I hope this is a good educational meeting as they need it. 
When this letter went out it was all over the web and about the lack of knowledge here on how the incentives and educational process was working. Electronic medical records no doubt are the way to go and I think that question was answered years ago as heck I was writing software for an EMR years ago myself. This is really sad that they don’t understand the investment here and I will go a little further to say that as on the “consumer” end they may not be participating much in their own care or maybe even as simple as paying attention to their own visits to their doctors. Otherwise I don’t we would have seen such a letter sent.
Digital Illiterate “Algo Duped” GOP Lawmakers Call for Suspending of Incentive Payments to Providers–Also Sent Letter to HHS Telling Them To Expect More From Meaningful Users–Walk A Mile in a Healthcare CIO’s Shoes Please…
I guess they don’t read the news about hospitals walking a fine line today with trying to stay out of the red and stay in business as those hospitals, if if were not for the incentives couldn’t afford to transition to electronic records. Again maybe newspapers and all the articles and opinions written about this topic may not circulate in DC? How does one miss it?
If you happen to read Dr. Halamka’s blog from Harvard he too said they were wrong in their assumptions and he was much nicer than me and said he would gladly spend some time and bring them up to date. So bring the folks from the House who wrote the letter on over too:) You don’t get much better input than his for sure and they would be wise to take him up on his offer…from his blog…
“I'm happy to walk them through the Standards and Certification Regulations (MU stage 1 and stage 2) so they understand that the majority of their letter is simply not true - it ignores the work of hundreds of people over thousands of hours to close the standards gaps via open, transparent, and bipartisan harmonization in both the Bush and Obama administrations.”
They also said enough was not being done to make the transition faster. Again, I guess they have not read up or asked any questions to this point. One thing that Congressman and the general public needs to be aware of….
“The short order code kitchen burned down a few years ago”
So what does that mean? We have a very complex Health IT i
infrastructure today and that has not sunk in yet. Years ago someone could come to us technologists and describe what they wanted and we would build it, not that easy today since data systems talk to each other and integrate, not like the old client/server silos we used years ago.
This brings me to a political statement if I can here as in the debates we keep hearing about uprooting the Medicare system and changing it to a voucher system. I just wish we would hear some real logic here and understand that a process of such would take 7 or 8 years and the US may not even have enough engineers to do this as Ryan keeps talking about, so repealing the healthcare law entirely and changing it is impossible. They can use the transition to electronic medical records as an example since this is what they are questioning. I keep hearing this in the debates and it’s farce and just generates useless chatter. Now modifications of at smaller levels can be done but again, even that takes time…so one more time…
“The short order code kitchen burned down a few years ago”
Perhaps this meeting will end up facilitating a level of communication between Congressmen and technologists? Bill Gates tried for years to get through some thick heads maybe lost in the70s in DC with very little effect so his foundation is doing its own thing now and rather well I 
might add. The accusations on the billing too was an astounding accusation. For years, and I’ll use one example of a standard office visit, doctors were afraid to bill more than the 99213 code for a standard office visit. If they spend more time and have an extended visit and document properly to include required elements of the visit, they can get more money for a 99214 or a 99215, which is perfectly legal and money they earn if they have an extended visit as it was set up that way.
Now with electronic medical records, it’s easier and more convenient not to mention more complete to make sure all those elements are there and that’s what most are doing, so add this up against all the MDs in the US using electronic records and of course there’s more codes that are tiered as such as well and that will probably account for a lot of the increased billing to Medicare. This normal and of course does not include the out and out “fraud” folks out there that exist and they are criminals and and make it tough for all of us and should be prosecutes. I can’t tell you how many times I heard doctors who were still using “paper” were afraid to use anything higher than the 99213 code even when they did the work as they were afraid of the “red” tape and slowing down the process of getting their claim paid, and that does happen when an extended visit is billed when Medicare looks for the substantiating documentation.
Now when it comes to medical records and automated billing
, sure that’s worth a look and we have seen some of that but HHS now has the technology to run queries and look for obvious abuse too, which they didn’t have before so they can audit big hospital system and find such items if they have developed a pattern and are being abused. Maybe the senators forgot about that part of what’s happening at HHS too, and it’s still fairly new, but a semi automated audit is in the stars. HCA was in the news about their potential coding situation and billing and who knows, maybe they just got better and more accurate with their billing but then again if they are more profitable than others, maybe take a look. That new audit software HHS has should get a work out.
How is HCA a For Profit Hospital Chain, Making All That Money–Billing in the ER a Contributing Factor for Reimbursements–The Algorithms Move Money and Created Some Very Large Profits And Others Generated ER Care Parameters for the Facilities
Again I hope this ends up to be a productive meeting and perhaps they will learn more about the world of Health IT and perhaps the entire Government IT infrastructure while they are at it. I should add one more item in here too and this has been a campaign of mine for a while on taxing the data sellers who get the data for nothing and profits for free. When you look at the NICC situation and the people that have
died due to the FDA not having enough staff to do routine inspections on drug and compounding companies in the US, don’t you think that Walgreens as an example would be happy to pay an excise tax on that revenue so they can be assured the FDA is on the job inspecting and ensuring we have safe drugs? Walgreen made short of $800 million on selling data in 2010, so see how big that pot can be when you include banks, high frequency trading companies, social network companies, etc. to license and have them pay a quarterly excise tax.
They need money to also hire more engineers for the device end of the business, but does anyone do anything about it to fund the FDA and the NIH? Nope…it could be a very good idea to let HHS and the ONC keep working the program and move over and focus on this item, as people are dying…more a the link below on the FDA needing funds….
Meningitis Fungus Investigation and Research Continues With FDA Inspection While Massachusetts Hospitals Contact Cardiac Patients About a Heart Medication Also Created at NECC
One more time….
“The short order code kitchen burned down a few years ago”
I could go on and I have but I would like to see Congress use better tools to make laws too like IBM Watson so all could use speech recognition and query from the same sources and that way both the House and Senate have the same information and then can go off to committees to continue their work and shoot the the GOP and Democrats just might even get along better if they worked collaboratively with everyone at least having the same starting place. After this meeting is done, could someone look into revolutionizing the way we make laws? If we could entertain a shift in focus over to the items at the link below we might all come out ahead and who knows, folks in Congress might become better participants in their own healthcare at the same time…it’s what they want us to do as consumers so what’s good for the goose is good for Congress:) BD
Congress To Investigate the Data Sellers - Need To Create a Law to Tax Them As The Algorithms Used For This Business Generate Billions of Dollars, Partly Why Corporate Profits Are So High - Remove the Medical Device Tax as They Produce Needed Jobs/Tangibles
Two weeks after top House Republicans called for HHS to halt meaningful-use incentive payments to providers, four senators have requested a meeting with staff members from the CMS and HHS' Office of the National Coordinator for Health Information Technology to discuss the program.
Sens. John Thune (R-S.D.) and Tom Coburn (R-Okla.) of the Senate Finance Committee and Sens. Richard Burr (R-N.C.) and Pat Roberts (R-Kansas) of the Senate Help, Education, Labor and Pensions Committee, sent a letter to HHS Secretary Kathleen Sebelius (PDF) indicating that a recent briefing with the administration's staff was not long enough for lawmakers to get answers to all of their questions about the final rule for the second stage of the government's electronic health-record system incentive program. The program pays providers for adopting and meaningfully using EHR systems.
The lawmakers posed several questions they want members of the CMS and the ONC to address, including whether the use of taxpayer-subsidized EHRs increases the use of diagnostic tests rather than reduces them. They also ask in the letter whether some healthcare providers received subsidies for EHR systems that were already established before the adoption of federal standards and mandates, and whether the digitalization of records and adoption of EHRs have raised providers' billing of Medicare and consequently increased the cost of the program for taxpayers.
http://www.modernhealthcare.com/article/20121018/NEWS/310189948?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMVGFWUHdKRWxiNUtpQzMyWmFyNW5RWUpiaXA=&utm_source=link-20121018-NEWS-310189948&utm_medium=email&utm_campaign=hits
look up and see how much funding start ups have gained, etc. I did an interview with a similar network called e-Zassi back in 2009 to where their network allowed for medical device companies to search and find software complimentary to their devices,etc. but the funding was not there but exchanges in a secure area to even include communicating with IP information is there. They have added resources and capabilities since that initial interview. Here’s a couple back articles on what they do. 
connections and exposure they need in one place. At least this way funders can see where a company is in development and the investors are more visible to the start ups. Anyway too as we all hear all the time, all start ups are not successful and a very small portion of them do really make it. Also too with being in this network startups can look at each other and maybe there could be some combining of efforts there too as many projects do resemble others or may have the same goals. 
I can imagine how the NECC folks feel as nobody does this intentionally; however it does bring an awareness around to pay attention to quality control and the need for the FDA to be able to make more on premise inspections. Everyone complains about the FDA not doing this but gee give them some money to fund it. Talk to anyone n the pharma business and they will tell you how over stretched the FDA is and how they don’t have the manpower. So while you sit and continue to read this, get behind this idea below that makes sense rather than just bitch about the FDA as they need money & staff to conduct regular inspections and we have too many companies holding our data ransom over our heads anyway and half of it seems to be flawed anymore. 
way beyond that number for sure when it comes to selling data and profiting, but it shows you how huge that pool is to tax and why corporate profits are at all time highs as they get their data for nothing and the profits for free, and in the meantime everyone beats up the FDA for not having enough money to do their job..duh? We can very comfortably call this idea the “alternative millionaire’s tax” if you like as it would a heck of lot bigger. 
states to include 82 hospitals and almost 90 continuing care facilities and hospice programs. The numbers of employees are 87,000 and 4000 of those are doctors employed by the current 2 systems. Catholic Health Initiatives, which Catholic Health East is a member of created a new VC group to also invest in various areas of Catholic healthcare. 
and Trinity Health, two leading Catholic health systems, announced today they signed a non-binding Letter of Intent to come together into a unified national health system that will enhance their mission of service to people and communities across the United States. 
received prescriptions were addicted to some type of drug or substance. He also had ecstasy and sold marijuana from his home, which the latter seems to be the least of his worries compared to the rest. He was the medical director of the Valley Health Plan that handles insurance so I wonder if any of those records could be included in the case as far as looking for payments and money? One wonders if the doctor was maybe on meth if he was writing prescriptions in exchange for it, or was he supplying it for others? They also found weapons in his home, so sounds like it may have been going on for a while. BD 
restructuring the company with a few hundred layoffs. Today we have the news that they are buying the lab business at UMass who themselves earlier this year in February announced they were cutting 700 to 900 jobs. At that time in February they also said they were looking to sell their lab business ant it appears Quest is the buyer. 
maybe not directly related but in the end we still have the same results, people losing jobs. Quest’s lab in Cambridge and it’s Athena Diagnostics group will both move to a centralized location, so the lab testing for UMass will be officially outsourced to Quest via the purchase. BD 
use Quants as well to help design their business models. Scroll down for more on that topic. You can watch the video below and maybe ask what kind of business model they have going here as the one patient in the video says she can’t go to her hospitals anymore as United owes them $11 million dollars. These are Medicare patients that have United Part D plans. In 2013 United patients will only have emergency access. United didn’t even tell them but the hospital put a big ad in the newspaper. This affects 10 hospitals in Florida, so that’s maybe how they do it. 
out technology war with Blue Cross as that subsidiary of Blue Cross looks like it will close and United is buying up or giving contracts to the subsidiaries/partners of TriWest that will remain. TriWest is owned by 11 Blue Cross and Blue Shield plans and two University Hospital systems so this gets even more interesting and do they use software that was created by United’s Optum division? 
insurers all have them along with their Quants. Now here’s a great documentary that I have used many times here and it’s still be read daily about the Quants Being the Alchemists of Wall Street…nobody checks their math or formulas but that’s what makes the money…business models so complex that CEOs struggle to make sense out of them, but they don’t touch as the algorithms move money and bring profits to banks and corporations and society gets Algo Duped and sometimes fed a lot of flawed data. 
earlier than mammograms can find it. A sensor is in the bra and measures temperatures with blood vessel growth, where the tumor can be fed. Next year Europe gets is and the US is planned in 2014 and still needs to get FDA approval. I would hope one would not have to wear this all the time. 
, is like a continuous monitoring system for breast cancer that could be more effective than mammograms. 
gave out a phone sex hotline number to Floridians seeking information on a deadly fungal meningitis outbreak. 
feel of Algo Duping around happened last week with Congress…it’s been a popular read here…and even the folks at Harvard were nice than me and offered to explain the medical record stimulus money and how it works and the fact that users can’t move any faster…the old “fast order code kitchen” burned down a few years ago…again out of touch and non participants draw these conclusions mostly. I am so concerned to see so many US and world executives and leaders falling in to Algo Duping because it hurts all of us and the rich get richer working as they do or hiring those folks to write the algos to keep all their money, it is what it is sadly. 
from Genentech (Roche) who makes Avastin. Avastin has been around a long time and it is not cheap either with an estimate of $5000 a month, but take on Zaltrap at double that cost? Cancer drugs and chemotherapy treatments are all over the map as far as cost. For Medicare patients, the out of pocket cost would be $2200 for Zaltrap. This will be interesting to watch to see if Zaltrap is somewhat forced to take another look at their pricing. I’m sure they will also want to see the exact results of the study. We could also see other cancer centers perhaps looking at the same thing to help substantiate the decisions made. BD 
still the hardest hit state. At the CDC they are working hard to notify everyone who could have been exposed. Also the 
campus of the Centers for Disease Control and Prevention are the staff on the front lines fighting a rare outbreak of fungal meningitis: A scientist in a white lab coat peers through a microscope at fungi on a glass slide. In another room, another researcher uses what looks like a long, pointed eye dropper to suck up DNA samples that will be tested for the suspect fungus.
light of all that, it is the the most accurate data base in the US to determine if someone is dead or alive. Last year the government clamped down on who could use it and who could not. Now we have medical research companies and universities that say it is hampering some of their research as they can’t calculate accurate information as relates to organ transplants and other issues.
consumer problems with the growing amount of flawed data that is surmounting when credible data is combined with non credible data for behavioral prediction behavior. Sure there’s knowledge to be gained on some of this but as a couple of university professors have agreed with me, “there are not enough trained people out there who know how to work with flawed data”. It’s sad that so many just believe any old numbers that are thrown at them today without checking the math and code as all become additionally “Algo Duped” over time. BD 
The federal agency that runs 
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Math–This Could be a Subject for Michael Moore to Explore and Document In a Movie
Screenings Too–Killer Algorithms Part 12–Medical Billing Codes Style
Assessing Consumer Credit Scores–Attack of the Killer Algorithms Chapter 21 With Flawed Data
Duping” Society Combined With A World of Rogue Algorithms & Flawed Data Continues In Markets As Seen With Knight Capital This Week-Attack of the Killer Algorithms Chapter 36
Study Fraud With EHR Technologies, Namely Medical Records/Billing Software Used by Hospitals– HHS And SEC Continue Getting Their Non-Algorithmic Fannies Kicked–Attack of the Killer Algorithms Chapter 46
SilverScript Senior Drug Program Sanctioned by Medicare Until the Payment And Billing Algorithms are Cleaned Up-Killer Algorithms Chapter 53
