There is no possible compromise on health care and the myth of Obama as a “post-partisan” president is exactly that – a myth. The health care industry generates billions of dollars in profits and many people are seething that these profits might be curtailed. This issue can never be negotiated in Washington back rooms as there are huge interests vested in the status quo – such as the big insurance companies, health maintenance organizations and pharmaceutical giants. Like many social changes, for this one there will be winners and losers and an historic battle will determine the outcome.
As Obama noted in his message to supporters, “In politics, there’s a rule that says when you ask people to get involved, always tell them it’ll be easy. Well, let’s be honest here: Passing comprehensive health insurance reform will not be easy. Every President since Harry Truman has talked about it, and the most powerful and experienced lobbyists in Washington stand in the way.” But this time Obama has what those presidents lacked: the Internet and a powerful social movement that potentially can shift the relationship of forces in America away from the traditional entrenched interests towards the needs of the population.
…the rising cost of healthcare is driving people to lose their coverage because costs of employer funded healthcare are rising faster than we can keep up. When I co-founded my web agency in 1997, we offered healthcare and paid the entire cost. Today that isn’t possible anymore and employees share part of the cost, and many business don’t even offer coverage, or offer “sham” coverage.
The reality is that the current approach to health insurance has resulted in a loss of coverage for millions of people. From 1998 to 2008, the percentage of large employers who offered health coverage shrank from 66% to 31%, and the trend continues downward today . Rising costs will mean that many employees who are offered coverage won’t be able to afford to accept it.
The result? “…it transmitted everything I’ve ever had. With almost no dates attached.” So you couldn’t tell, for instance, that the diagnosis of anxiety was related to chemotherapy-induced nausea: “… the ‘anxiety’ diagnosis was when I was puking my guts out during my cancer treatment. I got medicated for that, justified by the intelligent observation (diagnosis) that I was anxious. But you wouldn’t know that from looking at this.”
Where there was supposed to be “more info” about conditions listed, the information wasn’t particularly robust, and some conditions were listed that Dave never had.
I’ve been discussing this with the docs in the back room here, and they quickly figured out what was going on before I confirmed it: the system transmitted insurance billing codes to Google Health, not doctors’ diagnoses. And as those in the know are well aware, in our system today, insurance billing codes bear no resemblance to reality.
All this raises the question, and the point of Dave’s post: do you know what’s in your medical records? Is it accurate information? If some physician down the line was reading it, would (s)he make an accurate assessment of your history?
Think about THAT. I mean, some EMR pontificators are saying “Online data in the hospital won’t do any good at the scene of a car crash.” Well, GOOD: you think I’d want the EMTs to think I have an aneurysm, anxiety, migraines and brain mets?? Yet if I hadn’t punched that button, I never would have known my data in the system was erroneous.
Dave realized that the records transmitted to Google Health were in some cases erroneous, and overall incomplete.
So I went back and looked at the boxes I’d checked for what data to send, and son of a gun, there were only three boxes: diagnoses, medications, and allergies. So I went back and looked at the boxes I’d checked for what data to send, and son of a gun, there were only three boxes: diagnoses, medications, and allergies. Nothing about lab data, nothing about vital signs.
Dave goes on to make a rather long and magnificent post, which you should read (here’s the link again). The bottom line is that patients need working, interoperable data, and patients should be accessing and reviewing, and there should be methods for correcting factual inaccuracies.
We’re saying this having heard that most hospitals aren’t storing data digitally, anyway. This is new territory and we know we have to go there. Salient points:
- Get the records online
- Make sure they’re accurate
- Have interoperable data standards and a way to show a complete and accurate history for any patient
- Have clarity about who can change and who can annotate records
That’s just a first few thoughts – much more to consider. If you’re interested in this subject, read e-patients.net regularly.
Our friends and sometimes houseguests, Bruce Sterling and Jasmina Tesanovic, are facing an immigration hassle. Says Bruce, “We have no joint bank account, no insurance accounts and no joint children. The authorities therefore suspect that our marriage is a phony ‘Green Card marriage,’ and they would like to have Jasmina deported from the USA.”
Note to the harried couple: send INS our way, we can certainly verify your persistent, more or less blissful marital status…