<article>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#article10_03_02_1641223</id>
	<title>Federal Deadline Hobbling eHealth IT Rollout</title>
	<author>Soulskill</author>
	<datestamp>1267549620000</datestamp>
	<htmltext>Lucas123 writes <i>"A federal deadline that begins next year and requires hospitals to prove they're meaningfully using electronic health records <a href="http://www.computerworld.com/s/article/9162438/Deadline\_for\_e\_health\_rollout\_may\_do\_more\_harm\_than\_help">will lead to technical problems and data errors</a> affecting patient care, say politicians and top IT professionals responsible for the deployments. Physicians and hospitals have until the end of 2011 to receive the maximum federal incentive monies to deploy the technology. If not deployed by 2015, they face penalties through cuts in Medicare reimbursements. 'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health. 'I wonder if anybody understands the reality of IT systems and how complex they are, especially when they're integrated together. You're going to sacrifice quality if you increase the speed [of the rollout].'"</i></htmltext>
<tokenext>Lucas123 writes " A federal deadline that begins next year and requires hospitals to prove they 're meaningfully using electronic health records will lead to technical problems and data errors affecting patient care , say politicians and top IT professionals responsible for the deployments .
Physicians and hospitals have until the end of 2011 to receive the maximum federal incentive monies to deploy the technology .
If not deployed by 2015 , they face penalties through cuts in Medicare reimbursements .
'I think we have nontechnology people making decisions about technology, ' said Gregg Veltri , CIO at Denver Health .
'I wonder if anybody understands the reality of IT systems and how complex they are , especially when they 're integrated together .
You 're going to sacrifice quality if you increase the speed [ of the rollout ] .
' "</tokentext>
<sentencetext>Lucas123 writes "A federal deadline that begins next year and requires hospitals to prove they're meaningfully using electronic health records will lead to technical problems and data errors affecting patient care, say politicians and top IT professionals responsible for the deployments.
Physicians and hospitals have until the end of 2011 to receive the maximum federal incentive monies to deploy the technology.
If not deployed by 2015, they face penalties through cuts in Medicare reimbursements.
'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health.
'I wonder if anybody understands the reality of IT systems and how complex they are, especially when they're integrated together.
You're going to sacrifice quality if you increase the speed [of the rollout].
'"</sentencetext>
</article>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332996</id>
	<title>EMR Integration and Developer Pay</title>
	<author>ChronoFish</author>
	<datestamp>1267558020000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>3</modscore>
	<htmltext><p>After reading the posts here I felt compelled to respond to several points raised:</p><p>1. "Great software developers entering the field today aspire to work on pop culture technology like Facebook, Google, and CG animated film production. Who does that leave to work on hospital IT? Does hospital IT pay well enough to compete with the sexy IT jobs?"</p><p>Yes.  It pays quite well and with federal dollars flowing there is a HUGE push to implement and integrate EMR technology.  There are development gigs that pay more, but not a lot more (in either number of open positions or dollars).</p><p>2. "Non technology people dictating the technology sector. Obama does not have an ounce of knowledge about health care systems, yet thinks he knows everything that should be done. It's a farce."<br>True - Obama doesn't know about health care systems - Nor does he need to.  "He" is not dictating the "how" just the "what".  That seems appropriate for the Federal Government.  In terms of actual Federal input - it's pretty minimal - maybe even more minimal than desired.  They are certainly driving the industry in a good way (towards integrated health records) - but have not even specified format or protocol - much less the "single repository" that so many are afraid of.  The private sector - rightly or wrongly - has standardized on HL7 (v2 mostly from what I've seen - too bad really - v3 is XML while v2 is a bit arcane - pipe ("|") and carat ("^") delimited).</p><p>3. Deadline : Plain and simple, without a deadline the industry would easily take another 20 years to get fully automated.</p><p>4. "I bet this is another case of the leftovers crying about investing money in infrastructure that will save them money in the long run but they see it as an expense and fight it."<br>Because of the stimulus package no one is fighting it.  On the contrary - any given EMR is now reporting a six month backlog to integrate.</p></htmltext>
<tokenext>After reading the posts here I felt compelled to respond to several points raised : 1 .
" Great software developers entering the field today aspire to work on pop culture technology like Facebook , Google , and CG animated film production .
Who does that leave to work on hospital IT ?
Does hospital IT pay well enough to compete with the sexy IT jobs ? " Yes .
It pays quite well and with federal dollars flowing there is a HUGE push to implement and integrate EMR technology .
There are development gigs that pay more , but not a lot more ( in either number of open positions or dollars ) .2 .
" Non technology people dictating the technology sector .
Obama does not have an ounce of knowledge about health care systems , yet thinks he knows everything that should be done .
It 's a farce .
" True - Obama does n't know about health care systems - Nor does he need to .
" He " is not dictating the " how " just the " what " .
That seems appropriate for the Federal Government .
In terms of actual Federal input - it 's pretty minimal - maybe even more minimal than desired .
They are certainly driving the industry in a good way ( towards integrated health records ) - but have not even specified format or protocol - much less the " single repository " that so many are afraid of .
The private sector - rightly or wrongly - has standardized on HL7 ( v2 mostly from what I 've seen - too bad really - v3 is XML while v2 is a bit arcane - pipe ( " | " ) and carat ( " ^ " ) delimited ) .3 .
Deadline : Plain and simple , without a deadline the industry would easily take another 20 years to get fully automated.4 .
" I bet this is another case of the leftovers crying about investing money in infrastructure that will save them money in the long run but they see it as an expense and fight it .
" Because of the stimulus package no one is fighting it .
On the contrary - any given EMR is now reporting a six month backlog to integrate .</tokentext>
<sentencetext>After reading the posts here I felt compelled to respond to several points raised:1.
"Great software developers entering the field today aspire to work on pop culture technology like Facebook, Google, and CG animated film production.
Who does that leave to work on hospital IT?
Does hospital IT pay well enough to compete with the sexy IT jobs?"Yes.
It pays quite well and with federal dollars flowing there is a HUGE push to implement and integrate EMR technology.
There are development gigs that pay more, but not a lot more (in either number of open positions or dollars).2.
"Non technology people dictating the technology sector.
Obama does not have an ounce of knowledge about health care systems, yet thinks he knows everything that should be done.
It's a farce.
"True - Obama doesn't know about health care systems - Nor does he need to.
"He" is not dictating the "how" just the "what".
That seems appropriate for the Federal Government.
In terms of actual Federal input - it's pretty minimal - maybe even more minimal than desired.
They are certainly driving the industry in a good way (towards integrated health records) - but have not even specified format or protocol - much less the "single repository" that so many are afraid of.
The private sector - rightly or wrongly - has standardized on HL7 (v2 mostly from what I've seen - too bad really - v3 is XML while v2 is a bit arcane - pipe ("|") and carat ("^") delimited).3.
Deadline : Plain and simple, without a deadline the industry would easily take another 20 years to get fully automated.4.
"I bet this is another case of the leftovers crying about investing money in infrastructure that will save them money in the long run but they see it as an expense and fight it.
"Because of the stimulus package no one is fighting it.
On the contrary - any given EMR is now reporting a six month backlog to integrate.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332376</id>
	<title>Re:Does hospital IT work pay well enough?</title>
	<author>Kjella</author>
	<datestamp>1267555860000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>For some uses yes it's choke full of niche medical equipment and other lucrative business. But if you start talking about standardization and using common tools, then you have to start herding cats. If you ask a doctor to draw the organization chart they are often the senior medical expertize on this area with them on top and the management hierarchy is just the overhead coordinating the medical units. Even with the exchange of skills they aren't working on any true collaboration, most of the time it's one doctor, one patient. It becomes their patients, their way of doing it, their medical records. So along comes this electronic patient journal and everything has to be in this format. You will meet resistance and they have a trump card in pushing medical reasons like poorer data quality and health care in front of their own unwillingness to change. The result is a very fractured health system, we are working on a regional project now and each local hospital have their own system with wildly different versions and access methods and whatnot. Luckily we're not the ones dealing with that mess, but someone is...</p></htmltext>
<tokenext>For some uses yes it 's choke full of niche medical equipment and other lucrative business .
But if you start talking about standardization and using common tools , then you have to start herding cats .
If you ask a doctor to draw the organization chart they are often the senior medical expertize on this area with them on top and the management hierarchy is just the overhead coordinating the medical units .
Even with the exchange of skills they are n't working on any true collaboration , most of the time it 's one doctor , one patient .
It becomes their patients , their way of doing it , their medical records .
So along comes this electronic patient journal and everything has to be in this format .
You will meet resistance and they have a trump card in pushing medical reasons like poorer data quality and health care in front of their own unwillingness to change .
The result is a very fractured health system , we are working on a regional project now and each local hospital have their own system with wildly different versions and access methods and whatnot .
Luckily we 're not the ones dealing with that mess , but someone is.. .</tokentext>
<sentencetext>For some uses yes it's choke full of niche medical equipment and other lucrative business.
But if you start talking about standardization and using common tools, then you have to start herding cats.
If you ask a doctor to draw the organization chart they are often the senior medical expertize on this area with them on top and the management hierarchy is just the overhead coordinating the medical units.
Even with the exchange of skills they aren't working on any true collaboration, most of the time it's one doctor, one patient.
It becomes their patients, their way of doing it, their medical records.
So along comes this electronic patient journal and everything has to be in this format.
You will meet resistance and they have a trump card in pushing medical reasons like poorer data quality and health care in front of their own unwillingness to change.
The result is a very fractured health system, we are working on a regional project now and each local hospital have their own system with wildly different versions and access methods and whatnot.
Luckily we're not the ones dealing with that mess, but someone is...</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331740</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332254</id>
	<title>It's the Fed's money, they don't have to take it.</title>
	<author>WilliamBaughman</author>
	<datestamp>1267555560000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext><p>Is there something I'm missing?  It seems like the deadline is for applying to receive "federal incentive monies" to roll out the new technology.  If they're not rolling out the new technology, then they shouldn't be applying for the money.  If they are rolling out the technology, then send in the application for free money.</p></htmltext>
<tokenext>Is there something I 'm missing ?
It seems like the deadline is for applying to receive " federal incentive monies " to roll out the new technology .
If they 're not rolling out the new technology , then they should n't be applying for the money .
If they are rolling out the technology , then send in the application for free money .</tokentext>
<sentencetext>Is there something I'm missing?
It seems like the deadline is for applying to receive "federal incentive monies" to roll out the new technology.
If they're not rolling out the new technology, then they shouldn't be applying for the money.
If they are rolling out the technology, then send in the application for free money.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31339422</id>
	<title>Re:Interoperability</title>
	<author>gmhowell</author>
	<datestamp>1267542000000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>This is mainly from friends with knowledge of Meditech and Epic, some of them from HIMSS level 6 institutions (it only goes to 7).</p></div><p>There's your problem. Make it go to 11, and it'll kick ass.</p></div>
	</htmltext>
<tokenext>This is mainly from friends with knowledge of Meditech and Epic , some of them from HIMSS level 6 institutions ( it only goes to 7 ) .There 's your problem .
Make it go to 11 , and it 'll kick ass .</tokentext>
<sentencetext>This is mainly from friends with knowledge of Meditech and Epic, some of them from HIMSS level 6 institutions (it only goes to 7).There's your problem.
Make it go to 11, and it'll kick ass.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332726</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332040</id>
	<title>Stop Whining</title>
	<author>Fantom42</author>
	<datestamp>1267554780000</datestamp>
	<modclass>Flamebait</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health. 'I wonder if anybody understands the reality of IT systems and how complex they are, especially when they're integrated together. You're going to sacrifice quality if you increase the speed [of the rollout].'</p></div><p>You know what, Gregg?  Suck it up.  Man up and get your system production ready.  I am so tired of excuses from the IT department.</p><p>Maybe I'm being unfair here, but my experience with IT managers is that their development plans look something like this:</p><p>1. Promise the impossible<br>2. Get buy-in to develop an expensive system based on (1)<br>3. Essentially let people play with themselves until the time is up.<br>4. Realize what you have is not even close to (1)<br>5. Try to rebaseline the schedule, and GOTO 1.</p><p>Instead of telling us what you can't do, how about telling us what you can do.  Meaning what functionality you can deliver (production-ready) by the deadline.  Otherwise, you are just whining.</p></div>
	</htmltext>
<tokenext>'I think we have nontechnology people making decisions about technology, ' said Gregg Veltri , CIO at Denver Health .
'I wonder if anybody understands the reality of IT systems and how complex they are , especially when they 're integrated together .
You 're going to sacrifice quality if you increase the speed [ of the rollout ] .
'You know what , Gregg ?
Suck it up .
Man up and get your system production ready .
I am so tired of excuses from the IT department.Maybe I 'm being unfair here , but my experience with IT managers is that their development plans look something like this : 1 .
Promise the impossible2 .
Get buy-in to develop an expensive system based on ( 1 ) 3 .
Essentially let people play with themselves until the time is up.4 .
Realize what you have is not even close to ( 1 ) 5 .
Try to rebaseline the schedule , and GOTO 1.Instead of telling us what you ca n't do , how about telling us what you can do .
Meaning what functionality you can deliver ( production-ready ) by the deadline .
Otherwise , you are just whining .</tokentext>
<sentencetext>'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health.
'I wonder if anybody understands the reality of IT systems and how complex they are, especially when they're integrated together.
You're going to sacrifice quality if you increase the speed [of the rollout].
'You know what, Gregg?
Suck it up.
Man up and get your system production ready.
I am so tired of excuses from the IT department.Maybe I'm being unfair here, but my experience with IT managers is that their development plans look something like this:1.
Promise the impossible2.
Get buy-in to develop an expensive system based on (1)3.
Essentially let people play with themselves until the time is up.4.
Realize what you have is not even close to (1)5.
Try to rebaseline the schedule, and GOTO 1.Instead of telling us what you can't do, how about telling us what you can do.
Meaning what functionality you can deliver (production-ready) by the deadline.
Otherwise, you are just whining.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331794</id>
	<title>Re:Fast, Good, Cheap, pick 2...</title>
	<author>Anonymous</author>
	<datestamp>1267553880000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext><blockquote><div><p>Slow, Bad, Expensive, pick 1...</p></div></blockquote><p>
We're talking about the US Federal Government here.  In particular, the CMMS (Center for Medicare and Medicaid Security)
<br> <br>
You get all three.</p></div>
	</htmltext>
<tokenext>Slow , Bad , Expensive , pick 1.. . We 're talking about the US Federal Government here .
In particular , the CMMS ( Center for Medicare and Medicaid Security ) You get all three .</tokentext>
<sentencetext>Slow, Bad, Expensive, pick 1...
We're talking about the US Federal Government here.
In particular, the CMMS (Center for Medicare and Medicaid Security)
 
You get all three.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331680</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31333780</id>
	<title>"No duh!" moment</title>
	<author>Chris Mattern</author>
	<datestamp>1267561020000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><blockquote><div><p>'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health.</p></div></blockquote><p>Yes.  Yes, we do.  Frequently.</p></div>
	</htmltext>
<tokenext>'I think we have nontechnology people making decisions about technology, ' said Gregg Veltri , CIO at Denver Health.Yes .
Yes , we do .
Frequently .</tokentext>
<sentencetext>'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health.Yes.
Yes, we do.
Frequently.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31336106</id>
	<title>Re:Politicians playing the King!</title>
	<author>Civil\_Disobedient</author>
	<datestamp>1267526220000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><i>Side note: Jesus told the people they absolutly did not want a King, yet the people wanted to blindly follow and appointed a King anyway.</i></p><p>Side note: Nobody on Slashdot cares about your invisible friends.</p></htmltext>
<tokenext>Side note : Jesus told the people they absolutly did not want a King , yet the people wanted to blindly follow and appointed a King anyway.Side note : Nobody on Slashdot cares about your invisible friends .</tokentext>
<sentencetext>Side note: Jesus told the people they absolutly did not want a King, yet the people wanted to blindly follow and appointed a King anyway.Side note: Nobody on Slashdot cares about your invisible friends.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31333154</id>
	<title>Re:Stop Whining</title>
	<author>Anonymous</author>
	<datestamp>1267558620000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>Maybe I'm being unfair here, but my experience with IT managers is that their development plans look something like this:</p><p>1. Promise the impossible
2. Get buy-in to develop an expensive system based on (1)
3. Essentially let people play with themselves until the time is up.
4. Realize what you have is not even close to (1)
5. Try to rebaseline the schedule, and GOTO 1.</p><p>Instead of telling us what you can't do, how about telling us what you can do.  Meaning what functionality you can deliver (production-ready) by the deadline.  Otherwise, you are just whining.</p></div><p>In my experience it's usually management that demands the impossible (with often very vague ideas about what the final product should be), and IT that tells them it won't happen, but are forced to do it anyway.  So they have to build the infrastructure to support the vaguely-defined and moving target that they are supposed to deliver, the specifics of which will be determined by management and their proxies once they get to see the initial system.  At that point they tell you you got it all wrong and that it doesn't do half the things they wanted but never thought to ask for.</p></div>
	</htmltext>
<tokenext>Maybe I 'm being unfair here , but my experience with IT managers is that their development plans look something like this : 1 .
Promise the impossible 2 .
Get buy-in to develop an expensive system based on ( 1 ) 3 .
Essentially let people play with themselves until the time is up .
4. Realize what you have is not even close to ( 1 ) 5 .
Try to rebaseline the schedule , and GOTO 1.Instead of telling us what you ca n't do , how about telling us what you can do .
Meaning what functionality you can deliver ( production-ready ) by the deadline .
Otherwise , you are just whining.In my experience it 's usually management that demands the impossible ( with often very vague ideas about what the final product should be ) , and IT that tells them it wo n't happen , but are forced to do it anyway .
So they have to build the infrastructure to support the vaguely-defined and moving target that they are supposed to deliver , the specifics of which will be determined by management and their proxies once they get to see the initial system .
At that point they tell you you got it all wrong and that it does n't do half the things they wanted but never thought to ask for .</tokentext>
<sentencetext>Maybe I'm being unfair here, but my experience with IT managers is that their development plans look something like this:1.
Promise the impossible
2.
Get buy-in to develop an expensive system based on (1)
3.
Essentially let people play with themselves until the time is up.
4. Realize what you have is not even close to (1)
5.
Try to rebaseline the schedule, and GOTO 1.Instead of telling us what you can't do, how about telling us what you can do.
Meaning what functionality you can deliver (production-ready) by the deadline.
Otherwise, you are just whining.In my experience it's usually management that demands the impossible (with often very vague ideas about what the final product should be), and IT that tells them it won't happen, but are forced to do it anyway.
So they have to build the infrastructure to support the vaguely-defined and moving target that they are supposed to deliver, the specifics of which will be determined by management and their proxies once they get to see the initial system.
At that point they tell you you got it all wrong and that it doesn't do half the things they wanted but never thought to ask for.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332040</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332122</id>
	<title>A lot of hospitals already have e-records</title>
	<author>alen</author>
	<datestamp>1267555020000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext><p>i know people that work in the medical field and a lot of hospitals already have electronic charts. people i know have worked with them for years. going back to 2005 or earlier as far as i can remember.</p><p>I bet this is another case of the leftovers crying about investing money in infrastructure that will save them money in the long run but they see it as an expense and fight it. just like the genius MBA's at Dell and HP who concentrated on volume and tight margins while Apple went the opposite direction. Now Mac sales are growing by double digits, profits are rolling in from boring things like computer sales, the prices compared to higher end Dell/HP computers are comparable on the same specs most of the time, and Apple has a much better brand name. And they don't have Asus and Acer taking away their market share</p></htmltext>
<tokenext>i know people that work in the medical field and a lot of hospitals already have electronic charts .
people i know have worked with them for years .
going back to 2005 or earlier as far as i can remember.I bet this is another case of the leftovers crying about investing money in infrastructure that will save them money in the long run but they see it as an expense and fight it .
just like the genius MBA 's at Dell and HP who concentrated on volume and tight margins while Apple went the opposite direction .
Now Mac sales are growing by double digits , profits are rolling in from boring things like computer sales , the prices compared to higher end Dell/HP computers are comparable on the same specs most of the time , and Apple has a much better brand name .
And they do n't have Asus and Acer taking away their market share</tokentext>
<sentencetext>i know people that work in the medical field and a lot of hospitals already have electronic charts.
people i know have worked with them for years.
going back to 2005 or earlier as far as i can remember.I bet this is another case of the leftovers crying about investing money in infrastructure that will save them money in the long run but they see it as an expense and fight it.
just like the genius MBA's at Dell and HP who concentrated on volume and tight margins while Apple went the opposite direction.
Now Mac sales are growing by double digits, profits are rolling in from boring things like computer sales, the prices compared to higher end Dell/HP computers are comparable on the same specs most of the time, and Apple has a much better brand name.
And they don't have Asus and Acer taking away their market share</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332086</id>
	<title>Re:Fast, Good, Cheap, pick 2...</title>
	<author>Attila Dimedici</author>
	<datestamp>1267554900000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>Slow, Bad, Expensive, pick 1...</p><p>-Rick</p></div><p>Why? I know lots of companies that do all three very well.</p></div>
	</htmltext>
<tokenext>Slow , Bad , Expensive , pick 1...-RickWhy ?
I know lots of companies that do all three very well .</tokentext>
<sentencetext>Slow, Bad, Expensive, pick 1...-RickWhy?
I know lots of companies that do all three very well.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331680</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31351038</id>
	<title>Re:Fast, Good, Cheap, pick 2...</title>
	<author>jon3k</author>
	<datestamp>1267613760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Just FYI - It's abbreviated as CMS not CMMS.  But I couldn't agree with you more.</htmltext>
<tokenext>Just FYI - It 's abbreviated as CMS not CMMS .
But I could n't agree with you more .</tokentext>
<sentencetext>Just FYI - It's abbreviated as CMS not CMMS.
But I couldn't agree with you more.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331794</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31335214</id>
	<title>Re:Fast, Good, Cheap, pick 2...</title>
	<author>Thuktun</author>
	<datestamp>1267522920000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>It's "CMS".  Somehow the Ms overlap or something.</p><p><a href="http://www.cms.hhs.gov/" title="hhs.gov">http://www.cms.hhs.gov/</a> [hhs.gov]</p></htmltext>
<tokenext>It 's " CMS " .
Somehow the Ms overlap or something.http : //www.cms.hhs.gov/ [ hhs.gov ]</tokentext>
<sentencetext>It's "CMS".
Somehow the Ms overlap or something.http://www.cms.hhs.gov/ [hhs.gov]</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331794</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332812</id>
	<title>Re:Does hospital IT work pay well enough?</title>
	<author>ircmaxell</author>
	<datestamp>1267557240000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>When I was looking for a new job a few years ago, I applied to the hospital I worked at for a help desk position.  In that company, the help desk was more like a lower level sys admin (You were admin over all non-server computers on site).  I was offered the position, but turned it down when I learned the pay.  $8 per hour.  Considering I was making $19 an hour at the time (at the very same company) doing security, I laughed.  From the people I talked to who worked that job, they said it was actually a very good job.  The turnover rate was about 9 months, but instead of people quitting, they were usually promoted rather quickly (to full blown sys-admin or other IT positions) with an accompanying salary boost.  All IT employees regardless of credentials (except upper management) started in this "help desk" position.  While it was an insult to some (or most) of whom applied, there was a big upside.  Everyone in IT knew the base system very well, and knew not only the hospital layout, but where all the systems were and how the systems interacted.  Is it worth the $8 per hour?  Not to me it wasn't...</htmltext>
<tokenext>When I was looking for a new job a few years ago , I applied to the hospital I worked at for a help desk position .
In that company , the help desk was more like a lower level sys admin ( You were admin over all non-server computers on site ) .
I was offered the position , but turned it down when I learned the pay .
$ 8 per hour .
Considering I was making $ 19 an hour at the time ( at the very same company ) doing security , I laughed .
From the people I talked to who worked that job , they said it was actually a very good job .
The turnover rate was about 9 months , but instead of people quitting , they were usually promoted rather quickly ( to full blown sys-admin or other IT positions ) with an accompanying salary boost .
All IT employees regardless of credentials ( except upper management ) started in this " help desk " position .
While it was an insult to some ( or most ) of whom applied , there was a big upside .
Everyone in IT knew the base system very well , and knew not only the hospital layout , but where all the systems were and how the systems interacted .
Is it worth the $ 8 per hour ?
Not to me it was n't.. .</tokentext>
<sentencetext>When I was looking for a new job a few years ago, I applied to the hospital I worked at for a help desk position.
In that company, the help desk was more like a lower level sys admin (You were admin over all non-server computers on site).
I was offered the position, but turned it down when I learned the pay.
$8 per hour.
Considering I was making $19 an hour at the time (at the very same company) doing security, I laughed.
From the people I talked to who worked that job, they said it was actually a very good job.
The turnover rate was about 9 months, but instead of people quitting, they were usually promoted rather quickly (to full blown sys-admin or other IT positions) with an accompanying salary boost.
All IT employees regardless of credentials (except upper management) started in this "help desk" position.
While it was an insult to some (or most) of whom applied, there was a big upside.
Everyone in IT knew the base system very well, and knew not only the hospital layout, but where all the systems were and how the systems interacted.
Is it worth the $8 per hour?
Not to me it wasn't...</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331740</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331680</id>
	<title>Fast, Good, Cheap, pick 2...</title>
	<author>Anonymous</author>
	<datestamp>1267553460000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext><p>Slow, Bad, Expensive, pick 1...</p><p>-Rick</p></htmltext>
<tokenext>Slow , Bad , Expensive , pick 1...-Rick</tokentext>
<sentencetext>Slow, Bad, Expensive, pick 1...-Rick</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332388</id>
	<title>Re:Politicians playing the King!</title>
	<author>QuantumRiff</author>
	<datestamp>1267555860000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>You are right! The president of the united states actually writes all these rules and bills.  Unlike every president before him, that relied on advisers and people with intimate knowledge of subjects, this president does everything himself.  Hell, this president even goes one step further, and skips the whole legislative branch of government, and writes, votes, and enacts legislation and policies on his own!</p><p>Seriously, your a trolling idiot.</p><p>Take a basic civics class.  Please.  I beg you!  Or at least do everyone a favor, and stop voting.. (but don't worry, you can keep tea-bagging)</p></htmltext>
<tokenext>You are right !
The president of the united states actually writes all these rules and bills .
Unlike every president before him , that relied on advisers and people with intimate knowledge of subjects , this president does everything himself .
Hell , this president even goes one step further , and skips the whole legislative branch of government , and writes , votes , and enacts legislation and policies on his own ! Seriously , your a trolling idiot.Take a basic civics class .
Please. I beg you !
Or at least do everyone a favor , and stop voting.. ( but do n't worry , you can keep tea-bagging )</tokentext>
<sentencetext>You are right!
The president of the united states actually writes all these rules and bills.
Unlike every president before him, that relied on advisers and people with intimate knowledge of subjects, this president does everything himself.
Hell, this president even goes one step further, and skips the whole legislative branch of government, and writes, votes, and enacts legislation and policies on his own!Seriously, your a trolling idiot.Take a basic civics class.
Please.  I beg you!
Or at least do everyone a favor, and stop voting.. (but don't worry, you can keep tea-bagging)</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31334276</id>
	<title>Re:The Flip Side</title>
	<author>caudron</author>
	<datestamp>1267562580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I work in healthcare and my opinion here doesn't necessarily reflect my employer's.  That disclaimer aside, I feel for you.  I sincerely hope your situation has improved.  I will offer one counterpoint, though.  If your friend's practice couldn't get it together well enough to store prescriptions in Word, Excel, Access, or even Notepad, should we have any hope that they will be able to participate meaningfully in a fully transactionalized data transfer system without error or confusion?</p><p>I don't advocate doing nothing, mind you.  I'm very much behind the idea of seeing physicians moving into the 21st century.  I just worry that our current method for doing that may be flawed and create more problems than it solved.  I could be wrong, though.  It's been known to happen.<nobr> <wbr></nobr>:)</p><p>In any case, sorry to hear you had a bad time of things and I hope we all see general improvements soon.</p></htmltext>
<tokenext>I work in healthcare and my opinion here does n't necessarily reflect my employer 's .
That disclaimer aside , I feel for you .
I sincerely hope your situation has improved .
I will offer one counterpoint , though .
If your friend 's practice could n't get it together well enough to store prescriptions in Word , Excel , Access , or even Notepad , should we have any hope that they will be able to participate meaningfully in a fully transactionalized data transfer system without error or confusion ? I do n't advocate doing nothing , mind you .
I 'm very much behind the idea of seeing physicians moving into the 21st century .
I just worry that our current method for doing that may be flawed and create more problems than it solved .
I could be wrong , though .
It 's been known to happen .
: ) In any case , sorry to hear you had a bad time of things and I hope we all see general improvements soon .</tokentext>
<sentencetext>I work in healthcare and my opinion here doesn't necessarily reflect my employer's.
That disclaimer aside, I feel for you.
I sincerely hope your situation has improved.
I will offer one counterpoint, though.
If your friend's practice couldn't get it together well enough to store prescriptions in Word, Excel, Access, or even Notepad, should we have any hope that they will be able to participate meaningfully in a fully transactionalized data transfer system without error or confusion?I don't advocate doing nothing, mind you.
I'm very much behind the idea of seeing physicians moving into the 21st century.
I just worry that our current method for doing that may be flawed and create more problems than it solved.
I could be wrong, though.
It's been known to happen.
:)In any case, sorry to hear you had a bad time of things and I hope we all see general improvements soon.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332186</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31333596</id>
	<title>1 Billion Dollars</title>
	<author>spamking</author>
	<datestamp>1267560360000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>WASHINGTON, DC - Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis today announced a total of nearly $1 billion in Recovery Act awards to help health care providers advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future. The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology. This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers.<br> <br>

<a href="http://www.hhs.gov/news/press/2010pres/02/20100212a.html" title="hhs.gov" rel="nofollow">http://www.hhs.gov/news/press/2010pres/02/20100212a.html</a> [hhs.gov]</p> </div><p>Seems to me that regardless of any deadline, the Feds are making every effort to provide the financial assistance necessary to all types of health care providers so that Health Information Exchanges can be stood up and make electronic health records more available and their use more efficient.</p></div>
	</htmltext>
<tokenext>WASHINGTON , DC - Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis today announced a total of nearly $ 1 billion in Recovery Act awards to help health care providers advance the adoption and meaningful use of health information technology ( IT ) and train workers for the health care jobs of the future .
The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology .
This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers .
http : //www.hhs.gov/news/press/2010pres/02/20100212a.html [ hhs.gov ] Seems to me that regardless of any deadline , the Feds are making every effort to provide the financial assistance necessary to all types of health care providers so that Health Information Exchanges can be stood up and make electronic health records more available and their use more efficient .</tokentext>
<sentencetext>WASHINGTON, DC - Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis today announced a total of nearly $1 billion in Recovery Act awards to help health care providers advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future.
The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology.
This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers.
http://www.hhs.gov/news/press/2010pres/02/20100212a.html [hhs.gov] Seems to me that regardless of any deadline, the Feds are making every effort to provide the financial assistance necessary to all types of health care providers so that Health Information Exchanges can be stood up and make electronic health records more available and their use more efficient.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31336934</id>
	<title>Re:Does hospital IT work pay well enough?</title>
	<author>Anonymous</author>
	<datestamp>1267529520000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>not everyone wants to work on pop culture garbage</p></htmltext>
<tokenext>not everyone wants to work on pop culture garbage</tokentext>
<sentencetext>not everyone wants to work on pop culture garbage</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331740</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332326</id>
	<title>Re:Politicians playing the King!</title>
	<author>Anonymous</author>
	<datestamp>1267555740000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>This is the same as the political push for the CFL light bulbs.  Non technology people dictating the technology sector.  Obama does not have an ounce of knowledge about health care systems, yet thinks he knows everything that should be done.  It's a farce.


Side note: Jesus told the people they absolutly did not want a King, yet the people wanted to blindly follow and appointed a King anyway.  So, here is your King Obama, shortly to dictate Intel manfucaturing numbers because it effects "the environment".</p></div><p>Not even a competent troll.  Please try harder to amuse us.</p></div>
	</htmltext>
<tokenext>This is the same as the political push for the CFL light bulbs .
Non technology people dictating the technology sector .
Obama does not have an ounce of knowledge about health care systems , yet thinks he knows everything that should be done .
It 's a farce .
Side note : Jesus told the people they absolutly did not want a King , yet the people wanted to blindly follow and appointed a King anyway .
So , here is your King Obama , shortly to dictate Intel manfucaturing numbers because it effects " the environment " .Not even a competent troll .
Please try harder to amuse us .</tokentext>
<sentencetext>This is the same as the political push for the CFL light bulbs.
Non technology people dictating the technology sector.
Obama does not have an ounce of knowledge about health care systems, yet thinks he knows everything that should be done.
It's a farce.
Side note: Jesus told the people they absolutly did not want a King, yet the people wanted to blindly follow and appointed a King anyway.
So, here is your King Obama, shortly to dictate Intel manfucaturing numbers because it effects "the environment".Not even a competent troll.
Please try harder to amuse us.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31333090</id>
	<title>Re:Does hospital IT work pay well enough?</title>
	<author>RKThoadan</author>
	<datestamp>1267558380000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Keep in mind that the developers are not generally working for the hospitals, they are working for the software vendors.  The vendors are where the real time and resources crunch is.  It takes months (sometimes years) to convert a hospital over to a completely new system, and they are likely limited by staff and other resources as to how many hospitals they can bring up at one time.  Any individual hospital has plenty of time, but from the vendors perspective it's dozens, possibly hundreds of hospitals they need to get up in a limited timeframe.  I have a feeling they'll be hiring lots of developers, implementation managers and others, but it takes time to really get them trained up.  Do you want to have the junior implementation manager in charge of your hospitals migration when you're facing a looming federal deadline?</p></htmltext>
<tokenext>Keep in mind that the developers are not generally working for the hospitals , they are working for the software vendors .
The vendors are where the real time and resources crunch is .
It takes months ( sometimes years ) to convert a hospital over to a completely new system , and they are likely limited by staff and other resources as to how many hospitals they can bring up at one time .
Any individual hospital has plenty of time , but from the vendors perspective it 's dozens , possibly hundreds of hospitals they need to get up in a limited timeframe .
I have a feeling they 'll be hiring lots of developers , implementation managers and others , but it takes time to really get them trained up .
Do you want to have the junior implementation manager in charge of your hospitals migration when you 're facing a looming federal deadline ?</tokentext>
<sentencetext>Keep in mind that the developers are not generally working for the hospitals, they are working for the software vendors.
The vendors are where the real time and resources crunch is.
It takes months (sometimes years) to convert a hospital over to a completely new system, and they are likely limited by staff and other resources as to how many hospitals they can bring up at one time.
Any individual hospital has plenty of time, but from the vendors perspective it's dozens, possibly hundreds of hospitals they need to get up in a limited timeframe.
I have a feeling they'll be hiring lots of developers, implementation managers and others, but it takes time to really get them trained up.
Do you want to have the junior implementation manager in charge of your hospitals migration when you're facing a looming federal deadline?</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331740</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332250</id>
	<title>Upgrading in the middle of a recession</title>
	<author>PIPBoy3000</author>
	<datestamp>1267555500000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I work in the healthcare industry, though admittedly just on the web side of things.  There's been a lot of talk getting our current EMR to the place where we're getting the maximum amount of healthcare dollars.  Our healthcare organization is at a pretty good place, far ahead of most organizations.  At the same time, we're being asked to do so much with reduced staff due to minimal hiring.  I'm not sure we'll really be able to manage it all. There are also a number of non-technical issues, such as getting all the doctors ready for electronic order entry.  Cultural issues often drive technology decisions.
<br> <br>
That being said, I think it's a good idea to move people towards using EMRs in healthcare.  They're expensive, difficult to maintain, but can produce much improved healthcare.  As we often say, the main challenge facing healthcare these days is getting the right information to the right people at the right time.  Doing that electronically is the only approach that makes sense.</htmltext>
<tokenext>I work in the healthcare industry , though admittedly just on the web side of things .
There 's been a lot of talk getting our current EMR to the place where we 're getting the maximum amount of healthcare dollars .
Our healthcare organization is at a pretty good place , far ahead of most organizations .
At the same time , we 're being asked to do so much with reduced staff due to minimal hiring .
I 'm not sure we 'll really be able to manage it all .
There are also a number of non-technical issues , such as getting all the doctors ready for electronic order entry .
Cultural issues often drive technology decisions .
That being said , I think it 's a good idea to move people towards using EMRs in healthcare .
They 're expensive , difficult to maintain , but can produce much improved healthcare .
As we often say , the main challenge facing healthcare these days is getting the right information to the right people at the right time .
Doing that electronically is the only approach that makes sense .</tokentext>
<sentencetext>I work in the healthcare industry, though admittedly just on the web side of things.
There's been a lot of talk getting our current EMR to the place where we're getting the maximum amount of healthcare dollars.
Our healthcare organization is at a pretty good place, far ahead of most organizations.
At the same time, we're being asked to do so much with reduced staff due to minimal hiring.
I'm not sure we'll really be able to manage it all.
There are also a number of non-technical issues, such as getting all the doctors ready for electronic order entry.
Cultural issues often drive technology decisions.
That being said, I think it's a good idea to move people towards using EMRs in healthcare.
They're expensive, difficult to maintain, but can produce much improved healthcare.
As we often say, the main challenge facing healthcare these days is getting the right information to the right people at the right time.
Doing that electronically is the only approach that makes sense.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332186</id>
	<title>The Flip Side</title>
	<author>99BottlesOfBeerInMyF</author>
	<datestamp>1267555260000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>4</modscore>
	<htmltext><p>Clearly there are a lot of people here posting about how the government should not be getting involved and that seems to be the bias of both the article and summary. Allow me to go into some personal experience here though. As someone who has been very ill, lack of standardized medical records and the inability of various hospitals to transfer digital copies of video and images resulted in my spending another month or so of my life in a state I would not wish upon anyone. Right now a very good friend of mine works in healthcare and they have been (I shit you not) writing down patient information on recipe cards as the one and only method of storing drug prescription info. This resulted in, by her count, several hundred patients not getting needed insulin, antipsychotics, and other drugs as a result of numerous ordering errors that were never caught and were impossible to search for. So when people say digitizing medical records in a standard fashion is going to result in problems for patients... well not doing it is resulting in the very same.</p><p>I'm not big on government interference with many parts of our lives, but they are addressing a very real problem and they're doing it with kid gloves. They did not pass regulations requiring hospitals to comply, they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together. If medical providers have not done so and are rushing about now, that is absolutely not the fault of the feds.</p></htmltext>
<tokenext>Clearly there are a lot of people here posting about how the government should not be getting involved and that seems to be the bias of both the article and summary .
Allow me to go into some personal experience here though .
As someone who has been very ill , lack of standardized medical records and the inability of various hospitals to transfer digital copies of video and images resulted in my spending another month or so of my life in a state I would not wish upon anyone .
Right now a very good friend of mine works in healthcare and they have been ( I shit you not ) writing down patient information on recipe cards as the one and only method of storing drug prescription info .
This resulted in , by her count , several hundred patients not getting needed insulin , antipsychotics , and other drugs as a result of numerous ordering errors that were never caught and were impossible to search for .
So when people say digitizing medical records in a standard fashion is going to result in problems for patients... well not doing it is resulting in the very same.I 'm not big on government interference with many parts of our lives , but they are addressing a very real problem and they 're doing it with kid gloves .
They did not pass regulations requiring hospitals to comply , they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together .
If medical providers have not done so and are rushing about now , that is absolutely not the fault of the feds .</tokentext>
<sentencetext>Clearly there are a lot of people here posting about how the government should not be getting involved and that seems to be the bias of both the article and summary.
Allow me to go into some personal experience here though.
As someone who has been very ill, lack of standardized medical records and the inability of various hospitals to transfer digital copies of video and images resulted in my spending another month or so of my life in a state I would not wish upon anyone.
Right now a very good friend of mine works in healthcare and they have been (I shit you not) writing down patient information on recipe cards as the one and only method of storing drug prescription info.
This resulted in, by her count, several hundred patients not getting needed insulin, antipsychotics, and other drugs as a result of numerous ordering errors that were never caught and were impossible to search for.
So when people say digitizing medical records in a standard fashion is going to result in problems for patients... well not doing it is resulting in the very same.I'm not big on government interference with many parts of our lives, but they are addressing a very real problem and they're doing it with kid gloves.
They did not pass regulations requiring hospitals to comply, they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together.
If medical providers have not done so and are rushing about now, that is absolutely not the fault of the feds.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31337386</id>
	<title>Re:A lot of hospitals already have e-records</title>
	<author>Tekfactory</author>
	<datestamp>1267531080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Intermountain Healthcare had electronic medical records in the 1980s, used the data gathered from the system to improve their medical practices, improve patient outcomes and reduce costs.</p><p><a href="http://www.longwoods.com/product.php?productid=20146&amp;cat=571&amp;page=1" title="longwoods.com">http://www.longwoods.com/product.php?productid=20146&amp;cat=571&amp;page=1</a> [longwoods.com]</p><p>Their system was chosen as one of 5 to be studied by a Canadian Quality by Design process improvement team, and one of the 'few small exceptions' in the Congressional Budget Office report that eHealth records don't reduce healthcare costs. The others were the Cleveland Clinic and Mayo clinic.</p><p>What the report should have said is eHealth records by themselves don't reduce healthcare costs. If your system is a mess, taking it digital gives you a digital mess.</p><p>Intermountain was lucky that Dr. Brent James was also a computer geek, now he's pretty much the guru of healthcare improvement. The NYTimes did a couple of stories, one on him, others referencing his work.</p><p>In the Times article, Intermountain mentions they hurt themselves financially by improving their cardiac (or pulmonary?) practice to the tune of about $300k because the patients had fewer complications, they were leaving the hospital earlier costing them x number of days income per patient for the extra recovery time. They made the conscious decision that patient outcomes were more important.</p><p>I have no connection with these folks, just read a lot about them, and care enough to post about them even in an article that's about to fall off the front page.</p></htmltext>
<tokenext>Intermountain Healthcare had electronic medical records in the 1980s , used the data gathered from the system to improve their medical practices , improve patient outcomes and reduce costs.http : //www.longwoods.com/product.php ? productid = 20146&amp;cat = 571&amp;page = 1 [ longwoods.com ] Their system was chosen as one of 5 to be studied by a Canadian Quality by Design process improvement team , and one of the 'few small exceptions ' in the Congressional Budget Office report that eHealth records do n't reduce healthcare costs .
The others were the Cleveland Clinic and Mayo clinic.What the report should have said is eHealth records by themselves do n't reduce healthcare costs .
If your system is a mess , taking it digital gives you a digital mess.Intermountain was lucky that Dr. Brent James was also a computer geek , now he 's pretty much the guru of healthcare improvement .
The NYTimes did a couple of stories , one on him , others referencing his work.In the Times article , Intermountain mentions they hurt themselves financially by improving their cardiac ( or pulmonary ?
) practice to the tune of about $ 300k because the patients had fewer complications , they were leaving the hospital earlier costing them x number of days income per patient for the extra recovery time .
They made the conscious decision that patient outcomes were more important.I have no connection with these folks , just read a lot about them , and care enough to post about them even in an article that 's about to fall off the front page .</tokentext>
<sentencetext>Intermountain Healthcare had electronic medical records in the 1980s, used the data gathered from the system to improve their medical practices, improve patient outcomes and reduce costs.http://www.longwoods.com/product.php?productid=20146&amp;cat=571&amp;page=1 [longwoods.com]Their system was chosen as one of 5 to be studied by a Canadian Quality by Design process improvement team, and one of the 'few small exceptions' in the Congressional Budget Office report that eHealth records don't reduce healthcare costs.
The others were the Cleveland Clinic and Mayo clinic.What the report should have said is eHealth records by themselves don't reduce healthcare costs.
If your system is a mess, taking it digital gives you a digital mess.Intermountain was lucky that Dr. Brent James was also a computer geek, now he's pretty much the guru of healthcare improvement.
The NYTimes did a couple of stories, one on him, others referencing his work.In the Times article, Intermountain mentions they hurt themselves financially by improving their cardiac (or pulmonary?
) practice to the tune of about $300k because the patients had fewer complications, they were leaving the hospital earlier costing them x number of days income per patient for the extra recovery time.
They made the conscious decision that patient outcomes were more important.I have no connection with these folks, just read a lot about them, and care enough to post about them even in an article that's about to fall off the front page.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332122</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31333238</id>
	<title>Re:Politicians playing the King!</title>
	<author>jimbolauski</author>
	<datestamp>1267558980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Obama does have some sense of health care systems, Michael Obama worked at the University of Chicago Medical Center and pushed the Urban Health Initiative, a patient dumping scheme where "low income" patients were redirected to clinics so beds could be saved for people with insurance.  The firm that was hired to sell the Urban Health Initiative is owned by David Axelrod so the Obama administration does have experience.<br>
<a href="http://www.suntimes.com/news/politics/obama/1122691,CST-NWS-hosp23.article" title="suntimes.com">Urban Health Initiative </a> [suntimes.com]</htmltext>
<tokenext>Obama does have some sense of health care systems , Michael Obama worked at the University of Chicago Medical Center and pushed the Urban Health Initiative , a patient dumping scheme where " low income " patients were redirected to clinics so beds could be saved for people with insurance .
The firm that was hired to sell the Urban Health Initiative is owned by David Axelrod so the Obama administration does have experience .
Urban Health Initiative [ suntimes.com ]</tokentext>
<sentencetext>Obama does have some sense of health care systems, Michael Obama worked at the University of Chicago Medical Center and pushed the Urban Health Initiative, a patient dumping scheme where "low income" patients were redirected to clinics so beds could be saved for people with insurance.
The firm that was hired to sell the Urban Health Initiative is owned by David Axelrod so the Obama administration does have experience.
Urban Health Initiative  [suntimes.com]</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31334558</id>
	<title>qip-pro-quo Re:Fast, Good, Cheap, pick 2...</title>
	<author>OldHawk777</author>
	<datestamp>1267520580000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Slow, Bad, Expensive, pick 1..., You get all three.</p><p>WooWoo, qip-pro-quo and more zombie-land dogma for US.</p><p>Excuses are all bullshit for US. "Slow, Bad, Expensive" and no insurance company wants to do the job for US without far more "Slow, Bad, Expensive" bullshit.<br>"It is all to complicated," "It is all wrong," "It is too expensive," "It is bad,"<nobr> <wbr></nobr>.... How many more bullshit excuses for doing nothing, before we save US "The People" from more bullshit excuses.</p><p>If bullshit excuses were around 65 years ago, German would be the USA national language. If bullshit excuses were around 41 years ago, the USA would have invested more in bomb-shelters, than education, science, space research.... Where in the hell has all the wimpy-ass-mommy-puke US citizens come from, they can't be US born. Sounds like a bunch of web-foreigners, politicians, or C*Os supporting the failure, exploitation, and collapse of a great nation and people.</p><p>Zombie-land dogma (politics, religion, economic...) bullshit excuses are good for totalitarian plutocrats seeking to oppress free people with the help of witless qip-pro-quo fools/traitors.</p><p>"Dogma Knowledge" is individual or cultural idiom with no actual applied value, other then providing an agreeable reassuring explanation of reality.</p><p>This is not flaming/trolling. I have a colorful way of stating fact about bullshit excuses that hurt US as a nation and people.</p><p>===</p><p>"Authoritative Knowledge" is Implicit (factually required) and explicit (expressly required). Source is the origin of the implicit (Science / Engineering) or explicit (Law / Regulation). So, implicit a/o explicit implies authority.<br>"Prescient Knowledge" is personal heuristic (germane experience) perceptiveness into real and actual affect, or cause and effect, that adds unpredicted desirable value for the person, situation, community....<br>"Tacit Knowledge" appropriately applied is useful and valuable, individual or group, private/secret skills, methods, detail, experience, information....<br>"Unknown Knowledge" does not implicitly, explicitly, tacitly... exist, but as prescient/suspect (Hypothetical Imagination) can be investigated (Theoretical Science) for eventual use (Applied Science).<br>"Omitted Knowledge" is individual or group withheld (implicit, explicit, prescient, or tacit) to prevent applied value utilization and provide the individual or group an advantage (Secret, Personal, Private...).<br>"Open Knowledge" is free of any legal, economic, religious, or other encumbrances within acceptable limits of personal, family, social, community... species.<br>"Dogma Knowledge" is individual or cultural idiom with no actual applied value, other then providing an agreeable reassuring explanation of reality.</p></htmltext>
<tokenext>Slow , Bad , Expensive , pick 1... , You get all three.WooWoo , qip-pro-quo and more zombie-land dogma for US.Excuses are all bullshit for US .
" Slow , Bad , Expensive " and no insurance company wants to do the job for US without far more " Slow , Bad , Expensive " bullshit .
" It is all to complicated , " " It is all wrong , " " It is too expensive , " " It is bad , " .... How many more bullshit excuses for doing nothing , before we save US " The People " from more bullshit excuses.If bullshit excuses were around 65 years ago , German would be the USA national language .
If bullshit excuses were around 41 years ago , the USA would have invested more in bomb-shelters , than education , science , space research.... Where in the hell has all the wimpy-ass-mommy-puke US citizens come from , they ca n't be US born .
Sounds like a bunch of web-foreigners , politicians , or C * Os supporting the failure , exploitation , and collapse of a great nation and people.Zombie-land dogma ( politics , religion , economic... ) bullshit excuses are good for totalitarian plutocrats seeking to oppress free people with the help of witless qip-pro-quo fools/traitors .
" Dogma Knowledge " is individual or cultural idiom with no actual applied value , other then providing an agreeable reassuring explanation of reality.This is not flaming/trolling .
I have a colorful way of stating fact about bullshit excuses that hurt US as a nation and people. = = = " Authoritative Knowledge " is Implicit ( factually required ) and explicit ( expressly required ) .
Source is the origin of the implicit ( Science / Engineering ) or explicit ( Law / Regulation ) .
So , implicit a/o explicit implies authority .
" Prescient Knowledge " is personal heuristic ( germane experience ) perceptiveness into real and actual affect , or cause and effect , that adds unpredicted desirable value for the person , situation , community.... " Tacit Knowledge " appropriately applied is useful and valuable , individual or group , private/secret skills , methods , detail , experience , information.... " Unknown Knowledge " does not implicitly , explicitly , tacitly... exist , but as prescient/suspect ( Hypothetical Imagination ) can be investigated ( Theoretical Science ) for eventual use ( Applied Science ) .
" Omitted Knowledge " is individual or group withheld ( implicit , explicit , prescient , or tacit ) to prevent applied value utilization and provide the individual or group an advantage ( Secret , Personal , Private... ) .
" Open Knowledge " is free of any legal , economic , religious , or other encumbrances within acceptable limits of personal , family , social , community.. .
species. " Dogma Knowledge " is individual or cultural idiom with no actual applied value , other then providing an agreeable reassuring explanation of reality .</tokentext>
<sentencetext>Slow, Bad, Expensive, pick 1..., You get all three.WooWoo, qip-pro-quo and more zombie-land dogma for US.Excuses are all bullshit for US.
"Slow, Bad, Expensive" and no insurance company wants to do the job for US without far more "Slow, Bad, Expensive" bullshit.
"It is all to complicated," "It is all wrong," "It is too expensive," "It is bad," .... How many more bullshit excuses for doing nothing, before we save US "The People" from more bullshit excuses.If bullshit excuses were around 65 years ago, German would be the USA national language.
If bullshit excuses were around 41 years ago, the USA would have invested more in bomb-shelters, than education, science, space research.... Where in the hell has all the wimpy-ass-mommy-puke US citizens come from, they can't be US born.
Sounds like a bunch of web-foreigners, politicians, or C*Os supporting the failure, exploitation, and collapse of a great nation and people.Zombie-land dogma (politics, religion, economic...) bullshit excuses are good for totalitarian plutocrats seeking to oppress free people with the help of witless qip-pro-quo fools/traitors.
"Dogma Knowledge" is individual or cultural idiom with no actual applied value, other then providing an agreeable reassuring explanation of reality.This is not flaming/trolling.
I have a colorful way of stating fact about bullshit excuses that hurt US as a nation and people.==="Authoritative Knowledge" is Implicit (factually required) and explicit (expressly required).
Source is the origin of the implicit (Science / Engineering) or explicit (Law / Regulation).
So, implicit a/o explicit implies authority.
"Prescient Knowledge" is personal heuristic (germane experience) perceptiveness into real and actual affect, or cause and effect, that adds unpredicted desirable value for the person, situation, community...."Tacit Knowledge" appropriately applied is useful and valuable, individual or group, private/secret skills, methods, detail, experience, information...."Unknown Knowledge" does not implicitly, explicitly, tacitly... exist, but as prescient/suspect (Hypothetical Imagination) can be investigated (Theoretical Science) for eventual use (Applied Science).
"Omitted Knowledge" is individual or group withheld (implicit, explicit, prescient, or tacit) to prevent applied value utilization and provide the individual or group an advantage (Secret, Personal, Private...).
"Open Knowledge" is free of any legal, economic, religious, or other encumbrances within acceptable limits of personal, family, social, community...
species."Dogma Knowledge" is individual or cultural idiom with no actual applied value, other then providing an agreeable reassuring explanation of reality.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331680</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31336102</id>
	<title>Re:It's the Fed's money, they don't have to take i</title>
	<author>Lucas123</author>
	<datestamp>1267526220000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>If you don't roll them out by 2015 and show meaningful use of electronic health records, you then get penalized through Medicare reimbursement cuts.</htmltext>
<tokenext>If you do n't roll them out by 2015 and show meaningful use of electronic health records , you then get penalized through Medicare reimbursement cuts .</tokentext>
<sentencetext>If you don't roll them out by 2015 and show meaningful use of electronic health records, you then get penalized through Medicare reimbursement cuts.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331894</id>
	<title>The clear solution...</title>
	<author>Anonymous</author>
	<datestamp>1267554240000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext>The clear solution is to just not put a deadline on it at all.  Surely that will result in quality systems, right?  I mean, it's not like they can put this off indefinitely... can they?  Oh.</htmltext>
<tokenext>The clear solution is to just not put a deadline on it at all .
Surely that will result in quality systems , right ?
I mean , it 's not like they can put this off indefinitely... can they ?
Oh .</tokentext>
<sentencetext>The clear solution is to just not put a deadline on it at all.
Surely that will result in quality systems, right?
I mean, it's not like they can put this off indefinitely... can they?
Oh.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31339106</id>
	<title>Re:The Flip Side</title>
	<author>Anonymous</author>
	<datestamp>1267539540000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I also have some personal observations as an MD who has been involved in the design and implementation of EMRs (Electronic Medical Records). They definitely CAN be time saving for the clinicians (MDs, NPs, and PAs) but not necessarily. They definitely can reduce medical errors and improve patient care. The problem is misaligned incentives...</p><p>There is no bottom-line incentive to implement an EMR if the cost savings do not (1) Accrue to the hospital or medical practice, and (2) do not pay for the cost of the EMR. Many administrators at hospitals and medical groups see cost savings coming from fewer clerical staff to transcribe clinician notes or transmit test orders to their respective destinations. Instead, the clinician writes (read: types) their note at the time of the visit and also enters all of the orders into the computer. I can tell you that most of us do not like using our time with patients to do this, so we do it later. Leading to an extra hour or two a day in time completing our notes - this leads to a lot of resistance from the clinicians. The administrators do not reduce your appointment load to compensate, as then they would lose their cost-savings as a result of reduced productivity... Speech recognition sometimes is an acceptable alternative, but a missed inaccurate transcription can lead to significant mis-information that is actually counter-productive (and can lead to legal liability problems...)</p><p>Another unintended result (ah yes...) are notes that are overly brief (to avoid too much typing) or "standardized" thru the use of templates, thereby losing a lot of detail and accuracy. Aside from reduced clerical staff, where are the cost savings coming from? If there are shorter hospital stays or fewer redundant tests, this may be to a hospital's favor if the patient is on Medicare, since Medicare pays by diagnosis and not by cost to hospital. But if it is a privately insured patient, the savings accrue to the insurer thru a lower bill... And these large systems cost in the many millions of dollars. No wonder there is not a rush to buy them.... Yes, my patients probably would have better care, but who pays for that and how?</p><p>The other problem is the Babel one - unless we all use the same system (in the office and hospital), it is rare to be able to meaningfully exchange data. Yes, there is an HL7 (Health Level 7) standard for data interchange, but it has tons of problems related to free text fields and fuzzy definitions. I am in the San Francisco Bay area - several hospitals have implemented EPIC (Kaiser, Sutter Health, etc.) - yet the customizations each has made to accommodate their institutional needs has lead to a lack of data exchangability even using the same system!</p><p>Lastly, if you do not make your operations efficient before implementing a computer system, you have just taken an inefficient manual system and substituted an inefficient computer system - yet many practices never look at how things are done prior to implementing a computer system.</p><p>Whew<nobr> <wbr></nobr>... my 2 cents... back to my patients.</p></htmltext>
<tokenext>I also have some personal observations as an MD who has been involved in the design and implementation of EMRs ( Electronic Medical Records ) .
They definitely CAN be time saving for the clinicians ( MDs , NPs , and PAs ) but not necessarily .
They definitely can reduce medical errors and improve patient care .
The problem is misaligned incentives...There is no bottom-line incentive to implement an EMR if the cost savings do not ( 1 ) Accrue to the hospital or medical practice , and ( 2 ) do not pay for the cost of the EMR .
Many administrators at hospitals and medical groups see cost savings coming from fewer clerical staff to transcribe clinician notes or transmit test orders to their respective destinations .
Instead , the clinician writes ( read : types ) their note at the time of the visit and also enters all of the orders into the computer .
I can tell you that most of us do not like using our time with patients to do this , so we do it later .
Leading to an extra hour or two a day in time completing our notes - this leads to a lot of resistance from the clinicians .
The administrators do not reduce your appointment load to compensate , as then they would lose their cost-savings as a result of reduced productivity... Speech recognition sometimes is an acceptable alternative , but a missed inaccurate transcription can lead to significant mis-information that is actually counter-productive ( and can lead to legal liability problems... ) Another unintended result ( ah yes... ) are notes that are overly brief ( to avoid too much typing ) or " standardized " thru the use of templates , thereby losing a lot of detail and accuracy .
Aside from reduced clerical staff , where are the cost savings coming from ?
If there are shorter hospital stays or fewer redundant tests , this may be to a hospital 's favor if the patient is on Medicare , since Medicare pays by diagnosis and not by cost to hospital .
But if it is a privately insured patient , the savings accrue to the insurer thru a lower bill... And these large systems cost in the many millions of dollars .
No wonder there is not a rush to buy them.... Yes , my patients probably would have better care , but who pays for that and how ? The other problem is the Babel one - unless we all use the same system ( in the office and hospital ) , it is rare to be able to meaningfully exchange data .
Yes , there is an HL7 ( Health Level 7 ) standard for data interchange , but it has tons of problems related to free text fields and fuzzy definitions .
I am in the San Francisco Bay area - several hospitals have implemented EPIC ( Kaiser , Sutter Health , etc .
) - yet the customizations each has made to accommodate their institutional needs has lead to a lack of data exchangability even using the same system ! Lastly , if you do not make your operations efficient before implementing a computer system , you have just taken an inefficient manual system and substituted an inefficient computer system - yet many practices never look at how things are done prior to implementing a computer system.Whew ... my 2 cents... back to my patients .</tokentext>
<sentencetext>I also have some personal observations as an MD who has been involved in the design and implementation of EMRs (Electronic Medical Records).
They definitely CAN be time saving for the clinicians (MDs, NPs, and PAs) but not necessarily.
They definitely can reduce medical errors and improve patient care.
The problem is misaligned incentives...There is no bottom-line incentive to implement an EMR if the cost savings do not (1) Accrue to the hospital or medical practice, and (2) do not pay for the cost of the EMR.
Many administrators at hospitals and medical groups see cost savings coming from fewer clerical staff to transcribe clinician notes or transmit test orders to their respective destinations.
Instead, the clinician writes (read: types) their note at the time of the visit and also enters all of the orders into the computer.
I can tell you that most of us do not like using our time with patients to do this, so we do it later.
Leading to an extra hour or two a day in time completing our notes - this leads to a lot of resistance from the clinicians.
The administrators do not reduce your appointment load to compensate, as then they would lose their cost-savings as a result of reduced productivity... Speech recognition sometimes is an acceptable alternative, but a missed inaccurate transcription can lead to significant mis-information that is actually counter-productive (and can lead to legal liability problems...)Another unintended result (ah yes...) are notes that are overly brief (to avoid too much typing) or "standardized" thru the use of templates, thereby losing a lot of detail and accuracy.
Aside from reduced clerical staff, where are the cost savings coming from?
If there are shorter hospital stays or fewer redundant tests, this may be to a hospital's favor if the patient is on Medicare, since Medicare pays by diagnosis and not by cost to hospital.
But if it is a privately insured patient, the savings accrue to the insurer thru a lower bill... And these large systems cost in the many millions of dollars.
No wonder there is not a rush to buy them.... Yes, my patients probably would have better care, but who pays for that and how?The other problem is the Babel one - unless we all use the same system (in the office and hospital), it is rare to be able to meaningfully exchange data.
Yes, there is an HL7 (Health Level 7) standard for data interchange, but it has tons of problems related to free text fields and fuzzy definitions.
I am in the San Francisco Bay area - several hospitals have implemented EPIC (Kaiser, Sutter Health, etc.
) - yet the customizations each has made to accommodate their institutional needs has lead to a lack of data exchangability even using the same system!Lastly, if you do not make your operations efficient before implementing a computer system, you have just taken an inefficient manual system and substituted an inefficient computer system - yet many practices never look at how things are done prior to implementing a computer system.Whew ... my 2 cents... back to my patients.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332186</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332442</id>
	<title>Re:Politicians playing the King!</title>
	<author>wintercolby</author>
	<datestamp>1267555980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>shortly to dictate Intel manfucaturing numbers because it effects "the environment".</p></div><p>
I'm waiting with baited breath.  Mr. AC do you know nothing about business, politics, organizations or societies?  Ideas guide work, rarely do the people who come up with the ideas, or even the ones that push them get work done.  Even more rare is when they do the work themselves.  The only idea-men in our economy that actually know how to get work done and come up with the work that needs to be done are the entrepreneurs.  The financial incentives (did I forget to mention economics) mentioned in TFA provide more than enough for the market to take care of this.  In fact, what we have here is an <b>opportunity</b> for <b>private companies</b> to make a product that does what needs to be done, reliably.  Is it not the capitolism espousing party that is typically against Obama's policies that <b>encourages market competition?</b>  No small family physician will be able to afford quality one off software, but they'll be able to afford a really well developed commercial solution that's made to address this need.  All I want to know is which software firms are out there working to fill this niche and <b>profit?</b>
<br> <br>
STFU unless you have some insight to add to the topic.</p></div>
	</htmltext>
<tokenext>shortly to dictate Intel manfucaturing numbers because it effects " the environment " .
I 'm waiting with baited breath .
Mr. AC do you know nothing about business , politics , organizations or societies ?
Ideas guide work , rarely do the people who come up with the ideas , or even the ones that push them get work done .
Even more rare is when they do the work themselves .
The only idea-men in our economy that actually know how to get work done and come up with the work that needs to be done are the entrepreneurs .
The financial incentives ( did I forget to mention economics ) mentioned in TFA provide more than enough for the market to take care of this .
In fact , what we have here is an opportunity for private companies to make a product that does what needs to be done , reliably .
Is it not the capitolism espousing party that is typically against Obama 's policies that encourages market competition ?
No small family physician will be able to afford quality one off software , but they 'll be able to afford a really well developed commercial solution that 's made to address this need .
All I want to know is which software firms are out there working to fill this niche and profit ?
STFU unless you have some insight to add to the topic .</tokentext>
<sentencetext>shortly to dictate Intel manfucaturing numbers because it effects "the environment".
I'm waiting with baited breath.
Mr. AC do you know nothing about business, politics, organizations or societies?
Ideas guide work, rarely do the people who come up with the ideas, or even the ones that push them get work done.
Even more rare is when they do the work themselves.
The only idea-men in our economy that actually know how to get work done and come up with the work that needs to be done are the entrepreneurs.
The financial incentives (did I forget to mention economics) mentioned in TFA provide more than enough for the market to take care of this.
In fact, what we have here is an opportunity for private companies to make a product that does what needs to be done, reliably.
Is it not the capitolism espousing party that is typically against Obama's policies that encourages market competition?
No small family physician will be able to afford quality one off software, but they'll be able to afford a really well developed commercial solution that's made to address this need.
All I want to know is which software firms are out there working to fill this niche and profit?
STFU unless you have some insight to add to the topic.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31337464</id>
	<title>Re:The Flip Side</title>
	<author>bittmann</author>
	<datestamp>1267531440000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><blockquote><div><p>I'm not big on government interference with many parts of our lives, but they are addressing a very real problem and they're doing it with kid gloves. They did not pass regulations requiring hospitals to comply, they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together. If medical providers have not done so and are rushing about now, that is absolutely not the fault of the feds.</p></div></blockquote><p>

Actually...one of the dirty little secrets here is that the final rule for meeting "meaningful use" still isn't actually final.  The "interim final rule" wasn't even available to view until Jan, 2010 (<a href="http://www.regulations.gov/search/Regs/home.html#docketDetail?R=CMS-2009-0117" title="regulations.gov">link</a> [regulations.gov]), comments are accepted through March 15th, and we should have a final rule that we can (hopefully) comply with by the end of this month.</p><p>

And:  We don't have "many years" to do the install.  We have a few years...very few, if we want to actually participate in the government incentives.  Have to be installed and in production by late 2011 to qualify for the full incentive.  Any delay, and the incentives go down drastically.</p><p>

In our case, this whole thing really bites.  We have an EMR, fully deployed, and we haven't maintained a paper chart in years.  But, because of the definition of "Certified EMR" (which at this point basically means "Must be certified by <a href="http://www.cchit.org/" title="cchit.org">CCHIT</a> [cchit.org]"), we can't qualify for "Meaningful Use" under these proposed rules.  So, we have an EMR, we produce escripts, we do online order entry, we can even exchange imaging information (something that this round of certification doesn't require), but because we can't fill in all of the check-boxes in a CCHIT audit, we have to scrap our homegrown EMR and pay millions to replace it with a "certified" alternative.  And the government will give us <b>some</b> of that money back if we cram it in fast enough *and* if we are able to show that we meet whatever standards the final rule eventually mandates...all within the next 18-30 months.</p><p>

Nice.</p><p>

It may not be the <i>fault</i> of the Feds that <i>some</i> providers haven't transitioned to digital records, but the Feds certainly aren't making things very easy, either.</p></div>
	</htmltext>
<tokenext>I 'm not big on government interference with many parts of our lives , but they are addressing a very real problem and they 're doing it with kid gloves .
They did not pass regulations requiring hospitals to comply , they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together .
If medical providers have not done so and are rushing about now , that is absolutely not the fault of the feds .
Actually...one of the dirty little secrets here is that the final rule for meeting " meaningful use " still is n't actually final .
The " interim final rule " was n't even available to view until Jan , 2010 ( link [ regulations.gov ] ) , comments are accepted through March 15th , and we should have a final rule that we can ( hopefully ) comply with by the end of this month .
And : We do n't have " many years " to do the install .
We have a few years...very few , if we want to actually participate in the government incentives .
Have to be installed and in production by late 2011 to qualify for the full incentive .
Any delay , and the incentives go down drastically .
In our case , this whole thing really bites .
We have an EMR , fully deployed , and we have n't maintained a paper chart in years .
But , because of the definition of " Certified EMR " ( which at this point basically means " Must be certified by CCHIT [ cchit.org ] " ) , we ca n't qualify for " Meaningful Use " under these proposed rules .
So , we have an EMR , we produce escripts , we do online order entry , we can even exchange imaging information ( something that this round of certification does n't require ) , but because we ca n't fill in all of the check-boxes in a CCHIT audit , we have to scrap our homegrown EMR and pay millions to replace it with a " certified " alternative .
And the government will give us some of that money back if we cram it in fast enough * and * if we are able to show that we meet whatever standards the final rule eventually mandates...all within the next 18-30 months .
Nice . It may not be the fault of the Feds that some providers have n't transitioned to digital records , but the Feds certainly are n't making things very easy , either .</tokentext>
<sentencetext>I'm not big on government interference with many parts of our lives, but they are addressing a very real problem and they're doing it with kid gloves.
They did not pass regulations requiring hospitals to comply, they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together.
If medical providers have not done so and are rushing about now, that is absolutely not the fault of the feds.
Actually...one of the dirty little secrets here is that the final rule for meeting "meaningful use" still isn't actually final.
The "interim final rule" wasn't even available to view until Jan, 2010 (link [regulations.gov]), comments are accepted through March 15th, and we should have a final rule that we can (hopefully) comply with by the end of this month.
And:  We don't have "many years" to do the install.
We have a few years...very few, if we want to actually participate in the government incentives.
Have to be installed and in production by late 2011 to qualify for the full incentive.
Any delay, and the incentives go down drastically.
In our case, this whole thing really bites.
We have an EMR, fully deployed, and we haven't maintained a paper chart in years.
But, because of the definition of "Certified EMR" (which at this point basically means "Must be certified by CCHIT [cchit.org]"), we can't qualify for "Meaningful Use" under these proposed rules.
So, we have an EMR, we produce escripts, we do online order entry, we can even exchange imaging information (something that this round of certification doesn't require), but because we can't fill in all of the check-boxes in a CCHIT audit, we have to scrap our homegrown EMR and pay millions to replace it with a "certified" alternative.
And the government will give us some of that money back if we cram it in fast enough *and* if we are able to show that we meet whatever standards the final rule eventually mandates...all within the next 18-30 months.
Nice.

It may not be the fault of the Feds that some providers haven't transitioned to digital records, but the Feds certainly aren't making things very easy, either.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332186</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332902</id>
	<title>Re:Politicians playing the King!</title>
	<author>wintercolby</author>
	<datestamp>1267557660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Mod parent down:  Flamebait/Overrated/Troll</htmltext>
<tokenext>Mod parent down : Flamebait/Overrated/Troll</tokentext>
<sentencetext>Mod parent down:  Flamebait/Overrated/Troll</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331876</id>
	<title>Bah...</title>
	<author>Anonymous</author>
	<datestamp>1267554120000</datestamp>
	<modclass>Funny</modclass>
	<modscore>3</modscore>
	<htmltext><p>It's not like anything bad's ever happened when critical systems are rolled-out <a href="http://news.zdnet.com/2100-9595\_22-177729.html" title="zdnet.com">untested</a> [zdnet.com], <a href="http://www.itdisasters.com/" title="itdisasters.com">unprepared</a> [itdisasters.com], or <a href="http://www.baselinemag.com/c/a/IT-Management/Dirty-Dozen-Inside-12-IT-Disasters-874085/" title="baselinemag.com">irresposibly</a> [baselinemag.com].</p><p>I mean it's not like someone's <a href="http://www.novinite.com/view\_news.php?id=104972" title="novinite.com">life</a> [novinite.com] is ever put in jeaopardy by minor software glitches, especially in <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/?loc=cases&amp;sloc=Journal\%20of\%20South\%20Carolina" title="drexel.edu">hospitals</a> [drexel.edu].<nobr> <wbr></nobr>...on a side note, Googling "IT disasters" leads to some very interesting results.</p><p>-Matt</p></htmltext>
<tokenext>It 's not like anything bad 's ever happened when critical systems are rolled-out untested [ zdnet.com ] , unprepared [ itdisasters.com ] , or irresposibly [ baselinemag.com ] .I mean it 's not like someone 's life [ novinite.com ] is ever put in jeaopardy by minor software glitches , especially in hospitals [ drexel.edu ] .
...on a side note , Googling " IT disasters " leads to some very interesting results.-Matt</tokentext>
<sentencetext>It's not like anything bad's ever happened when critical systems are rolled-out untested [zdnet.com], unprepared [itdisasters.com], or irresposibly [baselinemag.com].I mean it's not like someone's life [novinite.com] is ever put in jeaopardy by minor software glitches, especially in hospitals [drexel.edu].
...on a side note, Googling "IT disasters" leads to some very interesting results.-Matt</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332962</id>
	<title>Re:A lot of hospitals already have e-records</title>
	<author>Anonymous</author>
	<datestamp>1267557900000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>The problem is not that they have to have e-records.  They have to DOCUMENT that they are used according to standards.  Many of the programs do not track use enough to document the flow of data, so even though they are used meaningfully they can't PROVE they are used meaningfully.  And that's what makes it sticky.</p><p>I have worked in healthcare IT and am looking at returning to the field, and some of the best-equipped hospitals are still sweating about meeting the standards, because they're not just "have electronic records."  They require dozens of programs, working together properly, with a data flow that meets (arbitrary?) standards, and has appropriate logging to demonstrate it in an audit.  "Meaningful use" is a higher standard than "have and use." The rules were set so that a large amount of hospitals and practices can't meet the standard, so the reimbursement rates for Medicare drop, helping to balance the budget.</p></htmltext>
<tokenext>The problem is not that they have to have e-records .
They have to DOCUMENT that they are used according to standards .
Many of the programs do not track use enough to document the flow of data , so even though they are used meaningfully they ca n't PROVE they are used meaningfully .
And that 's what makes it sticky.I have worked in healthcare IT and am looking at returning to the field , and some of the best-equipped hospitals are still sweating about meeting the standards , because they 're not just " have electronic records .
" They require dozens of programs , working together properly , with a data flow that meets ( arbitrary ?
) standards , and has appropriate logging to demonstrate it in an audit .
" Meaningful use " is a higher standard than " have and use .
" The rules were set so that a large amount of hospitals and practices ca n't meet the standard , so the reimbursement rates for Medicare drop , helping to balance the budget .</tokentext>
<sentencetext>The problem is not that they have to have e-records.
They have to DOCUMENT that they are used according to standards.
Many of the programs do not track use enough to document the flow of data, so even though they are used meaningfully they can't PROVE they are used meaningfully.
And that's what makes it sticky.I have worked in healthcare IT and am looking at returning to the field, and some of the best-equipped hospitals are still sweating about meeting the standards, because they're not just "have electronic records.
"  They require dozens of programs, working together properly, with a data flow that meets (arbitrary?
) standards, and has appropriate logging to demonstrate it in an audit.
"Meaningful use" is a higher standard than "have and use.
" The rules were set so that a large amount of hospitals and practices can't meet the standard, so the reimbursement rates for Medicare drop, helping to balance the budget.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332122</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331688</id>
	<title>Who?</title>
	<author>Anonymous</author>
	<datestamp>1267553460000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><nobr> <wbr></nobr></p><div class="quote"><p>....say <b>politicians</b> and top IT professionals responsible for the deployments.</p></div><p>I really don't care what a politician's opinion is because:</p><ol> <li>They're not qualified</li><li>They're liars</li><li>or they were paid, usually with soft money, to say what they say.</li> </ol><p>A prime example of soft money used to bri...lobby Congressmen is rides on corporate jets. It also explains why the airlines and TSA get away with their moronic bullshit.</p></div>
	</htmltext>
<tokenext>....say politicians and top IT professionals responsible for the deployments.I really do n't care what a politician 's opinion is because : They 're not qualifiedThey 're liarsor they were paid , usually with soft money , to say what they say .
A prime example of soft money used to bri...lobby Congressmen is rides on corporate jets .
It also explains why the airlines and TSA get away with their moronic bullshit .</tokentext>
<sentencetext> ....say politicians and top IT professionals responsible for the deployments.I really don't care what a politician's opinion is because: They're not qualifiedThey're liarsor they were paid, usually with soft money, to say what they say.
A prime example of soft money used to bri...lobby Congressmen is rides on corporate jets.
It also explains why the airlines and TSA get away with their moronic bullshit.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331882</id>
	<title>On the flip side</title>
	<author>Dynedain</author>
	<datestamp>1267554180000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>4</modscore>
	<htmltext><p>On the other hand, look at the digital TV transition debacle.</p><p>If you don't set a deadline and enforce it, difficult technology implementations tend to drag on forever.</p></htmltext>
<tokenext>On the other hand , look at the digital TV transition debacle.If you do n't set a deadline and enforce it , difficult technology implementations tend to drag on forever .</tokentext>
<sentencetext>On the other hand, look at the digital TV transition debacle.If you don't set a deadline and enforce it, difficult technology implementations tend to drag on forever.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332516</id>
	<title>The whole thing is ridiculous.</title>
	<author>Anonymous</author>
	<datestamp>1267556220000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>1</modscore>
	<htmltext><p>First off, only in the health care industry - which is insulated from almost any market pressure - would you have to have the government fund such a basic infrastructural system. All these companies/doctors have to do is sit back, rake in the profits, and wait for the government to improve their basic tools of business for them. It's bullshit - why should I have to pay for this as a taxpayer? Banks seem to have figured out how to do monetary transactions just fine on their own, why couldn't there be a visa of medical records come around? Take a few cents/dollars for a transfer of medical info, get it so ubiquitous that doctors/hospitals are FORCED into using them - Oh, wait, there's no incentive for the doctors/companies to make it easy for individuals to do this - because individuals aren't their customers, Insurance companies are. And why should they care about your medical records being easy to access and transfer?</p><p>Either make them pay for their own systems, or nationalize health care and give me my monies worth. The government owns half the equipment they use through tax breaks/incentives etc. anyways. I shouldn't have to subsidize their extortion and medicine should never have been a 'For Profit' business.</p></htmltext>
<tokenext>First off , only in the health care industry - which is insulated from almost any market pressure - would you have to have the government fund such a basic infrastructural system .
All these companies/doctors have to do is sit back , rake in the profits , and wait for the government to improve their basic tools of business for them .
It 's bullshit - why should I have to pay for this as a taxpayer ?
Banks seem to have figured out how to do monetary transactions just fine on their own , why could n't there be a visa of medical records come around ?
Take a few cents/dollars for a transfer of medical info , get it so ubiquitous that doctors/hospitals are FORCED into using them - Oh , wait , there 's no incentive for the doctors/companies to make it easy for individuals to do this - because individuals are n't their customers , Insurance companies are .
And why should they care about your medical records being easy to access and transfer ? Either make them pay for their own systems , or nationalize health care and give me my monies worth .
The government owns half the equipment they use through tax breaks/incentives etc .
anyways. I should n't have to subsidize their extortion and medicine should never have been a 'For Profit ' business .</tokentext>
<sentencetext>First off, only in the health care industry - which is insulated from almost any market pressure - would you have to have the government fund such a basic infrastructural system.
All these companies/doctors have to do is sit back, rake in the profits, and wait for the government to improve their basic tools of business for them.
It's bullshit - why should I have to pay for this as a taxpayer?
Banks seem to have figured out how to do monetary transactions just fine on their own, why couldn't there be a visa of medical records come around?
Take a few cents/dollars for a transfer of medical info, get it so ubiquitous that doctors/hospitals are FORCED into using them - Oh, wait, there's no incentive for the doctors/companies to make it easy for individuals to do this - because individuals aren't their customers, Insurance companies are.
And why should they care about your medical records being easy to access and transfer?Either make them pay for their own systems, or nationalize health care and give me my monies worth.
The government owns half the equipment they use through tax breaks/incentives etc.
anyways. I shouldn't have to subsidize their extortion and medicine should never have been a 'For Profit' business.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31333320</id>
	<title>Re:Fast, Good, Cheap, pick 2...</title>
	<author>Hurricane78</author>
	<datestamp>1267559220000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>Fast, Good, Cheap, pick 2...</p></div><p>We&rsquo;re the government. We don&rsquo;t need any of those.<nobr> <wbr></nobr>;)</p></div>
	</htmltext>
<tokenext>Fast , Good , Cheap , pick 2...We    re the government .
We don    t need any of those .
; )</tokentext>
<sentencetext>Fast, Good, Cheap, pick 2...We’re the government.
We don’t need any of those.
;)
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331680</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31332726</id>
	<title>Interoperability</title>
	<author>Anonymous</author>
	<datestamp>1267556940000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>2</modscore>
	<htmltext><p>That's the biggest problem I've seen.<br>There's no real e-standard for e-medical records.<br>This is mainly from friends with knowledge of Meditech and Epic, some of them from HIMSS level 6 institutions (it only goes to 7).<br>The systems might be able to talk to others of the same type (maybe, sometimes they don't), but so far, there's no real "medical record standard" that everyone can read.</p><p>Another added problem is actually DOING the e-record...<br>History, documentation, orders, verifying meds,,,<br>I've heard of widely varying times for these activities, anywhere from 20 to 60 min. on a new patient, all usually done by the RN on duty, typing away instead of actually attending to the patient directly.<br>Speed of completion is usually in relation of the RN's language skills relative to the patient (native english speaking RNs are usually the fastest, bi-lingual eng/spanish are almost always the exact same speed).</p></htmltext>
<tokenext>That 's the biggest problem I 've seen.There 's no real e-standard for e-medical records.This is mainly from friends with knowledge of Meditech and Epic , some of them from HIMSS level 6 institutions ( it only goes to 7 ) .The systems might be able to talk to others of the same type ( maybe , sometimes they do n't ) , but so far , there 's no real " medical record standard " that everyone can read.Another added problem is actually DOING the e-record...History , documentation , orders , verifying meds,,,I 've heard of widely varying times for these activities , anywhere from 20 to 60 min .
on a new patient , all usually done by the RN on duty , typing away instead of actually attending to the patient directly.Speed of completion is usually in relation of the RN 's language skills relative to the patient ( native english speaking RNs are usually the fastest , bi-lingual eng/spanish are almost always the exact same speed ) .</tokentext>
<sentencetext>That's the biggest problem I've seen.There's no real e-standard for e-medical records.This is mainly from friends with knowledge of Meditech and Epic, some of them from HIMSS level 6 institutions (it only goes to 7).The systems might be able to talk to others of the same type (maybe, sometimes they don't), but so far, there's no real "medical record standard" that everyone can read.Another added problem is actually DOING the e-record...History, documentation, orders, verifying meds,,,I've heard of widely varying times for these activities, anywhere from 20 to 60 min.
on a new patient, all usually done by the RN on duty, typing away instead of actually attending to the patient directly.Speed of completion is usually in relation of the RN's language skills relative to the patient (native english speaking RNs are usually the fastest, bi-lingual eng/spanish are almost always the exact same speed).</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331760</id>
	<title>Politicians playing the King!</title>
	<author>Anonymous</author>
	<datestamp>1267553760000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>1</modscore>
	<htmltext><p>This is the same as the political push for the CFL light bulbs.  Non technology people dictating the technology sector.  Obama does not have an ounce of knowledge about health care systems, yet thinks he knows everything that should be done.  It's a farce.<br>
&nbsp; <br>Side note: Jesus told the people they absolutly did not want a King, yet the people wanted to blindly follow and appointed a King anyway.  So, here is your King Obama, shortly to dictate Intel manfucaturing numbers because it effects "the environment".</p></htmltext>
<tokenext>This is the same as the political push for the CFL light bulbs .
Non technology people dictating the technology sector .
Obama does not have an ounce of knowledge about health care systems , yet thinks he knows everything that should be done .
It 's a farce .
  Side note : Jesus told the people they absolutly did not want a King , yet the people wanted to blindly follow and appointed a King anyway .
So , here is your King Obama , shortly to dictate Intel manfucaturing numbers because it effects " the environment " .</tokentext>
<sentencetext>This is the same as the political push for the CFL light bulbs.
Non technology people dictating the technology sector.
Obama does not have an ounce of knowledge about health care systems, yet thinks he knows everything that should be done.
It's a farce.
  Side note: Jesus told the people they absolutly did not want a King, yet the people wanted to blindly follow and appointed a King anyway.
So, here is your King Obama, shortly to dictate Intel manfucaturing numbers because it effects "the environment".</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment10_03_02_1641223.31331740</id>
	<title>Does hospital IT work pay well enough?</title>
	<author>Anonymous</author>
	<datestamp>1267553700000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Great software developers entering the field today aspire to work on pop culture technology like Facebook, Google, and CG animated film production.  Who does that leave to work on hospital IT?  Does hospital IT pay well enough to compete with the sexy IT jobs?</htmltext>
<tokenext>Great software developers entering the field today aspire to work on pop culture technology like Facebook , Google , and CG animated film production .
Who does that leave to work on hospital IT ?
Does hospital IT pay well enough to compete with the sexy IT jobs ?</tokentext>
<sentencetext>Great software developers entering the field today aspire to work on pop culture technology like Facebook, Google, and CG animated film production.
Who does that leave to work on hospital IT?
Does hospital IT pay well enough to compete with the sexy IT jobs?</sentencetext>
</comment>
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