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Commentology

MToubbeh, MD wrote us in response to Eric Novack's slightly incendiary post. ("The Expansion of the Federal Healthcare Bureaucracy Bill")

I don't think that when we built the Highway system
in the country that people were worried that the Government was going
to control the flow of travel.  The ONC was established under the Bush administration, is headed up by
a provider and the new advisory board (NeHC) has at least 8 physicians
on it including many who post on this blog regularly.  

This
bill in fact has blocked the power of many lobbying groups (ie it isn't
a vendor dominated organization) and is only one small part of the
total amount of money that needs to be implemented in health IT. The
private sector has been catering to their clients (hospitals) and both
providers and consumers have been left out of this process up until
now.

Bev MD had this comment on David Kibbe's landmark post on Clinical Groupware:

"As
a former medical laboratory and blood bank director, I have seen every
conceivable(and some inconceivable) way that a patient's identity can
be mistaken and incorrect information entered in a patient record. This
is one reason why every blood bank will re-draw a patient's blood on
every admission to confirm their blood type is really the same as what
is in their record. And no, one cannot rely on the patient himself to
verify the information, for a variety of reasons. Please do not
overlook the critical necessity for at least one, preferably two,
unique patient identifiers in any type of system that is developed – or
you may literally kill someone."

FLY4Vino had this to say to Dr. Adrian Gropper's recent post.  "A Transparent Health Record." 

"The record of the federal government in developing, deploying and managing systems is not encouraging. One needs only to look at the historical performance of the FAA, USPS, DOJ, FBI etc to find computer systems that cost far more than budgeted, were delivered long after promised, failed to perform and were filled with worms and security breaches.

Despite pledges of privacy we have seen the FBI investigative files distributed to political operatives, repetitive large scale intrusions into supposedly secure data bases, govt employee misuse of data and a host of other problems.

The personal privacy issues are great. A young woman has an abortion, a young man is treated for drug dependency, the holder of a politically sensitive job (or candidate) was treated for a social disease while married-all of these will serve as the foundation of attacks and potential blackmail.

The answer is perhaps a voluntary system where the patient has the right to exclude any treatment from the record. The potential mischief instituted by well meaning but inept bureaucrats knows no limits.  To tuck this concept into the Stimulus Bill without careful scrutiny breaks many of the promises Obama made to the American people …….."

Janet commented on John Houghton MD's "Stimulus Bill Offers Big Incentives for Technology, But Demands Effective Use."

"My husband was in the doctor's lounge and got infected by the fear that they are going to "make us" get EHR.  So I decided to spend some time actually reading the bill.  That's no small task and I can say that I have not read it completely and comprehensively.  But at a glance it seems like a plan to study and promote the development of EHR with an incentive to apply it.  Actually it seems to me like a nod to the fact that EHR are very much a work in progress but there needs to be some standardization and collaboration if they are going to come close to realizing their potential."

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