amending, not correcting, meeting minutes

[Lewis Lorton <llorton@jobe.shell.portal.com>]

  I appreciate Jamie Love's including me in the minutes, but what I wanted to
  say was not what was heard, evidently.
  
  What I did want say is that I was surprised that virtually everyone around
  the table  was  using  "correction of the medical record" as emblematic of
  the actions to change the medical reord which would be ennabled by this
  legislation.  Amendments are, and should be, the most common form of
  externally generated changes.
  
   I was NOT, repeat "NOT", exercised about the misuse of the terms -trivial
  in the long run - but rather that many of the most vocal participants seemed
  oblivious both to this fact and to the workings of the electronic portions
  of the industry.  This seemed to be indicative of a low level of
  understanding of how the industry of providing health care actually runs.  
  
  In the meeting discussions, which are nominally about the pending bill,
  I see people, seemingly with little or no functional background, who are
  committed
  to "fixing the industry."  I understand the issues and the problems - it is
  the Luddite manner of addressing the issues that seems unproductive.   When
  I am ill, I work with my health care provider to cure me - I give the
  symptoms, listen to the response, chhose amongst the proferred treatments
   and insist on becoming better -  I do not grab the instruments and start
  doing my own surgical procedures. 
  
  As an exercise, I would suggest that the members of the group operationalize
  their suggested additions to the legislation -  What are the current
  problems and the costs? How would each new legislative requirement  actually
  be performed? - how much time would the processes take and cost?   Multiple
  the time/labor/infrastructure costs by 10,000 for hospital based processes,
  by 130 000 000 patient-care giver encounters etc. 
  
   Would this sum come from current health care dollars? Is this sum worth the
  results? Who doesn't get actual health care because of the dollars expended
  to insure
  (for example) that every company who stores reels of tape in a cave in
  Arizona is a certified Health Information Service? 
  
  It seems that with this legislation, as with the last car I bought, the
  basic vehicle is vital, extraordinarily worthwhile, useful, economical - it
  is the accessories that were added "to make the perfect package" that
  boosted the price the most, provided the least benefit and are the most
  difficult to maintain.  
  
  By the way, I'm thinking of convening a group of computer scientists to
  decide how attorneys should try cases and the courts should be run.  Stand
  by for new instructions.
  
  LL
  Lewis Lorton, Executive Director
  Healthcare Open Systems and Trials
  HOST@sso.org
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