eHealth
Initiative
HIT System
The initiative shifts the focus of medical care from the doctor-patient relationship to one of information collection and exchange among the providers of services so that everybody can have access to your medical record. In the new paradigm of Health IT, you are a "consumer" not a patient.
There are several critical aspects of the planning for the HIT system that should be understood by all. The following is a brief discussion of each.
The collected data will reside in networked systems at the community, state, and national (and international) levels. The initiatives are supposed improve the quality of care for the "consumers" and reduce costs system wide. In reality, it will simply shift health care dollars from the pockets of providers to the information technology industry. The savings will come from replacing qualified doctors with less qualified people using "Decision Support" systems and shifting the focus of medical care from caring for the sick to caring for the healthy. This new way of looking at health care is a set up to 'blame the victim' with built in incentives for the health care provider to dump sick people because sick people will affect their performance ratings and as a result, their compensation.
Legal Framework
In order to implement this system - and I'm calling it a single system because multiple systems that are networked together are in effect a single system - requires changes in the following areas:
Privacy
An electronic medical record that resides on a network connected to other networked systems will eliminate medical privacy altogether. Once implemented, there will be no such thing as medical record privacy. For all intents and purposes it will be public information there for the taking. Think of all the system break-ins and stolen data of recent years and you will understand how easy it will be to get your private information if somebody is of a mind to get it.
Licensure laws
Gov. Phil Bredesen talked about how the health care licensing laws would have to be changed because the plan is to allow 'remote' medicine and 'Decision Support'. When he talked about it, he said 'health care providers in other states' but the real idea is to have "Dr. Punjab" in Calcutta as the remote "doctor". This is already being done with radiological reports. They are transmitted to India so that the radiology 'call center' doctors can interpret the x-rays.
Coincidently - and fortunately, I happened to be listening to C-Span2's coverage of the Senate yesterday. Senator Jeff Sessions brought an amendment to floor S.AMDT.2374 to S.1642 calling for a lowering of the academic standards for entry into U.S. medical schools. His reason was supposedly the need for more medical providers and keeping medical education dollars in the U.S. rather than having them go offshore to the Brand-X alleged medical schools in the Caribbean. This is a classic example of how an issue is presented in one framework when the real goal is something quite different. The real reason for lowering standards is because IBM and the other Information Technology companies are selling "Decision Support" systems to replace highly qualified doctors.
If you've had to call a software company for technical support in the past few years, you've had the 'Decision Support' experience. The idea is that experts can be replaced with clerks when they have a 'Decision Support' system. In the development of the knowledge base, the expert provides the Question & Answer sets and the logic path that theoretically allows the clerk to go through the same "thinking" process as an expert and he would arrive at the correct answer to solve the problem. If that doesn't scare the hell out of you, try calling one of the large software companies for technical support - you'll soon see what the 'Decision Support' process is about. (Garbage in - Garbage Out). And that's the real reason for the lowering of standards to get into medical school. They are anticipating not needing as many "expert" physicians in the future. Bubba from the football team will be good enough.
"Personalized Genomic Medicine"
Without a doubt, this is the most disturbing aspect of the electronic medical record. They aren't satisfied with simply making your medical information virtually public, they want your DNA so that they can apply IBM's analysis of your 'risk factors' relative to your lifestyle, DNA and medical history. Listen carefully to what Dr. Douglas Woods of the Mayo Clinic and Ginny Wagner, IBM Project Manager have to say:
National Governor's Association Meeting, 7/22/2007
Ginny Wagner, IBM Project Executive - Audio File
Dr. Douglas Woods, Mayo
Clinic - Audio File
(Text excerpts)
[How can we reduce costs with IT?] It is a new form of
medicine. We prevent the progression of disease using IT
prediction and prevention tools coupled with personalized
genomic medicine. We're doing a project at Mayo now with IBM
which allows us to link the capabilities of knowing the
genetics of each persons background along with their
behavioral and environmental factors which in fact,
influence the development of disease. In that fashion we can
actually undertake individualized interventions that will
make it less likely that any one person will suffer the
ravages of a disease later on and collectively improve the
health of the population - again as well as controlling
costs. So this is the future of disease treatment. Very
different than our current emphasis on acute care.
How might this work in reality from the perspective of prediction and prevention? With a simple buckle swab maybe even a simple blood test.. now even possible to do at home by obtaining a drop of dry blood and sending it to a laboratory, we can reconstitute it, we can create a genetic profile. By using the computerized health risk assessment, we can then combine the genetic information with an individual's behaviors to understand their proclivities for actually developing disease that may not be evident. This allows us to do a physician-patient interaction that could occur with a computer - not in an office. The only way that I'm paid now to provide care is in the office. So this represents a substantial opportunity in terms of actually moving this capability forward.
In terms of acute episodes of care at Mayo Clinic, we are now using web-based protocols for our own employees to be able to access and guide their care for simple problems - upper respiratory infections, urinary track infections and the like can be managed just that way by individuals with the right guidance. Doesn't require an office visit... doesn't require coming into the clinic. But again, I don't get paid for that as a physician. From an employer perspective, its a great advantage for us to do this because we manage to not only save the cost of the physician visit but improved the productivity of the employee - less time away from work.
BE A RESISTER !
DON'T LET THIS HAPPEN AGAIN!
'Nationalized - Shared network of Individualized medical records...
"Personalized
genomic medicine... knowing genetics, background, behaviors
and environmental factors which influence
disease....individualized interventions to .....collectively
improve the health of the population.
"We can create a genetic profile...By using the computerized health risk assessment, we can then combine the genetic information with an individual's behaviors to understand their proclivities for actually developing disease...
This allows us to do a physician-patient interaction that could occur with a computer - not in an office.
A "new" form of
medicine...
Resistance likely to be..."Consumers"... Manage their own care (audio)
"Wagner - Identity Proofing" (audio) - Needed
'Real ID" for adults and
children
with
country code
Include all
populations (audio)
"Pay for meeting performance goals" (audio)
Dr. Wood -
Quality of Care (audio)
Brain Chips for Soldiers (and for you soon)
By using the computerized health risk assessment, we can then combine the genetic information with an individual's behaviors to understand their proclivities for actually developing disease that may not be evident. This allows us to do a physician-patient interaction that could occur with a computer - not in an office.
IBM and Dr. Mengele - Together Again
IBM, "The Solutions Company" helped Hitler with the 'Final Solution' for millions of people.
IBM and the Holocaust, Edwin Black
IBM, Verichip, and the Fourth Reich
Using a computer system for
'remote medicine' will provide the opportunity for the
population to be culled of "undesirables".
The combination of "behavioral" information and
"environmental" factors (i.e. location (ghetto),
religion, ), plus DNA (genetic defects, race) will provide
the selection criteria.
Populations of people can be selected for experimentation as well. Since the networked, shared medical information will be available on ALL citizens, the 'selected' population can be distributed in such a way that negative outcomes from the experimentation will be very hard - if not impossible to detect outside the research community.
FCC's Universal Service Program for Rural Health Care Providers
The four Nationwide Health Information Network Consortia consist of the following organizations:
http://www.hhs.gov/news/press/2005pres/20051110.html (PDF recovered 9/3/2010)
- Accenture, working with Apelon, Cisco, CGI-AMS, Creative Computing Solutions, eTech Security Pro, Intellithought, Lucent Glow, Oakland Consulting Group, Oracle, and Quovadx. This group will work with the following health market areas: Eastern Kentucky Regional Health Community (Kentucky); CareSpark (Tennessee); and West Virginia eHealth Initiative (West Virginia).
- CSC, working with Browsersoft, Business Networks International, Center for Information Technology Leadership, Connecting for Health, DB Consulting Group, eHealth Initiative, Electronic Health Record Vendors Association, Microsoft, Regenstrief Institute, SiloSmashers, and Sun Microsystems. This group will work with the following health market areas: Indiana Health Information Exchange (Indiana); MA-SHARE (Massachusetts); and Mendocino HRE (California).
- IBM, working with Argosy Omnimedia, Business Innovation, Cisco, HMS Technologies, IDL Solutions, Ingenium, and VICCS. This group will work with the following health market areas: Taconic Health Information Network and Community (New York); North Carolina Healthcare Information and Communications Alliance (Research Triangle, North Carolina); and North Carolina Healthcare Information and Communications Alliance (Rockingham County, North Carolina).
- Northrop Grumman, working with Air Commander, Axolotl, Client/Server Software Solutions, First Consulting Group, SphereCom Enterprises, and WebMD. This group will work with the following health market areas: Santa Cruz RHIO (Santa Cruz, California); and HealthBridge (Cincinnati, Ohio); University Hospitals Health System (Cleveland, Ohio).
California - Department of Managed Care
"Fined health plans (Plans) more than $986,000 for violations of the Knox-Keene Act in 2005 and $723,000 in 2004. Two of the more significant cases were a $200,000 fine to Kaiser for exposing patient information via its website and $250,000 to HealthNet for the underpayment of provider claims."
Being Unhealthy Could Cost You Money
Clarian Health, the Indianapolis-based hospital system announced that starting in 2009, it will fine employees $10 per paycheck if their body mass index (BMI is over 30). Other finable 'offenses', if their cholesterol, blood pressure, and glucose levels are too high; . Ditto if they smoke.
Governor Announces Creation of California Broadband Task Force
I just came from a conference on telemedicine where I saw a great example of how broadband can improve people’s lives. We have seen a doctor here in San Francisco examining one of the patients that is 100 miles away, and it’s done by video, and it is really extraordinary to see the using of broadband capabilities here. Technology like this is the future, and I always want California to lead the way. I mean, just of what we have seen—this can save money, this save time, and this can save lives.
I also want to recognize the leadership of TechNet. Cisco was, obviously, a founder and a proud member of TechNet, and none of this would have been possible without the great leadership from that organization. I know that our chief executive officer, John Chambers, would have loved to be here today; unfortunately he’s not, but I am honored to be here in his stead.
(John Chambers, Tech companies building bridges with China, IT World, Sept. 27, 2004
"Explaining why Cisco chose Shanghai for the site of an R&D center, Chambers was quick to note China's excellent infrastructure, a good university system that provides a pool of talent from which to recruit researchers and business-friendly policies implemented by the country's government. But Cisco's decision is about more than developing future VOIP products, it's about positioning Cisco for future growth in China.
"What we're trying to do is outline an entire strategy of becoming a Chinese company," Chambers said."