but of course I'm an IT idiot so maybe I'm naive.

"Within five years, all of America's medical records are computerized," he announced in January 2009, when visiting Virginia's George Mason University to unveil his stimulus plan. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests."
Unfortunately, in some ways, our medical records aren't in any better shape today than they were before.We've Spent Billions to Fix Our Medical Records, and They're Still a Mess. Here's Why. | Mother Jones

Government comes and says 'I'm here to help' ?

From the abject failure that was the ObamaCare web site, to many other instances of late and over budget IT projects that the government has run (and many out right failures!), the conclusion that I draw is that government just can't do IT.

There must be something at odds between delivering IT projects and performing then well, and the government that are just mutually exclusive somehow.
 
Yeah - I wish they hadn't bothered to start. Twice this year my son's doctor has lost track of his medication history. "What medication did i prescribe your son?" Is NOT something you ever want to HEAR.

Digitizing the records was suppose to solve that problem. They need to be digitized, we just need to find a company that can do it- create a great system at a fair price. Not give preferred treatment to political doners that then overcharge and do a lousy job.
 
Digitizing hospital records is a great idea but spending 28 billion so far and we have a system without interoperability of working together with different networks, devices, and operating systems. Somehow I think a great system could have been done at a fraction of the cost, but of course I'm an IT idiot so maybe I'm naive.

"Within five years, all of America's medical records are computerized," he announced in January 2009, when visiting Virginia's George Mason University to unveil his stimulus plan. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests."
Unfortunately, in some ways, our medical records aren't in any better shape today than they were before.We've Spent Billions to Fix Our Medical Records, and They're Still a Mess. Here's Why. | Mother Jones

If Loyola Unicersity Hospital were closer than 45 minutes away, I would never go outside their network.

Every doctor with privileges there is on the same network. All of the tests I take thru that hospital are on line...every X-ray, ct, EKG, mammogram, blood test, biopsy, etc etc is digitally recorded and available to every doctor treating you for whatever. The meds you take are meticulously recorded by the nurse at every doctor visit...who prescribed, dosage, etc.

Anyone who thinks this doesn't make for better medicine is an idiot.

IMO, there should be legislation on the national level to make this reality everywhere. What a difference it would make in patient care.
 
Yeah - I wish they hadn't bothered to start. Twice this year my son's doctor has lost track of his medication history. "What medication did i prescribe your son?" Is NOT something you ever want to HEAR.


I understand your skepticism, but that begs the question whether the problem is the records or the doctor. Anyway, over at least the past decade, I've been with three family doctors/clinics all of whom kept electronic records. Every appointment, they came in with their laptops and could access and update my records quicker, easier and probably more accurately than thumbing through a paper chart. Also, I can access my records online. I think the more one monitors their own health, the better the care they get. And online access makes my records more portable.
 
Yeah - I wish they hadn't bothered to start. Twice this year my son's doctor has lost track of his medication history. "What medication did i prescribe your son?" Is NOT something you ever want to HEAR.

Why are you still going to that doctor? If I recall posts about your son, meds are everything for him. He's lazy...he has too many patients...he's dangerous. Just sayin'...
 
If Loyola Unicersity Hospital were closer than 45 minutes away, I would never go outside their network.

Every doctor with privileges there is on the same network. All of the tests I take thru that hospital are on line...every X-ray, ct, EKG, mammogram, blood test, biopsy, etc etc is digitally recorded and available to every doctor treating you for whatever. The meds you take are meticulously recorded by the nurse at every doctor visit...who prescribed, dosage, etc.

Anyone who thinks this doesn't make for better medicine is an idiot.

IMO, there should be legislation on the national level to make this reality everywhere. What a difference it would make in patient care.

Quit trying to make sense. Can't you see this is one of the "Obama is a failure" threads where people who don't know what they're talking about try to come off as experts?

For a president who has remained immune to the right wing noise machine, that fabricates controversy and spends millions of tax dollars on political witch hunts, to do the smart thing is to fight a ceaseless tide of idiocy from the right. I agree that anyone who thinks that the task of creating a comprehensive network of existing physicians and their records is easy is, in fact, an idiot.

I always chuckle at how Obama must operate at a different standard than his predecessors. Righties demand instant gratification from liberal presidents but they are soooo patient while their own fumble around in the whitehouse, starting wars and giving the wealthy access to the treasury. There has not been a conservative president in the last four decades, at least, who has attempted anything as important as healthcare reform. This was an idea that was doomed to be met with right-wing hysteria. You can spend twelve billion a week on blowing up Afghanistan, if you want, but by god don't spend a dime on the future health of this nation or the conservative backlash will be instantaneous and shrill.
 
Quit trying to make sense. Can't you see this is one of the "Obama is a failure" threads where people who don't know what they're talking about try to come off as experts?

For a president who has remained immune to the right wing noise machine, that fabricates controversy and spends millions of tax dollars on political witch hunts, to do the smart thing is to fight a ceaseless tide of idiocy from the right. I agree that anyone who thinks that the task of creating a comprehensive network of existing physicians and their records is easy is, in fact, an idiot.

I always chuckle at how Obama must operate at a different standard than his predecessors. Righties demand instant gratification from liberal presidents but they are soooo patient while their own fumble around in the whitehouse, starting wars and giving the wealthy access to the treasury. There has not been a conservative president in the last four decades, at least, who has attempted anything as important as healthcare reform. This was an idea that was doomed to be met with right-wing hysteria. You can spend twelve billion a week on blowing up Afghanistan, if you want, but by god don't spend a dime on the future health of this nation or the conservative backlash will be instantaneous and shrill.

Totally wrong why I started this thread. I'm a centrist, not a rightie. I have long favored state single payer and digitizing of medical records. I got the link of the article from a Mark Cuban tweet, who is no rightie, who sees the same problem, that after so many billions there shouldn't be the flaws that we have. I give Obama administration credit, unlike the GOP, for seeing the need for digitizing medical records, but they've made some serious mistakes in delivering it. And how you state I try to come off as an expert when I stated in the OP I am no IT expert and may be naive on cost I have no clue. Maybe it is you who should take off the Leftie glasses in not being able to take any Obama administration criticism.
 
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It is an issue of standards for storing information. Since at least the Clinton administration, more and more standards have been published, commented upon, and changed. Even Diagnosis codes are on their 10th version. Government is a useful entity for defining standards but it is a messy process. This is not an issue specific to ObamaCare.

This was never a simple task and often organizations had their own standards they had to changed.
 
Government comes and says 'I'm here to help' ?

From the abject failure that was the ObamaCare web site, to many other instances of late and over budget IT projects that the government has run (and many out right failures!), the conclusion that I draw is that government just can't do IT.

There must be something at odds between delivering IT projects and performing then well, and the government that are just mutually exclusive somehow.

If you had read the article, you would know tha the govt is not running these projects - the private sector is
 
If Loyola Unicersity Hospital were closer than 45 minutes away, I would never go outside their network.

Every doctor with privileges there is on the same network. All of the tests I take thru that hospital are on line...every X-ray, ct, EKG, mammogram, blood test, biopsy, etc etc is digitally recorded and available to every doctor treating you for whatever. The meds you take are meticulously recorded by the nurse at every doctor visit...who prescribed, dosage, etc.

Anyone who thinks this doesn't make for better medicine is an idiot.

IMO, there should be legislation on the national level to make this reality everywhere. What a difference it would make in patient care.

Loyola uses EPIC EMR systems which are the ones the article in the OP talks about.
 
Loyola uses EPIC EMR systems which are the ones the article in the OP talks about.

Wow! Who knew? Sangha knew! Thank you.

It is, I think, YEARS ahead of other health network. My paramedics would take me to Alexian Bros Hospital. Their physicians don't have anything even close. They own another hospital about 12 miles away. The HOSPITALS don't even communicate.

We'll look back on this waste of technology as Stone Age some day. The tech's there..just not the will.
 
Wow! Who knew? Sangha knew! Thank you.

It is, I think, YEARS ahead of other health network. My paramedics would take me to Alexian Bros Hospital. Their physicians don't have anything even close. They own another hospital about 12 miles away. The HOSPITALS don't even communicate.

We'll look back on this waste of technology as Stone Age some day. The tech's there..just not the will.

It's not so much a lack of will as it is a problem of complexity.

People have thousands of body parts, each of which can experience scores of medical conditions and each of those conditions can be treated in a myriad of ways. Adding to this complexity is that every hospital and doctor's office does things differently. You can't just write a program that asks a list of questions (and stores the answers, of course) and think that will work in a clinical setting.

Doctors don't work like that. They ask a question, and then their next question depends on the answer to the first question. And people, being people, will often bring up things (ex symptoms,medical history, etc) that aren't directly responsive to the question but are medically relevant. And that can prompt the doctor to begin a new line of questioning. It can be very unpredictable, and computers don't like unpredictable.

Designing systems to support health care is very complex. Some applications are fairly simple, such as drug dispensaries (they just have to record what was prescribed and delivered), but most of it is not simple. It will take many years for doctors and programmers to figure out how to do it
 
Digitizing hospital records is a great idea but spending 28 billion so far and we have a system without interoperability of working together with different networks, devices, and operating systems. Somehow I think a great system could have been done at a fraction of the cost, but of course I'm an IT idiot so maybe I'm naive.

"Within five years, all of America's medical records are computerized," he announced in January 2009, when visiting Virginia's George Mason University to unveil his stimulus plan. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests."
Unfortunately, in some ways, our medical records aren't in any better shape today than they were before.We've Spent Billions to Fix Our Medical Records, and They're Still a Mess. Here's Why. | Mother Jones



How many hospitals are there. How many computers in each?

How many patients are there?

You may thing that $28 billion is a lot, but it isn't. It isn't simply a matter of name, address and phone, this requires pages and pages of doctors notes spanned over the life of each patient, no mistakes in each hospital most of varying operating systems.

If you're looking for a national database of the patients in the United States from infancy to death, $28 billion is spare change.

Canada tried to register the firearms, rifles and shotguns of all Canadians. It was supposed to cost 200 million, it was shut down still unfinished at $2 billion and it didn't work.

Then we can talk about the Obamacare exchanges....
 
Wow! Who knew? Sangha knew! Thank you.

It is, I think, YEARS ahead of other health network. My paramedics would take me to Alexian Bros Hospital. Their physicians don't have anything even close. They own another hospital about 12 miles away. The HOSPITALS don't even communicate.

We'll look back on this waste of technology as Stone Age some day. The tech's there..just not the will.



One of the pluses of universal health care. I go to any hospital, show up in emerge and while checking in they have my whole recent history, everything except doctor visits, know I am diabetic, my meds all of it.
 
It's not so much a lack of will as it is a problem of complexity.

People have thousands of body parts, each of which can experience scores of medical conditions and each of those conditions can be treated in a myriad of ways. Adding to this complexity is that every hospital and doctor's office does things differently. You can't just write a program that asks a list of questions (and stores the answers, of course) and think that will work in a clinical setting.

Doctors don't work like that. They ask a question, and then their next question depends on the answer to the first question. And people, being people, will often bring up things (ex symptoms,medical history, etc) that aren't directly responsive to the question but are medically relevant. And that can prompt the doctor to begin a new line of questioning. It can be very unpredictable, and computers don't like unpredictable.

Designing systems to support health care is very complex. Some applications are fairly simple, such as drug dispensaries (they just have to record what was prescribed and delivered), but most of it is not simple. It will take many years for doctors and programmers to figure out how to do it

If it is that complex, then we walk before we run.

Communicating lab results, putting digital X-rays up, mammograms on line, CBC results etc. colonoscopy film, etc etc etc ought to be a piece of cake. And, in fact, it would seem that Loyola does that and more.

It won't get any easier the longer we wait...
 
Totally wrong why I started this thread. I'm a centrist, not a rightie. I have long favored state single payer and digitizing of medical records. I got the link of the article from a Mark Cuban tweet, who is no rightie, who sees the same problem, that after so many billions there shouldn't be the flaws that we have. I give Obama administration credit, unlike the GOP, for seeing the need for digitizing medical records, but they've made some serious mistakes in delivering it. And how you state I try to come off as an expert when I stated in the OP I am no IT expert and may be naive on cost I have no clue. Maybe it is you who should take off the Leftie glasses in not being able to take any Obama administration criticism.


I agree that this is not an Obama bashing branch, to not move ahead is dark ages.

I would like to know WHO things $28 billion is too much and what they say the problems are. Often in this sort of thing "problems" are entirely transitional and part of the growing process
 
Yeah - I wish they hadn't bothered to start. Twice this year my son's doctor has lost track of his medication history. "What medication did i prescribe your son?" Is NOT something you ever want to HEAR.

That's exactly why we should have a national system. Individual doctors offices keep horrible records. Your doc should be able to see your entire medical history, including every drug you have ever taken (legally that is), with your permission.
 
The EMR has major growing pains, and one of the problems is that it was farmed out to private companies who have incompatable systems by design. Universal health care (like the VA, for example) doesnt have this issue, and is markedly better. This was done because the GOP and paid off Democrat legislators would have completely freaked out if Obama tried to put a universal EMR in place. Its like universal heath care - never was on the table.

There is tremendous resistance to the use of these systems that is getting better - its hard making doctors change habits (trust me - its been my career!) to improve patient care, but they are slowly coming along by giving them a financial carrot for using EMR and a stick if they dont.

Remember - the initial seed money to get health care systems and doctors to move to EMR predates Obamacare - the money came from the 2009 stimulus. If you didnt move to EMR, by 2015, there is no more stimulus money but you'd start getting dinged by insurers who want the info electronically. (Thanks, Obama!)
 
If it is that complex, then we walk before we run.

Communicating lab results, putting digital X-rays up, mammograms on line, CBC results etc. colonoscopy film, etc etc etc ought to be a piece of cake. And, in fact, it would seem that Loyola does that and more.

It won't get any easier the longer we wait...



It's not that simple. In order to walk you have to have legs, and the legs cost money.

We don't even know if this is OVER budget.

It is far from a piece of cake as we are dealing with highly detailed imagery, highly detailed text data, with it's own language and terminology, varying terminology from hospital to hospital, and in your case privately owned, for profit hospitals.

If you delay moving forward it only gets more expensive, its the same with all technology so you have to get on board somewhere.


The OP provides no information, but I suspect with $28 billion you still have a defective system, but you also have some great gains. The plane may not fly well yet, but you have the plane. If you wait, like some countries you will pay more.

British Columbia started this in the 90's with the idea of putting a hand held computer in every doctor and nurses' hand. We have evolved at great cost to have centralized data between hospitals and pharmacies, but doctors and clinics are not on line.

I would have to see what has been completed against the design before I could say this has been a waste of $28 billion, certainly not as uch a waste as 999 weeks unemployment or "shovel ready" jobs
 
If Loyola Unicersity Hospital were closer than 45 minutes away, I would never go outside their network.

Every doctor with privileges there is on the same network. All of the tests I take thru that hospital are on line...every X-ray, ct, EKG, mammogram, blood test, biopsy, etc etc is digitally recorded and available to every doctor treating you for whatever. The meds you take are meticulously recorded by the nurse at every doctor visit...who prescribed, dosage, etc.

Anyone who thinks this doesn't make for better medicine is an idiot.

IMO, there should be legislation on the national level to make this reality everywhere. What a difference it would make in patient care.

That's where I had my fingers put back on. Good food too. One night I ordered liver and onions. It was almost as good as Mom's. Didn't consider the judgement of ordering liver in a hospital until later.
 
That's where I had my fingers put back on. Good food too. One night I ordered liver and onions. It was almost as good as Mom's. Didn't consider the judgement of ordering liver in a hospital until later.

It's a great hospital. Famous burn unit, trauma center, etc. Organ meat where they do transplants, huh? Risky.
 
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