I can understand this type of comment with encouraging more doctors and hospitals to get into the electronic records programs sure, but the rest of it takes time to write.  Congress, consumers and others have no clue on the amount of programming time all of this takes.  I read all the time about everyone complaining about the time it takes? Do you not think folks are moving on this as fast as they can?  Again we have disconnect on what people want and the time frame they want it it…guess what, developer can’t meet your time frames…get a clue:)  This is exactly why we need executives in cabinet positions all over and most importantly the SEC right now.  We have bumbles like this and demand all you want but you can’t hurry it as this takes time.

In the early days of Health IT when you had nothing, sure it was easier to build a solution but duh folks, those days are gone.  When you read about the complexities in IT today, guess what, this is it!  IT infrastructure education is so much needed again all the way down from lawmakers to consumers so grab what you can.  If you want to look at story about time and the amount of code required, look at Allscripts who tried to do this and made a commitment that developers couldn’t fulfill on the time schedule the CEO wanted and where’s he at today, no longer the CEO.  I read an article the other day and I thought it was a good one, “if you are not a Geek or into technology, don’t start a technology company” and you know that makes perfect sense.  You can’t just run around with a “simple” vision anymore and say this is what I want when there are constraints, IT Infrastructure snags, integration, you name it out there.  Secondly don’t blame the developers for delays as we all have them today.  My suggestion here is to “grow up” and get a little knowledge from somewhere on the timing elements here and quit putting out useless statements like this, it means nothing other than I’m showing everyone I’m doing something, well what is it? 

I’m sure the CIOs out there just sigh too when articles as such come out, again they probably share the same impression, will someone get a clue on how this stuff doesn’t happen in the time frame you want:)  This whole readmissions issue with looking for “magic algorithms” is yet another issue.  Sure analytics help but they are not the 100% answer. 

Readmission Analytics Not Much Better Than Flipping A Coin, Large and Poorest Hospitals At Risk Of Facing Larger Fines, CMS Needs Some New Math Models and Algorithms

UCSF had some real success with their efforts and it was a combination use of smart analytics and involving humans and they did a good job, so why not give everyone the same grant they received and use this as a good model?  Again it comes down to where “value” is and where it is not with analytics and telling the difference is very hard for non tech people and they don’t get it but rather hang on to this rhetoric of rushing things.  To quote Charlie Siefe in one of his lectures (watch the video on the left side of this blog page) you get something along this line, “well the formula has a square root in it, and the story has been all over the news in the last few weeks, so it must be good”…yup seen that a lot and it still happens out there.

UCSF Medical Center Reduced Readmissions With Heart Failure And It Was Not That Magical Flipping Algorithm Everyone Is Looking for That Did the Trick

During the election the issue about redesigning Medicare and changing it to a voucher system was a media splash and when you get down to it, as it would not  happen.  Congress could use some better modelers.  First of all where are you going to find a large enough group of engineers to take on such a large IT infrastructure task? Second of all with trying to save money, the budget for something this huge would shoot another big hole in the economy as it would be huge, not to mention the disruption and inconveniences caused to consumers.  Does anyone think of what kind of work their public statements would require?  Can we look at a bit of reality for a change, please!  Back in 2011 someone I think finally saw the light as software builds on itself and to build an entirely new “connected” system would be a huge nightmare but it played out well during the election for OMG news.  Here a couple back links on this topic.

Republicans Shelve Medicare Overhaul Plan–Lack of Business Intelligence, Technology And Behavioral Analytics Will Serve To Shelve Any Such Proposed Bill

Digital Illiteracy Still Plaguing Lawmakers With Not Using High Powered Technology to Model and Simulate Healthcare Laws–Ryan Hasn’t Figured Out He’s No White Hope Yet (Video)

So please enough with rushing the development as you can see all are working as fast as they can and there’s a lot to this and simplistic statements with “hurrying” the process are not vogue anymore.  To do this blog I use some free predictive services like Recorded Future and does it give me the 100% answers I need, of course not but it can “trend” the future and that’s about what it is good for as my brain still has to formulate what it shows me.  To the right are a couple of topics I was following as a simple example with a graph. Anyone else writing blogs doing any of this I wonder?  I said Congress should look at better technology themselves so they would all get along better and see the same numbers at the same time, and it makes sense if corporate USA is out there kicking your fannies, better get some better tools to model laws.  As soon as law is passed, companies have their options already built and slip in option A, B, C, D, E or F..you get the picture and there may be a few thousand models they have already built with anticipating each result of a law before it is passed, get a clue.  If this were the case lobbyists would assume a role of less value too as it would be more difficult to be “snowed”, happens when you have facts and are better educated on big pictures and have modeled many unintended circumstances in advance. 

Use of IBMWatson Technology in Congress Would Allow For Smarter Laws and Decision Processes With Bonus Points For Lowering Over All Impact of Lobbyists

So all of you wishing and wanting faster IT Infrastructure keep dreaming…(grin) because developers and IT professionals can only do so much at a time and you don’t want to put so much pressure on them to where they walk out, as they will if we don’t all get one the same path here with perceptions and reality of what we want to do.  Take a look at the video at the left, Quants the Alchemists of Wall Street and listen to Mike Oslinski who wrote the software for the big bank re-fi scam. 

It could not have happened without technology but more importantly listen to him as a developer as to some key statements he makes “with software you can do anything”, but it doesn’t always work out in the real world.  The quants in the video make that point loud and clear too. Sure he has a big buzz when everyone is using his software and all developers get a bit of this of “being smarter” and better than others as they write the code that turns the wheels.  No code, no wheels turn and he’s not the bad guy here, it’s the people who used it and how they used the software.  It’s buying a copy of MS Word to do your work, Microsoft is not responsible for what you do with it. 

I would really like to see a higher level of understanding here and it’s all about context too and the link below has a great panel of people discussing where “value” comes from.  Ford, NASA and others and they are stumbling around with trying to find where analytics work and where they don’t work.  Government needs to do the same and hats off to the gal from T-Mobile who has the guts to say “what we are doing with analytics is silly”.  She’ not talking any time limits but rather addressing reality. 

Big Data/Analytics If Used Out of Context and Without True Values Stand To Be A Huge Discriminatory Practice Against Consumers–More Honest Data Scientists Needed to Formulate Accuracy/Value To Keep Algo Duping For Profit Out of the Game

Here’s the video from the link above and it’s gets going in the second half and they really debunk a lot of the misconceptions on big data and try to straighten out a lot of perceptions that are not real and if not used properly corporate USA will have one of the biggest attacks on consumers as they can use algorithms get more money, comes out of our pockets. 

Ok so enough said here with my rant of the day with hurrying code development and hope this made a dent in some misconceptions out there as everything is not as it seems and the time has come for some executives with hands on tech knowledge an computer science if you can get them.  Yes starting with electronic medical records is a good thing, but please for goodness sakes get a clue on how the rest of the Health IT business runs because when a hospital or doctor gets started they do have a whole new world here that integrates with this decision with the complex system we have today.  Yes I’m an advocate of medical record systems of course as I wrote one years back, but again we need people at the top that understand the full spectrum here and do more than say we need to “rush” as they might be talking a dead end street with being convincing and reality is better.  BD

Leaders of healthcare policy encouraged the industry to speed up the rate of change during a keynote address at the National Health Policy Conference Monday in Washington, D.C. “… help us speed up the rate of change,” Health and Human Services Secretary Kathleen Sebelius encouraged conference attendees.



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