Quote:
Originally Posted by Pugchief
I think you are misunderstanding my point. In the last 15 years (in particular) the regulatory burden imposed by the govt onto health care has driven up costs substantially. Some examples include EMR, prohibiting denial of coverage due to preexisting conditions and expanding Medicaid eligibility. Also required coverage for random thing like pediatric dental, birth control, and soon, maybe IVF. All of those things drive up the cost of healthcare, causing premiums to spike bc:
Ins Co PROFIT = PREMIUMS - PAYOUTS - OVERHEAD
I'm saying if the govt had not inserted itself into the free market with all of these requirements, payouts would be lower (prob overhead too, bc less rules), so you could lower premiums and still make the same profit.
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Taken in total isolation, without looking at any benefits, you might (very slight probability) have a point, but I highly doubt it. CoachK, my wife, works in regulatory reporting, helps make sure the systems do what is needed, that the data is correct, and sends filings to many regulatory agencies. . From our discussions for many years about EMRs, etc. since we both are professional geeks and nerds at different points in our careers, there is a ton of misconceptions in this post.
4 years ago, I transitioned my mom from a local doctor's office to a gerontologist. When trying to get records sent to the gerontologist's system, I was given a stack of paper documents about 3 inches thick to hand deliver. While at her practice, i asked about the last tetanus shot due to a hospital stay, and they didn't know that there is a central state immunization database
required for all immunizations given to all state residents. They said it will take some time to read through the documents to find the information.
At the gerontologists office, the documents were all scanned and data extracted into a standardized format, and the questions were all able to be electronically queried. .
If one perceives the hospitals as only break fix locations, and that medical histories aren't important to an ER room for correct diagnosis when time is of the essence, then yes, paper records are fine, wherever they may be found when needed to be used.
However, if you want more than just break fix services at medical offices, then you are looking for evidence and outcome based medicine. That requires standardized medical records, detailed medical records, the more history for trend analysis, etc than just a point in time break fix situation. the EMR is not just a collection of data points, but also able to make calculations with the data, present warning flags for deficient conditions, all instantaneously for the doctor to send less time reading paper records to help prepare for a better outcome.
However, there is a trade off for great medical care with great records for both analysis and quick retrieval: data entry takes human time, and humans are lazy self centered creatures who can't all understand the benefits of whole systems having integrated medical records available, especially when not involved. . humans make mistakes, and humans don't always want to be bothered when they being self centered with a medical emergency. . .
we all are the beneficiaries of the best medical system in the world, due to the electronic processes having been brought to the the medical field. There are no longer people reading doctor's scribbles in notes to get to historical diagnosis, etc. yes there is a trade off of data time entry, and system costs of implementation. . but that is also the private sector, free market enterprise helping create these great modern systems, wanting to get payback for their investment . . .
And there are also so many benefits in the medical back office that patients take for granted because they can't see them, and medical records are much more detailed with time stamps for each step, interactions, etc, than one can imagine just being a patient. .
Finally, because of the legal cost of "malpractice', which is also a very real part of the cost equation, EMRs are used as proof for events happening, steps occurring to mitigate legal costs of deposing a doctor, putting him on the stand, reading scribble to see if certain standards of care were missing. . something you might want if you are getting a second opinion or wanting to be litigious. .
So, there's a lot of ignorance and solely cost based beliefs in a vastly huge world of medicine, and systems, and break fix versus outcomes. . and good outcomes not only comes from good drug trials, but also from good procedures, and constant monitoring of human processes within medical systems for the best outcome. .
go watch "The PITT" with noah wylie and tell me that technology there isn't helpful to save lives, when looking at each human's medical records looking for situations to avoid to which could be catastrophic. .