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amending, not correcting, meeting minutes
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
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
(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.
Lewis Lorton, Executive Director
Healthcare Open Systems and Trials
444 North Captol, NW
Washington, DC 20001
tel 202/434-4771 fax 202/434-4766
Program Home Pages
Healthcare Information Infrastructure Technology Program -- http://hiit.scra.org
Healthcare Information Technology Enabling Community Care --
10096 Hatbrim Terrace
direct 410-715-1181 direct fax 410-992-7060