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Go Back   Theoryland of the Wheel of Time Forums > THEORYLAND STEDDINGS > Forum Archives > Archived - Non Wot Discussion Boards > Archived: Non WoT Related Discussion 09/09 - 9/10
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  #1  
Old 10-26-2009, 11:26 AM
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Default Interesting Article on $$ Waste in Healthcare System

One thought I had when reading this concerns the electronic records system. The VA has a great electronic system (I have no idea if Medicare does but I tend to doubt it). The VA and Tricare both already do this and it is extremely helpful. Having all records electronic would also quickly cut down on doctor shopping and the flow of illegal prescription drugs (i.e. oxycontin addicts, etc) so it would have that side effect going for it. Thoughts? (not trying to stir up the debate about insurance reform again, I swear).

Quote:

Health care waste reaches $800 billion a year
Proposed reforms could be paid for by fixing inefficiencies, report claims


Reuters
updated 11:56 a.m. ET, Mon., Oct . 26, 2009
WASHINGTON - The U.S. health care system is just as wasteful as President Barack Obama says it is, and proposed reforms could be paid for by fixing some of the most obvious inefficiencies, preventing mistakes and fighting fraud, according to a Thomson Reuters report released on Monday.

The U.S. health care system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of health care analytics at Thomson Reuters, found.

"America's health care system is indeed hemorrhaging billions of dollars, and the opportunities to slow the fiscal bleeding are substantial," the report reads.

"The bad news is that an estimated $700 billion is wasted annually. That's one-third of the nation's health care bill," Kelley said in a statement.

"The good news is that by attacking waste we can reduce health care costs without adversely affecting the quality of care or access to care."

One example a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.

"It is waste when caregivers duplicate tests because results recorded in a patient's record with one provider are not available to another or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed," the report reads.

Some other findings in the report from Thomson Reuters, the parent company of Reuters:

Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of health care waste or $200 to $300 billion a year.
Fraud makes up 22 percent of health care waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.
Administrative inefficiency and redundant paperwork account for 18 percent of health care waste.
Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.
Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.
"The average U.S. hospital spends one-quarter of its budget on billing and administration, nearly twice the average in Canada," reads the report, citing dozens of other research papers.

"American physicians spend nearly eight hours per week on paperwork and employ 1.66 clerical workers per doctor, far more than in Canada," it says, quoting a 2003 New England Journal of Medicine paper by Harvard University researcher Dr. Steffie Woolhandler.


Yet primary care doctors are lacking, forcing wasteful use of emergency rooms, for instance, the report reads.

All this could help explain why Americans spend more per capita and the highest percentage of GDP on health care than any other OECD country, yet has an unhealthier population with more diabetes, obesity and heart disease and higher rates of neonatal deaths than other developed nations.

Democratic Senator Charles Schumer said on Sunday that Senate Democratic leaders are close to securing enough votes to pass legislation to start reform of the country's $2.5 trillion health care system.
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Old 10-26-2009, 02:42 PM
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Oooh Brita, I wonder if eHealth will come up?

Dav, we're in the midst of our own provincial eHealth scandal here...nightmare.
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Old 10-26-2009, 03:56 PM
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Quote:
Originally Posted by Ishara
Dav, we're in the midst of our own provincial eHealth scandal here...nightmare.
Sigh- it is, and it is such an important initiative. To have corruption ruin the idea is just tragic...
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Old 10-27-2009, 07:40 AM
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Well, some definitely chalk it up to corruption, but I'd say it was really a lack of strategic direction that has been the main problem to date. If there had been more (any?) strategic direction then there would have been significantly less opportunity for corruption. I still have high hopes for a great program.
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Old 10-28-2009, 09:50 PM
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The VA EMR (electronic medical records) system is great, but that's mainly because most VA patients go to VA hospitals, and the EMR systems are all linked. I actually believe the private system (Cerner) that our hospital has is easier to use, but I would gladly give up that usability for easy access to outside records. From first hand experience, the most frustrating thing about medical records are when you have to obtain them from outside hospitals/clinics.

A fully linked EMR system would be great, but it's not going to happen any time soon because there's too much money and too little guiding legislation thown at EMR. There are a ton of companies all independently developing and selling their systems across the country because everyone is getting huge amounts of funding for EMR. All of these systems are proprietary, and none of these private companies are interested in developing a common format for EMR transfer. They want to win the big war, by dominating the market and imposing their format, forcing other companies to license their technology to interface with their system. There's virtually no legislation dealing with minimal requirements and/or common formats for EMR. Until that happens, none of these systems are going to talk to each other, and we'll continue to have to jump through all sorts of loops to get outside records.
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Old 10-29-2009, 07:35 AM
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I used to work for a healthcare software company (my last job) and they had a great network for their hospitals. Of course, our servers and network was ONLY for their client hospitals but it was a start. It was one of the larger such companies in the country and I think it would be possible (but not easy) to make it work. We actually focused on 2 separate software systems with one for imagery (x-rays, MRIs, CT scans, etc) and one for records (everything else). Basically the former was so memory intensive that bandwidth became an issue if they were to be combined so it was easier logistically to do seaparte system.
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Old 10-29-2009, 07:57 AM
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I think there will have to be some regulations from either the state or federal government that would require either the same system intigration or easy compatability between systems at public, government, and public university hospitals.I imagine it working similar to the change over to computer records. The governments chose windows loaded PCs for their change over and if anyone who wanted to do business with the government had better have windows loaded PCs too. And now something like 99% of all government computers are windows loaded PCs, So contractors and the like have to have windows loaded PCs. I think the government may also have to buy the server and upkeep the massive amounts of servers that are going to be needed to store everyones records on... Probrably have some special code like .med or .rx or something simalar. Of course your going to have to have special permissions to access the system... It will probrably have to be paper based so it can be documented, it will also probrably take a couple of days because you dont want every doctor and nurse to be able to look at your records. Hmm...I wonder if it will actually be any faster.
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Old 10-29-2009, 08:16 AM
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We had all our servers on-site in our building and the hospitals we supported had to uplink to them. It let us have control over the data and comply with all the Privacy Act concerns. Our controls were extensive. The Servers were in a card access room with very very limited access (even the CEO had to be escorted as he didn't have access as he had no need to go in). Anyone going in or out had to sign a physical log as well as card swipe in and card swipe out. The servers were in locked server cages and of course were password protected log-ins. We had multiple CCTV cameras in each server room that monitored every workstation individually. We got inspected regularly and had no issues. As I am the one that designed and maintained the security system, I can say it was pretty good. I modeled off of what the Gov't does for highly classified material (above TS). We never had any incidents on the server end. We had something like 25 server towers in each room completely full with harddrives of patient information and that was for the Northeast (New England and the Mid-Atlantic). We also had offices in Chicago, Waukesha, WI, Tucson, New Orleans and several other areas that I can't recall. I was only responsible for the NE hub though.
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