possible creation of a National Coordinator of Health Information Technology

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Stealth Vector

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Sounds like it is going to be like a "care rationer" is going to dictate more of what we do! And just how is this going to stimulate the economy?
 
Actually, I don't think this has anything to do with how teams of caregivers/physicians work. I think this is an overseer of patient information, the emergence of Electronic Medical Records and how they are integrated into the healthcare system and maybe how we can use the boatloads of data that every hospital has to make healthcare more efficient and perhaps more evidence-based. The whole EMR evolution is essentially stalled by poor integration, high costs, and not enough people who can speak Information Technology and understand how hospitals work. If I had to guess, I would say this Coordinator would help advance the use of electronic technology in healthcare, which is sorely needed.
 
Exactly. I think it's to institute a national EMR (based on the VA system?) so health information will be accessible on every patient, at every institution. I would support it 100%.
 
the article does not simply list it as a national health record (as a pain physician I am all for having a nationwide databank to see how many pharmacies my patient's are using). It adds governmental oversight into health care utilization.
We do not need big brother telling us what is in a patient's best interest like workers comp does.
 
This is something I've been (peripherally) involved in for some time.

This is one manifestation of Obama's plan to invest heavily in healthcare IT. If you're interested in learning more, read the Congressional Budget Office's report from last May (which has been criticized as an attack on Obama's plan.)

This is not about telling physicians how to practice.
 
lets hope its not what some fear this to be...but I still get a bad feeling from this. I think this should be further reviewed and brought to light, and soon. However, the manner that this was silently put in the proposed legislation doesn't inspire any trust.
 
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It's a way to ration care and cut costs...so when grandma turns 74, someone gets to hold a pillow over her head when she gets sick so a 17 year old teenybopper on the dance team will get that MRI. Wouldn't want to impinge on her quality of life after all.
 
Old_Mill : will the intervention on the teeny bopper significantly improve her quality life for the next 50 years? If said teenybopper might have a serious injury, that MRI is probably worth it, since 50 years is a long time.

And what exactly are you going to do to fix 74 year old grandma? We don't have anything to stop aging, and once she gets dementia, grandma stops even remembering who she is. So it doesn't really make sense to give grannie the expensive stuff unless grannie is rich and wants to pay for it.
 
Exactly. I think it's to institute a national EMR (based on the VA system?) so health information will be accessible on every patient, at every institution. I would support it 100%.

There is a nice article posted over in Topics In Healthcare on this very topic, and you'd be surprised at exactly what Daschle has in mind, written in his own words.
 
There is a nice article posted over in Topics In Healthcare on this very topic, and you'd be surprised at exactly what Daschle has in mind, written in his own words.

I believe said article is the same article linked above in this thread.
 
Well that mofo is going to have to pay his taxes first before he can have any input in society.
 
lets hope its not what some fear this to be...but I still get a bad feeling from this. I think this should be further reviewed and brought to light, and soon. However, the manner that this was silently put in the proposed legislation doesn't inspire any trust.

I'm not quite sure what you're getting at and I'm naive to all the cynicism about this. Daschle at least spent time talking about health care reform, even if it was -- at worst -- just talk. I think most anyone on this board will agree our health care system is FUBAR in its current state, so someone willing to change it I think deserves some recognition.

As for the thrust of this article listed above, I also don't see why this is a bad idea. At its most basic, it signals that health care is getting attention from the White House, something that we haven't had for at least 8 years. Any publicity is good publicity, especially in this financial market.

Tighter governmental control of medical information was going to be a foregone conclusion with HIPAA passing a few years ago. If implemented correctly, this coordinator position can hopefully salvage the one redeeming prospect from HIPAA which is better use and utility of medical information.
 
Well it looks like Daschle is going to play a role in the Obama administration even if he isn't a member of the cabinet. Kind of like a Karl Rove/shadow advisor.
 
Tighter governmental control of medical information was going to be a foregone conclusion with HIPAA passing a few years ago. If implemented correctly, this coordinator position can hopefully salvage the one redeeming prospect from HIPAA which is better use and utility of medical information.


Why does the government have to control medical information?
 
I'm not quite sure what you're getting at and I'm naive to all the cynicism about this. Daschle at least spent time talking about health care reform, even if it was -- at worst -- just talk. I think most anyone on this board will agree our health care system is FUBAR in its current state, so someone willing to change it I think deserves some recognition.

As for the thrust of this article listed above, I also don't see why this is a bad idea. At its most basic, it signals that health care is getting attention from the White House, something that we haven't had for at least 8 years. Any publicity is good publicity, especially in this financial market.

Tighter governmental control of medical information was going to be a foregone conclusion with HIPAA passing a few years ago. If implemented correctly, this coordinator position can hopefully salvage the one redeeming prospect from HIPAA which is better use and utility of medical information.

Its a good thing that health care problems and the need for reform are starting to get the attention of policy makers. It is frustrating that much hasnt been said in years past. I'll agree that Mr. Daschle can be applauded for shedding some light on it. He may have some good ideas, but also has some ideas that may not be so good in the opinion of others. Also keep in mind, or at least a question to ask is, has he had conflicts of interest in the past few years (who has been paying him since he left the senate), when it comes to what to do for health care and who to listen to.

In terms of politics, usually when something is put in at the last minute or sneaked into a bill, its usually because someone doesn't want it to get attention till after the bill is passed. Maybe I'm wrong (optometrist lobbies have used this tactic in some states, to sneak in some legislation into a larger bill if I'm not mistaken, to grant themselves privileges to procedures that only ophthalmologist were once only legally allowed to perform. Better for patients?) but whats the harm in having something important as this out in the open, receiving some debate so all voting members are better informed before they vote. This topic should receive more attention, but not indirectly by being in the shadow of a much larger bill. Some in congress may be thinking about this, but the white house appears to have its attention on the economy and international matters for the moment.
 
Not sure I like the idea of a government agency trying to oversee what's "reasonable and cost effective", but the idea of being able to easily transfer medical information from one setting to another may be a good idea. It should cut down on repeat testing as well.
If someone is chronically undiagnosed, perhaps having all their symptoms listed out in one place could speed up a diagnosis, especially if the symptoms come and go and many doctors at different facilities are involved.
 
There was some talk of this on CNN, (lou doubs).
They mentioned that Daschle had stated in his most recent book that he would recommend that a way to get a bill like this passed is to put into an economic bill of importance so very little light or attention gets drawn to it.
 
This is socialized medicine plain and simple.

Just what do you think Tom Dashole means when he says "get away from private practice" and "the government will guide your doctors decisions".

That's why this was slipped in, that's the goal.

The American Sheeple will fall for it too, then gripe when they have to wait 2 years for a knee replacement, or when their loved one isn't allowed dialysis because they are over 50 etc etc.

Of course congress and the media will still find a way to blame the doctors, and the people will believe them.
 
I have asked this question before, but can someone tell me WHAT THE HELL IS THE AMA GOOD FOR? If you have not read this bill, go read it please. This is the beginning of a new era, I repeat, a brand new freaking era. Guys, it is not a joke, this is government control without government pay. This is a special version of socialized medicine where the government makes most of the decisions without spending a dime. Physicians and the healthcare system are about to get dealt the biggest under the belt blow of our time.
 
Well that mofo is going to have to pay his taxes first before he can have any input in society.
Word 😆

This is socialized medicine plain and simple.

Just what do you think Tom Dashole means when he says "get away from private practice" and "the government will guide your doctors decisions".

That's why this was slipped in, that's the goal.

The American Sheeple will fall for it too, then gripe when they have to wait 2 years for a knee replacement, or when their loved one isn't allowed dialysis because they are over 50 etc etc.

Of course congress and the media will still find a way to blame the doctors, and the people will believe them.

Agreed
 
I have asked this question before, but can someone tell me WHAT THE HELL IS THE AMA GOOD FOR? If you have not read this bill, go read it please. This is the beginning of a new era, I repeat, a brand new freaking era. Guys, it is not a joke, this is government control without government pay. This is a special version of socialized medicine where the government makes most of the decisions without spending a dime. Physicians and the healthcare system are about to get dealt the biggest under the belt blow of our time.

Don't get me started on the AMA.

http://www.ama-assn.org/ama/no-index/news-events/senate-passes-economic.shtml

what they (ama) have to say....
 
Not sure I like the idea of a government agency trying to oversee what's "reasonable and cost effective", but the idea of being able to easily transfer medical information from one setting to another may be a good idea. It should cut down on repeat testing as well.
If someone is chronically undiagnosed, perhaps having all their symptoms listed out in one place could speed up a diagnosis, especially if the symptoms come and go and many doctors at different facilities are involved.

:laugh::laugh::laugh: An agency run by the same people that created it with a bill full of $800 billion of random bullcrap paid for with money they don't have. The irony is fabulous.
 
That's some foreward thinking right there. Clearly this centralized record keeping system will never be used inappropriately by the benevolent servants in Washington 🙄.

Eventually, someone ought to create a new professional organization and just overshadow the AMA.

Enough said.
 
I'm going to quote some stuff from the original article...

"Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version).

The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.

But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”

Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.

New Penalties

Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time” (511, 518, 540-541)

What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.

The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.

Elderly Hardest Hit

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye.
 
Old_Mill : will the intervention on the teeny bopper significantly improve her quality life for the next 50 years? If said teenybopper might have a serious injury, that MRI is probably worth it, since 50 years is a long time.

Much of the time, it won't. It'll be the difference between wandering around in a boot and losing a season on the dance team or not.

And what exactly are you going to do to fix 74 year old grandma? We don't have anything to stop aging, and once she gets dementia, grandma stops even remembering who she is. So it doesn't really make sense to give grannie the expensive stuff unless grannie is rich and wants to pay for it.

While we don't have anything to stop aging, it's unlikely that at 74, grandma has end stage dementia. Oh, and see my previous post - we can keep her from going blind.
 
this is truly a disaster for physicians. Trust me, no good will come of this.
 
This is more foundation for covert rationing. Read this Doc's blog for some good insight: http://covertrationingblog.com/

It's funny how the medical system ailments in our country caused by government intervention, are now to be 'solved' by government intervention only to breed more problems. Expect more unintended consequences.

The government as vocalized by daschle aim to limit spending. The easiest way to do that would have been to be a complete government pull out and embrace of the market. This would be much cheaper on the tax payers, but that isn't their goal.
 
FYI the National Coordinator for Health Information Technology was created by Bush in 2004. Here's the official HHS link: http://www.hhs.gov/healthit/onc/background/

Also, do doctors really make decisions? When was the last time someone had to "pre-authorize" with an insurance company before a treatment?

What do I know, I'm just a lowly medical student...

Hopefully, the newer generations of physicians will be on more proactive with protecting our patients and what "little" we have left, instead of being to focused on making a quick $$$$buck and complaining about things in the physicians lounge.
 
And what exactly are you going to do to fix 74 year old grandma? We don't have anything to stop aging, and once she gets dementia, grandma stops even remembering who she is. So it doesn't really make sense to give grannie the expensive stuff unless grannie is rich and wants to pay for it.

Dementia can have a slow course and Grandma can remember who she is for quite some time.
If you're referring to medications to treat dementia of the Alzheimer's type as the "expensive stuff", Aricept has been shown to delay the need for nursing home placement. Aricept may be expensive, but not compared to the cost of a nursing home for the memory impaired. Should we refuse to pay for the drugs but be willing to pay for a much more costly stay in a nursing home? Or is a pillow over their face the way to go?🙄
Obama's attitude toward healthcare for the elderly was the most important reason why I hoped he wouldn't get elected.
Donepezil is associated with delayed nursing home placement in patients with Alzheimer's Disease.Journal of American Geriatrics Society.2003;51(7):937-944.
 
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