<article>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#article09_12_01_0115246</id>
	<title>Harvard Says Computers Don't Save Hospitals Money</title>
	<author>kdawson</author>
	<datestamp>1259695680000</datestamp>
	<htmltext>Lucas123 writes <i>"Researchers at Harvard Medical School pored over survey data from more than 4,000 'wired' hospitals and determined that computerization of those facilities not only <a href="http://www.computerworld.com/s/article/print/9141428/Harvard\_study\_Computers\_don\_t\_save\_hospitals\_money?taxonomyName=Hardware&amp;taxonomyId=12">didn't save them a dime</a>, but the technology didn't improve administrative efficiency either. The study also showed most of the IT systems were aimed at improving efficiency for hospital management &mdash; not doctors, nurses, and medical technicians. 'For 45 years or so, people have been claiming computers are going to save vast amounts of money and that the payoff was just around the corner. So the first thing we need to do is stop claiming things there's no evidence for. It's based on vaporware and [hasn't been] shown to exist or shown to be true,' said Dr. David Himmelstein, the study's lead author."</i></htmltext>
<tokenext>Lucas123 writes " Researchers at Harvard Medical School pored over survey data from more than 4,000 'wired ' hospitals and determined that computerization of those facilities not only did n't save them a dime , but the technology did n't improve administrative efficiency either .
The study also showed most of the IT systems were aimed at improving efficiency for hospital management    not doctors , nurses , and medical technicians .
'For 45 years or so , people have been claiming computers are going to save vast amounts of money and that the payoff was just around the corner .
So the first thing we need to do is stop claiming things there 's no evidence for .
It 's based on vaporware and [ has n't been ] shown to exist or shown to be true, ' said Dr. David Himmelstein , the study 's lead author .
"</tokentext>
<sentencetext>Lucas123 writes "Researchers at Harvard Medical School pored over survey data from more than 4,000 'wired' hospitals and determined that computerization of those facilities not only didn't save them a dime, but the technology didn't improve administrative efficiency either.
The study also showed most of the IT systems were aimed at improving efficiency for hospital management — not doctors, nurses, and medical technicians.
'For 45 years or so, people have been claiming computers are going to save vast amounts of money and that the payoff was just around the corner.
So the first thing we need to do is stop claiming things there's no evidence for.
It's based on vaporware and [hasn't been] shown to exist or shown to be true,' said Dr. David Himmelstein, the study's lead author.
"</sentencetext>
</article>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280512</id>
	<title>wrong metric</title>
	<author>timmarhy</author>
	<datestamp>1259659440000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>to hell with wether it saved a dime. did it improve patient outcome? cost saving it the wrong wrong WRONG aim of a hospital.</htmltext>
<tokenext>to hell with wether it saved a dime .
did it improve patient outcome ?
cost saving it the wrong wrong WRONG aim of a hospital .</tokentext>
<sentencetext>to hell with wether it saved a dime.
did it improve patient outcome?
cost saving it the wrong wrong WRONG aim of a hospital.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30295446</id>
	<title>Re:The key being ...</title>
	<author>cavebison</author>
	<datestamp>1259580960000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>Your typical Lab software for example might not have a straightforward way to cross-check isolates for emerging resistance trends, run critical screens or automatically report to a global EPI database</p></div><p>That's interesting, as I'm currently helping maintain a small EPI reporting system at a Perth hospital, aimed at checking isolates for emerging trends across different hospitals. This is directly used by the Microbiology lab technicians. It's in Access 97, believe it or not, running on last-decade PCs. Goes to show how much you can do by simply focussing on immediate goals with existing tech, instead of spending $millions on grand schemes concocted by grand consultants.</p><p>I've also written an online system used by many hospital labs in Oz to share information about Staph infections and outcomes. Sounds grand perhaps, but it's not - again, a small, focussed web app addressing specific needs.</p><p>For me, this is the work that satisfies. Focussed projects, working with the end users, helping them do what they want to do. But then I'm a freelancer, not an IT Solutions Consultancy with a big office and staff to pay.</p></div>
	</htmltext>
<tokenext>Your typical Lab software for example might not have a straightforward way to cross-check isolates for emerging resistance trends , run critical screens or automatically report to a global EPI databaseThat 's interesting , as I 'm currently helping maintain a small EPI reporting system at a Perth hospital , aimed at checking isolates for emerging trends across different hospitals .
This is directly used by the Microbiology lab technicians .
It 's in Access 97 , believe it or not , running on last-decade PCs .
Goes to show how much you can do by simply focussing on immediate goals with existing tech , instead of spending $ millions on grand schemes concocted by grand consultants.I 've also written an online system used by many hospital labs in Oz to share information about Staph infections and outcomes .
Sounds grand perhaps , but it 's not - again , a small , focussed web app addressing specific needs.For me , this is the work that satisfies .
Focussed projects , working with the end users , helping them do what they want to do .
But then I 'm a freelancer , not an IT Solutions Consultancy with a big office and staff to pay .</tokentext>
<sentencetext>Your typical Lab software for example might not have a straightforward way to cross-check isolates for emerging resistance trends, run critical screens or automatically report to a global EPI databaseThat's interesting, as I'm currently helping maintain a small EPI reporting system at a Perth hospital, aimed at checking isolates for emerging trends across different hospitals.
This is directly used by the Microbiology lab technicians.
It's in Access 97, believe it or not, running on last-decade PCs.
Goes to show how much you can do by simply focussing on immediate goals with existing tech, instead of spending $millions on grand schemes concocted by grand consultants.I've also written an online system used by many hospital labs in Oz to share information about Staph infections and outcomes.
Sounds grand perhaps, but it's not - again, a small, focussed web app addressing specific needs.For me, this is the work that satisfies.
Focussed projects, working with the end users, helping them do what they want to do.
But then I'm a freelancer, not an IT Solutions Consultancy with a big office and staff to pay.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281316</id>
	<title>Re:I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259667960000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>The study mentions that computers don't save the hospitals money, the cause being that computerisation is implemented by and for managers, and badly at that. If your hospital uses computers differently, then the Harvard study doesn't apply. Also, the study didn't take into account patient safety etc. but only cost and managerial efficiency.<br>Take a look at the things that would be impossible without computers (in the broad sense): MRI machines, pinhole surgery with a camera, pacemakers, all kinds of medical analysis equipment, surgical equipment barcode checking... don't take the study to mean "stop using computers". Take it as "lots of hospitals are using computers ineffectively".</p></htmltext>
<tokenext>The study mentions that computers do n't save the hospitals money , the cause being that computerisation is implemented by and for managers , and badly at that .
If your hospital uses computers differently , then the Harvard study does n't apply .
Also , the study did n't take into account patient safety etc .
but only cost and managerial efficiency.Take a look at the things that would be impossible without computers ( in the broad sense ) : MRI machines , pinhole surgery with a camera , pacemakers , all kinds of medical analysis equipment , surgical equipment barcode checking... do n't take the study to mean " stop using computers " .
Take it as " lots of hospitals are using computers ineffectively " .</tokentext>
<sentencetext>The study mentions that computers don't save the hospitals money, the cause being that computerisation is implemented by and for managers, and badly at that.
If your hospital uses computers differently, then the Harvard study doesn't apply.
Also, the study didn't take into account patient safety etc.
but only cost and managerial efficiency.Take a look at the things that would be impossible without computers (in the broad sense): MRI machines, pinhole surgery with a camera, pacemakers, all kinds of medical analysis equipment, surgical equipment barcode checking... don't take the study to mean "stop using computers".
Take it as "lots of hospitals are using computers ineffectively".</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283418</id>
	<title>This study is garbage</title>
	<author>Anonymous</author>
	<datestamp>1259683680000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>This is the biggest load of bone headed Harvard BS I've ever seen. Let's see some university hospitals throw out their billing systems. Start sending insurance claims on paper. But wait, there is a LAW that doesn't allow paper billing! This study is crap! Sure hospitals waste a ton in IT. I wonder if that is related to the fact that hospital IT is the lowest paid of any industry that employs IT.</p></htmltext>
<tokenext>This is the biggest load of bone headed Harvard BS I 've ever seen .
Let 's see some university hospitals throw out their billing systems .
Start sending insurance claims on paper .
But wait , there is a LAW that does n't allow paper billing !
This study is crap !
Sure hospitals waste a ton in IT .
I wonder if that is related to the fact that hospital IT is the lowest paid of any industry that employs IT .</tokentext>
<sentencetext>This is the biggest load of bone headed Harvard BS I've ever seen.
Let's see some university hospitals throw out their billing systems.
Start sending insurance claims on paper.
But wait, there is a LAW that doesn't allow paper billing!
This study is crap!
Sure hospitals waste a ton in IT.
I wonder if that is related to the fact that hospital IT is the lowest paid of any industry that employs IT.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282118</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259676840000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>As a former RN I can attest that nothing entered the mind of management regards software for use by staff except to use it as a tool to detect errors by staff or to in some way make the staff do work for management not related to patient care.  The whole purpose was to catch you making an error rather than to help you do your job so that you didn't get into an error position in the first place.  For example, they would time the posting of MD orders and punish for posting them later than a certian amount of time after they were written even if you didn't arrive in your hands prior to that time.  If the orders were unclear or illegible that wasn't the problem you were.   Suppose a medicine didn't arrive from pharmacy in time, you were late and wrong.   No they wouldn't have the MD post his own orders  and let the system propigate them down.  We had to transcribe the.  This is all a farce.  I am skilled in software design. If there was a system designed to assist in making the job work faster, easier etc management has no interest.</p><p>Examples of such a system include the ability to post pharmacy orders and check interactions electronically.  They include systems to bring ordered supplies to the RN on time.  They include systems to cross check what needs to be done at the time it is to be done.  These do not exist and are not going to exist.</p></htmltext>
<tokenext>As a former RN I can attest that nothing entered the mind of management regards software for use by staff except to use it as a tool to detect errors by staff or to in some way make the staff do work for management not related to patient care .
The whole purpose was to catch you making an error rather than to help you do your job so that you did n't get into an error position in the first place .
For example , they would time the posting of MD orders and punish for posting them later than a certian amount of time after they were written even if you did n't arrive in your hands prior to that time .
If the orders were unclear or illegible that was n't the problem you were .
Suppose a medicine did n't arrive from pharmacy in time , you were late and wrong .
No they would n't have the MD post his own orders and let the system propigate them down .
We had to transcribe the .
This is all a farce .
I am skilled in software design .
If there was a system designed to assist in making the job work faster , easier etc management has no interest.Examples of such a system include the ability to post pharmacy orders and check interactions electronically .
They include systems to bring ordered supplies to the RN on time .
They include systems to cross check what needs to be done at the time it is to be done .
These do not exist and are not going to exist .</tokentext>
<sentencetext>As a former RN I can attest that nothing entered the mind of management regards software for use by staff except to use it as a tool to detect errors by staff or to in some way make the staff do work for management not related to patient care.
The whole purpose was to catch you making an error rather than to help you do your job so that you didn't get into an error position in the first place.
For example, they would time the posting of MD orders and punish for posting them later than a certian amount of time after they were written even if you didn't arrive in your hands prior to that time.
If the orders were unclear or illegible that wasn't the problem you were.
Suppose a medicine didn't arrive from pharmacy in time, you were late and wrong.
No they wouldn't have the MD post his own orders  and let the system propigate them down.
We had to transcribe the.
This is all a farce.
I am skilled in software design.
If there was a system designed to assist in making the job work faster, easier etc management has no interest.Examples of such a system include the ability to post pharmacy orders and check interactions electronically.
They include systems to bring ordered supplies to the RN on time.
They include systems to cross check what needs to be done at the time it is to be done.
These do not exist and are not going to exist.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30290364</id>
	<title>I can fix that</title>
	<author>rcharbon</author>
	<datestamp>1259668500000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>It's not the systems.  Replace the people with competent workers.  Then you'll see real gains!</p></htmltext>
<tokenext>It 's not the systems .
Replace the people with competent workers .
Then you 'll see real gains !</tokentext>
<sentencetext>It's not the systems.
Replace the people with competent workers.
Then you'll see real gains!</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281326</id>
	<title>No computers was used to perform this study.</title>
	<author>HollyMolly-1122</author>
	<datestamp>1259668080000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext>All calculations was made by hand, saving money for calculators as well.</htmltext>
<tokenext>All calculations was made by hand , saving money for calculators as well .</tokentext>
<sentencetext>All calculations was made by hand, saving money for calculators as well.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281870</id>
	<title>Re:I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259674320000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>&gt; Computers have made my life much easier. With electronic charting I can follow all of my patients directly from a terminal that I carry with me.</p><p>You have not clearly stated whether you *input* the data yourself. Generally speaking, clinicians like consuming electronic data. It's the creating part that they are not so hot about.<br>If you are mostly looking at data entered by interns or nurses, I can see why you would like your system.</p><p>&gt; I don't know where Dr. harvard did his research but maybe he just has bad software.</p><p>Your personal, subjective, anecdotal experience vs. statistical analysis on well defined variables across multiple software systems.<br>To know where, you just need to read his methods section. It's cost data across sites that met their inclusion criteria.</p><p>Also, it is not a satisfaction survey. There are other studies for that.</p></htmltext>
<tokenext>&gt; Computers have made my life much easier .
With electronic charting I can follow all of my patients directly from a terminal that I carry with me.You have not clearly stated whether you * input * the data yourself .
Generally speaking , clinicians like consuming electronic data .
It 's the creating part that they are not so hot about.If you are mostly looking at data entered by interns or nurses , I can see why you would like your system. &gt; I do n't know where Dr. harvard did his research but maybe he just has bad software.Your personal , subjective , anecdotal experience vs. statistical analysis on well defined variables across multiple software systems.To know where , you just need to read his methods section .
It 's cost data across sites that met their inclusion criteria.Also , it is not a satisfaction survey .
There are other studies for that .</tokentext>
<sentencetext>&gt; Computers have made my life much easier.
With electronic charting I can follow all of my patients directly from a terminal that I carry with me.You have not clearly stated whether you *input* the data yourself.
Generally speaking, clinicians like consuming electronic data.
It's the creating part that they are not so hot about.If you are mostly looking at data entered by interns or nurses, I can see why you would like your system.&gt; I don't know where Dr. harvard did his research but maybe he just has bad software.Your personal, subjective, anecdotal experience vs. statistical analysis on well defined variables across multiple software systems.To know where, you just need to read his methods section.
It's cost data across sites that met their inclusion criteria.Also, it is not a satisfaction survey.
There are other studies for that.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283922</id>
	<title>re: the ones who can't keep up get filtered out ..</title>
	<author>King\_TJ</author>
	<datestamp>1259686080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>My mom is a retired R.N. and she's friends with quite a few older doctors out there.  One of the big complaints she's heard repeatedly from them is, hospitals are starting to demand they get on-board with using their computer systems.  If they refuse, and want to keep track of things on pen and paper, or using their own favorite methods, the hospital simply bars them from working there anymore.</p><p>So the computer illiterate doctors are often voluntarily retiring, rather than deal with the learning curve this late into their careers.  A few just run their private practice and stay out of the hospitals, so they can do things the "old fashioned way" for a few more years until they're ready to retire.</p></htmltext>
<tokenext>My mom is a retired R.N .
and she 's friends with quite a few older doctors out there .
One of the big complaints she 's heard repeatedly from them is , hospitals are starting to demand they get on-board with using their computer systems .
If they refuse , and want to keep track of things on pen and paper , or using their own favorite methods , the hospital simply bars them from working there anymore.So the computer illiterate doctors are often voluntarily retiring , rather than deal with the learning curve this late into their careers .
A few just run their private practice and stay out of the hospitals , so they can do things the " old fashioned way " for a few more years until they 're ready to retire .</tokentext>
<sentencetext>My mom is a retired R.N.
and she's friends with quite a few older doctors out there.
One of the big complaints she's heard repeatedly from them is, hospitals are starting to demand they get on-board with using their computer systems.
If they refuse, and want to keep track of things on pen and paper, or using their own favorite methods, the hospital simply bars them from working there anymore.So the computer illiterate doctors are often voluntarily retiring, rather than deal with the learning curve this late into their careers.
A few just run their private practice and stay out of the hospitals, so they can do things the "old fashioned way" for a few more years until they're ready to retire.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280500</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282462</id>
	<title>Consider the source? Do doctors love secrets?</title>
	<author>walterbyrd</author>
	<datestamp>1259679180000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I don't know, but I have heard that doctors love a system of badly filed, illegibly scrawled, notes - a system that only they can understand. Doctors do not want a system where data can be easily transfered, or easily reviewed. Doctor's want to protect their turf, and they want to be immune from any possibly legalities.</p><p>Whenever I see a "study" in a pop-media publication, my first thought is: who funded this, and why? IMO, there is usually some agenda involved.</p></htmltext>
<tokenext>I do n't know , but I have heard that doctors love a system of badly filed , illegibly scrawled , notes - a system that only they can understand .
Doctors do not want a system where data can be easily transfered , or easily reviewed .
Doctor 's want to protect their turf , and they want to be immune from any possibly legalities.Whenever I see a " study " in a pop-media publication , my first thought is : who funded this , and why ?
IMO , there is usually some agenda involved .</tokentext>
<sentencetext>I don't know, but I have heard that doctors love a system of badly filed, illegibly scrawled, notes - a system that only they can understand.
Doctors do not want a system where data can be easily transfered, or easily reviewed.
Doctor's want to protect their turf, and they want to be immune from any possibly legalities.Whenever I see a "study" in a pop-media publication, my first thought is: who funded this, and why?
IMO, there is usually some agenda involved.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280470</id>
	<title>Let me add to this</title>
	<author>Anonymous</author>
	<datestamp>1259658660000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>2</modscore>
	<htmltext>Having worked in an academic medical center and having a bit of exposure to doctors, I can say this...they may be able to patch you up but most doctors don't know shit about computers.  It's the reason that most of them still scribble things down in some incomprehensible handwriting--they either don't have the time or don't want to learn a different system for keeping records.<br> <br>

Actual savings probably won't be realized until everyone in the system starts to use it and have information that is easily transferable between clinics/doctors/hospitals.  Another hoop to jump through are the HIPPA requirements, not only on the federal level but on individual states as well.<br> <br>

The other thing I looked for but didn't find in the surprisingly short study (only 7 page PDF) is any type of linking the potential administrative gains which were offset by IT costs.  The study glances at this question, but admits it doesn't know why the costs had not decreased.  Not that this isn't the case, but it's just guesswork which takes a fair amount of bite out of the report.  If they could definitely say that yes, IT costs are eating up the savings, then that's something.  But with the way our health system is run here in the States, I wouldn't say that our system couldn't be improved upon...of course, that's a whole different discussion.</htmltext>
<tokenext>Having worked in an academic medical center and having a bit of exposure to doctors , I can say this...they may be able to patch you up but most doctors do n't know shit about computers .
It 's the reason that most of them still scribble things down in some incomprehensible handwriting--they either do n't have the time or do n't want to learn a different system for keeping records .
Actual savings probably wo n't be realized until everyone in the system starts to use it and have information that is easily transferable between clinics/doctors/hospitals .
Another hoop to jump through are the HIPPA requirements , not only on the federal level but on individual states as well .
The other thing I looked for but did n't find in the surprisingly short study ( only 7 page PDF ) is any type of linking the potential administrative gains which were offset by IT costs .
The study glances at this question , but admits it does n't know why the costs had not decreased .
Not that this is n't the case , but it 's just guesswork which takes a fair amount of bite out of the report .
If they could definitely say that yes , IT costs are eating up the savings , then that 's something .
But with the way our health system is run here in the States , I would n't say that our system could n't be improved upon...of course , that 's a whole different discussion .</tokentext>
<sentencetext>Having worked in an academic medical center and having a bit of exposure to doctors, I can say this...they may be able to patch you up but most doctors don't know shit about computers.
It's the reason that most of them still scribble things down in some incomprehensible handwriting--they either don't have the time or don't want to learn a different system for keeping records.
Actual savings probably won't be realized until everyone in the system starts to use it and have information that is easily transferable between clinics/doctors/hospitals.
Another hoop to jump through are the HIPPA requirements, not only on the federal level but on individual states as well.
The other thing I looked for but didn't find in the surprisingly short study (only 7 page PDF) is any type of linking the potential administrative gains which were offset by IT costs.
The study glances at this question, but admits it doesn't know why the costs had not decreased.
Not that this isn't the case, but it's just guesswork which takes a fair amount of bite out of the report.
If they could definitely say that yes, IT costs are eating up the savings, then that's something.
But with the way our health system is run here in the States, I wouldn't say that our system couldn't be improved upon...of course, that's a whole different discussion.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280274</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30287610</id>
	<title>Read this a few days ago and had to laugh</title>
	<author>CoffeePlease</author>
	<datestamp>1259700180000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>About 5 years ago I attended a dinner in Michigan where Senator Debbie Stabenow gave a speech on how we would save the auto industry by switching to electronic medical records. The theory was that that would reduce the 1200 or more per car that GM was spending on health insurance and pensions for retirees.</htmltext>
<tokenext>About 5 years ago I attended a dinner in Michigan where Senator Debbie Stabenow gave a speech on how we would save the auto industry by switching to electronic medical records .
The theory was that that would reduce the 1200 or more per car that GM was spending on health insurance and pensions for retirees .</tokentext>
<sentencetext>About 5 years ago I attended a dinner in Michigan where Senator Debbie Stabenow gave a speech on how we would save the auto industry by switching to electronic medical records.
The theory was that that would reduce the 1200 or more per car that GM was spending on health insurance and pensions for retirees.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282032</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259675880000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Exactly.  Having asked my doctors outright why they still rely so heavily on paper records carried around in file folders, the answer was universally that it was much easier to make quick notes on paper than to enter patient data into any software foisted upon them.</p></htmltext>
<tokenext>Exactly .
Having asked my doctors outright why they still rely so heavily on paper records carried around in file folders , the answer was universally that it was much easier to make quick notes on paper than to enter patient data into any software foisted upon them .</tokentext>
<sentencetext>Exactly.
Having asked my doctors outright why they still rely so heavily on paper records carried around in file folders, the answer was universally that it was much easier to make quick notes on paper than to enter patient data into any software foisted upon them.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281968</id>
	<title>My experience in medical information mgt ...</title>
	<author>LaughingCoder</author>
	<datestamp>1259675220000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext>I developed products in this space for a number of years. One big problem we always encountered was the in-house proprietary systems. Time and again we would hear "we'll buy your system as long as it can interface with this shiny, homegrown monstrosity that we developed". Of course the person most responsible for the purchasing decision (at least from the technical end) was also usually the manager who was responsible for creating (or at least maintaining) the inhouse monstrosity. To throw it out is to admit a giant mistake, to potentially cut staff (and hence reduce power) and so instead they try to make vendors jump through hoops. Our natural response was to wrap our products with integration services, which breeds a support nightmare (no two customers have the same thing) and is also very labor intensive, and hence expensive, making it very hard to justify for the projected "savings".

As an example, I once spent a year (mostly on my own time each night at home) logging in remotely to a hospital system, running migration scripts to move image data from an inhouse system into our system. Each morning I would tell the customer's technician to load a new batch of disks, then I would kick off the migration each night. And mind you, this is ONE customer at ONE hospital. And of course first I had to write the migration scripts<nobr> <wbr></nobr>... another sunk cost.</htmltext>
<tokenext>I developed products in this space for a number of years .
One big problem we always encountered was the in-house proprietary systems .
Time and again we would hear " we 'll buy your system as long as it can interface with this shiny , homegrown monstrosity that we developed " .
Of course the person most responsible for the purchasing decision ( at least from the technical end ) was also usually the manager who was responsible for creating ( or at least maintaining ) the inhouse monstrosity .
To throw it out is to admit a giant mistake , to potentially cut staff ( and hence reduce power ) and so instead they try to make vendors jump through hoops .
Our natural response was to wrap our products with integration services , which breeds a support nightmare ( no two customers have the same thing ) and is also very labor intensive , and hence expensive , making it very hard to justify for the projected " savings " .
As an example , I once spent a year ( mostly on my own time each night at home ) logging in remotely to a hospital system , running migration scripts to move image data from an inhouse system into our system .
Each morning I would tell the customer 's technician to load a new batch of disks , then I would kick off the migration each night .
And mind you , this is ONE customer at ONE hospital .
And of course first I had to write the migration scripts ... another sunk cost .</tokentext>
<sentencetext>I developed products in this space for a number of years.
One big problem we always encountered was the in-house proprietary systems.
Time and again we would hear "we'll buy your system as long as it can interface with this shiny, homegrown monstrosity that we developed".
Of course the person most responsible for the purchasing decision (at least from the technical end) was also usually the manager who was responsible for creating (or at least maintaining) the inhouse monstrosity.
To throw it out is to admit a giant mistake, to potentially cut staff (and hence reduce power) and so instead they try to make vendors jump through hoops.
Our natural response was to wrap our products with integration services, which breeds a support nightmare (no two customers have the same thing) and is also very labor intensive, and hence expensive, making it very hard to justify for the projected "savings".
As an example, I once spent a year (mostly on my own time each night at home) logging in remotely to a hospital system, running migration scripts to move image data from an inhouse system into our system.
Each morning I would tell the customer's technician to load a new batch of disks, then I would kick off the migration each night.
And mind you, this is ONE customer at ONE hospital.
And of course first I had to write the migration scripts ... another sunk cost.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280794</id>
	<title>Computers need to be implemented correctly...</title>
	<author>mgchan</author>
	<datestamp>1259662440000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>3</modscore>
	<htmltext><p>And they usually aren't.</p><p>I'm a radiologist and computers have definitely improved patient care and saved the hospital money (or alternatively made the hospital more money) in our field. From digitized images and the ability to outsource to overnight coverage to voice recognition to get turnaround for finalized reports in an hour it has undoubtedly worked. And that's with in most cases only fair implementation of a computer system.</p><p>With most hospitals, the problem is that they like to do a piecemeal transition. Digitize a subset of notes and vital signs, half the time what you need isn't there so you have to look through the paper chart AND the computer chart. Or the vital signs are only half in the computer and half on a chart, so nurses double their workload. And when it's set up, they do it with an IT-centric interface that doesn't make intuitive sense to most users. When I use them I can see through my background in computer science and engineering why things are done a certain way, but it doesn't make any sense to physicians, nurses, etc.</p><p>Then they add in a new piece, such as more vital signs (but in a different section), some dictated notes, some linking to the outside. Outpatient notes are digitized, inpatient notes are still handwritten, etc. ED notes are separate, with their own system. It's a complete mess. This method is a waste of money and time, all for the sake of early deployment of a suboptimal system and minimal re-training of the staff to use a new system.</p><p>The VA had a decent attempt with CPRS. They digitized everything - from physician admission notes to clergy notes. At least everything is in one place, but people are overwhelmed with data and it's too easy to copy and paste incorrect or inaccurate information. The interface is also suboptimal (graphing lab values involves selecting a range of tests, building a worksheet, etc. much like you'd expect an engineer to make it for maximum flexibility, but minimal ease of use). And connecting to other VA systems is hit or miss.</p><p>Perhaps the best method is to build a new hospital from the ground up. All patient records get digitized (scanned, at least, if not run through some OCR). Have a tightly integrated medical record system developed in collaboration with health care practitioners. That would save the hospital money, in the long run, compared to them starting from scratch with paper records.</p></htmltext>
<tokenext>And they usually are n't.I 'm a radiologist and computers have definitely improved patient care and saved the hospital money ( or alternatively made the hospital more money ) in our field .
From digitized images and the ability to outsource to overnight coverage to voice recognition to get turnaround for finalized reports in an hour it has undoubtedly worked .
And that 's with in most cases only fair implementation of a computer system.With most hospitals , the problem is that they like to do a piecemeal transition .
Digitize a subset of notes and vital signs , half the time what you need is n't there so you have to look through the paper chart AND the computer chart .
Or the vital signs are only half in the computer and half on a chart , so nurses double their workload .
And when it 's set up , they do it with an IT-centric interface that does n't make intuitive sense to most users .
When I use them I can see through my background in computer science and engineering why things are done a certain way , but it does n't make any sense to physicians , nurses , etc.Then they add in a new piece , such as more vital signs ( but in a different section ) , some dictated notes , some linking to the outside .
Outpatient notes are digitized , inpatient notes are still handwritten , etc .
ED notes are separate , with their own system .
It 's a complete mess .
This method is a waste of money and time , all for the sake of early deployment of a suboptimal system and minimal re-training of the staff to use a new system.The VA had a decent attempt with CPRS .
They digitized everything - from physician admission notes to clergy notes .
At least everything is in one place , but people are overwhelmed with data and it 's too easy to copy and paste incorrect or inaccurate information .
The interface is also suboptimal ( graphing lab values involves selecting a range of tests , building a worksheet , etc .
much like you 'd expect an engineer to make it for maximum flexibility , but minimal ease of use ) .
And connecting to other VA systems is hit or miss.Perhaps the best method is to build a new hospital from the ground up .
All patient records get digitized ( scanned , at least , if not run through some OCR ) .
Have a tightly integrated medical record system developed in collaboration with health care practitioners .
That would save the hospital money , in the long run , compared to them starting from scratch with paper records .</tokentext>
<sentencetext>And they usually aren't.I'm a radiologist and computers have definitely improved patient care and saved the hospital money (or alternatively made the hospital more money) in our field.
From digitized images and the ability to outsource to overnight coverage to voice recognition to get turnaround for finalized reports in an hour it has undoubtedly worked.
And that's with in most cases only fair implementation of a computer system.With most hospitals, the problem is that they like to do a piecemeal transition.
Digitize a subset of notes and vital signs, half the time what you need isn't there so you have to look through the paper chart AND the computer chart.
Or the vital signs are only half in the computer and half on a chart, so nurses double their workload.
And when it's set up, they do it with an IT-centric interface that doesn't make intuitive sense to most users.
When I use them I can see through my background in computer science and engineering why things are done a certain way, but it doesn't make any sense to physicians, nurses, etc.Then they add in a new piece, such as more vital signs (but in a different section), some dictated notes, some linking to the outside.
Outpatient notes are digitized, inpatient notes are still handwritten, etc.
ED notes are separate, with their own system.
It's a complete mess.
This method is a waste of money and time, all for the sake of early deployment of a suboptimal system and minimal re-training of the staff to use a new system.The VA had a decent attempt with CPRS.
They digitized everything - from physician admission notes to clergy notes.
At least everything is in one place, but people are overwhelmed with data and it's too easy to copy and paste incorrect or inaccurate information.
The interface is also suboptimal (graphing lab values involves selecting a range of tests, building a worksheet, etc.
much like you'd expect an engineer to make it for maximum flexibility, but minimal ease of use).
And connecting to other VA systems is hit or miss.Perhaps the best method is to build a new hospital from the ground up.
All patient records get digitized (scanned, at least, if not run through some OCR).
Have a tightly integrated medical record system developed in collaboration with health care practitioners.
That would save the hospital money, in the long run, compared to them starting from scratch with paper records.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280870</id>
	<title>Re:Yeah but...</title>
	<author>MichaelSmith</author>
	<datestamp>1259663220000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>When I broke my arm there was a long wait for X-Ray because their system had a virus. Later I got my X-Rays on CD and it came with convenient DLL files to help load the data. If I ran windows I would have been a bit worried about that.</p></htmltext>
<tokenext>When I broke my arm there was a long wait for X-Ray because their system had a virus .
Later I got my X-Rays on CD and it came with convenient DLL files to help load the data .
If I ran windows I would have been a bit worried about that .</tokentext>
<sentencetext>When I broke my arm there was a long wait for X-Ray because their system had a virus.
Later I got my X-Rays on CD and it came with convenient DLL files to help load the data.
If I ran windows I would have been a bit worried about that.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280488</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283448</id>
	<title>Re:I work in a major hospital</title>
	<author>tsstahl</author>
	<datestamp>1259683860000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I would hope the reporting functions are easier with a computer.  However, what about the processes that input the data?  Are they better than paper? Did they require paper first then an input session after acquisition?  How many QC checks are required before the data are accepted?

<br> <br>
There are plenty of benefits in computerized health care systems. The study confirms that they are not a panacea for uber cheap healthcare and perpetual youthful health.</htmltext>
<tokenext>I would hope the reporting functions are easier with a computer .
However , what about the processes that input the data ?
Are they better than paper ?
Did they require paper first then an input session after acquisition ?
How many QC checks are required before the data are accepted ?
There are plenty of benefits in computerized health care systems .
The study confirms that they are not a panacea for uber cheap healthcare and perpetual youthful health .</tokentext>
<sentencetext>I would hope the reporting functions are easier with a computer.
However, what about the processes that input the data?
Are they better than paper?
Did they require paper first then an input session after acquisition?
How many QC checks are required before the data are accepted?
There are plenty of benefits in computerized health care systems.
The study confirms that they are not a panacea for uber cheap healthcare and perpetual youthful health.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280554</id>
	<title>What about VISTA?</title>
	<author>Anonymous</author>
	<datestamp>1259660040000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Did the Harvard study include the computer system used in the Veterans' Administration hospitals?<br>It is an in-house system started in about 1980.<br>It seems to serve the VA particularly well -- doctors, patients, labs as well as management.<br>It is known as VISTA, and it can be tried and downloaded from a VA server.</p></htmltext>
<tokenext>Did the Harvard study include the computer system used in the Veterans ' Administration hospitals ? It is an in-house system started in about 1980.It seems to serve the VA particularly well -- doctors , patients , labs as well as management.It is known as VISTA , and it can be tried and downloaded from a VA server .</tokentext>
<sentencetext>Did the Harvard study include the computer system used in the Veterans' Administration hospitals?It is an in-house system started in about 1980.It seems to serve the VA particularly well -- doctors, patients, labs as well as management.It is known as VISTA, and it can be tried and downloaded from a VA server.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280658</id>
	<title>um twits running hospitals</title>
	<author>CHRONOSS2008</author>
	<datestamp>1259661300000</datestamp>
	<modclass>None</modclass>
	<modscore>-1</modscore>
	<htmltext><p>A) when you have massive budgets people in that IT industry formmicrosoft WILL RIP YOU OFF<br>try linux and open source ITS FREE just hten have to hire a tech or three vs the entire marketing dept of MS plus 4 lawyers and a IT farm team<br>B) get rid a stupid old men running your IT depts they dont have a clue what a computer is , hten go back to A)</p><p>C) repeat as needed A) and B) save BIG BUCKS</p></htmltext>
<tokenext>A ) when you have massive budgets people in that IT industry formmicrosoft WILL RIP YOU OFFtry linux and open source ITS FREE just hten have to hire a tech or three vs the entire marketing dept of MS plus 4 lawyers and a IT farm teamB ) get rid a stupid old men running your IT depts they dont have a clue what a computer is , hten go back to A ) C ) repeat as needed A ) and B ) save BIG BUCKS</tokentext>
<sentencetext>A) when you have massive budgets people in that IT industry formmicrosoft WILL RIP YOU OFFtry linux and open source ITS FREE just hten have to hire a tech or three vs the entire marketing dept of MS plus 4 lawyers and a IT farm teamB) get rid a stupid old men running your IT depts they dont have a clue what a computer is , hten go back to A)C) repeat as needed A) and B) save BIG BUCKS</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280252</id>
	<title>Re:Transferability</title>
	<author>ximenes</author>
	<datestamp>1259699700000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>2</modscore>
	<htmltext><p>Your records belong to you. You can request them (and depending on the hospital / doctor's office, they may claim you can only receive copies or that they will only send them directly to your new healthcare provider) at any time and take them with you.</p></htmltext>
<tokenext>Your records belong to you .
You can request them ( and depending on the hospital / doctor 's office , they may claim you can only receive copies or that they will only send them directly to your new healthcare provider ) at any time and take them with you .</tokentext>
<sentencetext>Your records belong to you.
You can request them (and depending on the hospital / doctor's office, they may claim you can only receive copies or that they will only send them directly to your new healthcare provider) at any time and take them with you.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280240</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284234</id>
	<title>Staffing</title>
	<author>MikeURL</author>
	<datestamp>1259687460000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>At the end of the day the only way that "computers" save a business money is if they allow for staffing levels to be cut.  This works great in businesses where lives are not on the line.  In a hospital just using "computers" isn't going to mean that you can cut even one FTE employee.  In fact, if you don't implement the new system well you may wind up with people maintaining both electronic AND paper records.
<br> <br>
Further, we don't, and probably shouldn't, trust "computers" to do things like schedule surgery, administer medication, do consults, triage, etc etc etc.</htmltext>
<tokenext>At the end of the day the only way that " computers " save a business money is if they allow for staffing levels to be cut .
This works great in businesses where lives are not on the line .
In a hospital just using " computers " is n't going to mean that you can cut even one FTE employee .
In fact , if you do n't implement the new system well you may wind up with people maintaining both electronic AND paper records .
Further , we do n't , and probably should n't , trust " computers " to do things like schedule surgery , administer medication , do consults , triage , etc etc etc .</tokentext>
<sentencetext>At the end of the day the only way that "computers" save a business money is if they allow for staffing levels to be cut.
This works great in businesses where lives are not on the line.
In a hospital just using "computers" isn't going to mean that you can cut even one FTE employee.
In fact, if you don't implement the new system well you may wind up with people maintaining both electronic AND paper records.
Further, we don't, and probably shouldn't, trust "computers" to do things like schedule surgery, administer medication, do consults, triage, etc etc etc.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285314</id>
	<title>Usability</title>
	<author>Anonymous</author>
	<datestamp>1259692200000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>One problem is that some of the software that is used might not be so great. There's this one piece of software that I use that is ridiculously inefficient. When you do a electronic medication review, the software opens up an internal Internet Explorer browser window that medications administered for the current day. So to get to a particular day, you have to click a link in the browser window. So if you want to see information from several months ago, it takes a considerable amount of time. And that doesn't even factor in the times that the program doesn't respond when you click the link.</p><p>The human resource software can also be problematic. Set up is a pain. One particular web staffing solution I've used is so poorly designed that it's barely usable. But by far the worst one I've seen is this one staff scheduling software. It was clearly first written for DOS, because the calendars and job statuses are still represented using single characters, <b>including symbols</b>. So to decipher what they mean you need a friggin' rosetta stone. An "#" might be used to represent "out sick" for example. Then you get such fun situations with upper and lower case letters. So "A" could mean "Annual Leave" while "a" could mean "Absent". To make things even more complicated, there are several different calendars, from a preliminary one to a final one. So you could conceivably get confused and make changes to preliminary calendar thinking that it's the final one. Couple this with the fact that you have to select a date range, and it gets confusing real fast. It literally takes months to train people to use this piece of garbage.</p><p>Why the heck can't you just have one calendar for one employee? And instead of representing schedules using dollar signs and exclamation points, why can't each day just say a full word or phrase like "7 AM - 3 PM"?  Or "tentatively scheduled for 11 AM - 7 PM"?</p><p>In this day and age, we have display devices with thousands and pixels and user interfaces that allow you to zoom in and zoom out. We have plenty of metrics of usability. Yet we're still stuck with the lousy design paradigms of yesterday. It's no wonder that this technology costs so much but does so little.</p></htmltext>
<tokenext>One problem is that some of the software that is used might not be so great .
There 's this one piece of software that I use that is ridiculously inefficient .
When you do a electronic medication review , the software opens up an internal Internet Explorer browser window that medications administered for the current day .
So to get to a particular day , you have to click a link in the browser window .
So if you want to see information from several months ago , it takes a considerable amount of time .
And that does n't even factor in the times that the program does n't respond when you click the link.The human resource software can also be problematic .
Set up is a pain .
One particular web staffing solution I 've used is so poorly designed that it 's barely usable .
But by far the worst one I 've seen is this one staff scheduling software .
It was clearly first written for DOS , because the calendars and job statuses are still represented using single characters , including symbols .
So to decipher what they mean you need a friggin ' rosetta stone .
An " # " might be used to represent " out sick " for example .
Then you get such fun situations with upper and lower case letters .
So " A " could mean " Annual Leave " while " a " could mean " Absent " .
To make things even more complicated , there are several different calendars , from a preliminary one to a final one .
So you could conceivably get confused and make changes to preliminary calendar thinking that it 's the final one .
Couple this with the fact that you have to select a date range , and it gets confusing real fast .
It literally takes months to train people to use this piece of garbage.Why the heck ca n't you just have one calendar for one employee ?
And instead of representing schedules using dollar signs and exclamation points , why ca n't each day just say a full word or phrase like " 7 AM - 3 PM " ?
Or " tentatively scheduled for 11 AM - 7 PM " ? In this day and age , we have display devices with thousands and pixels and user interfaces that allow you to zoom in and zoom out .
We have plenty of metrics of usability .
Yet we 're still stuck with the lousy design paradigms of yesterday .
It 's no wonder that this technology costs so much but does so little .</tokentext>
<sentencetext>One problem is that some of the software that is used might not be so great.
There's this one piece of software that I use that is ridiculously inefficient.
When you do a electronic medication review, the software opens up an internal Internet Explorer browser window that medications administered for the current day.
So to get to a particular day, you have to click a link in the browser window.
So if you want to see information from several months ago, it takes a considerable amount of time.
And that doesn't even factor in the times that the program doesn't respond when you click the link.The human resource software can also be problematic.
Set up is a pain.
One particular web staffing solution I've used is so poorly designed that it's barely usable.
But by far the worst one I've seen is this one staff scheduling software.
It was clearly first written for DOS, because the calendars and job statuses are still represented using single characters, including symbols.
So to decipher what they mean you need a friggin' rosetta stone.
An "#" might be used to represent "out sick" for example.
Then you get such fun situations with upper and lower case letters.
So "A" could mean "Annual Leave" while "a" could mean "Absent".
To make things even more complicated, there are several different calendars, from a preliminary one to a final one.
So you could conceivably get confused and make changes to preliminary calendar thinking that it's the final one.
Couple this with the fact that you have to select a date range, and it gets confusing real fast.
It literally takes months to train people to use this piece of garbage.Why the heck can't you just have one calendar for one employee?
And instead of representing schedules using dollar signs and exclamation points, why can't each day just say a full word or phrase like "7 AM - 3 PM"?
Or "tentatively scheduled for 11 AM - 7 PM"?In this day and age, we have display devices with thousands and pixels and user interfaces that allow you to zoom in and zoom out.
We have plenty of metrics of usability.
Yet we're still stuck with the lousy design paradigms of yesterday.
It's no wonder that this technology costs so much but does so little.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280768</id>
	<title>Bollocks</title>
	<author>iamacat</author>
	<datestamp>1259662260000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Palo Alto medical foundation implemented online system to allow any doctor or patient to access patient's records and exchange e-mails. If you see a specialist and then go to a primary care physician for annual exam, he/she immediately sees what happened to you and what tests need to be done. Many routine matters like prescription renewals or questions about OTC drugs can be handled without revisiting the clinic. How is that not saving money or even health/lives?</p></htmltext>
<tokenext>Palo Alto medical foundation implemented online system to allow any doctor or patient to access patient 's records and exchange e-mails .
If you see a specialist and then go to a primary care physician for annual exam , he/she immediately sees what happened to you and what tests need to be done .
Many routine matters like prescription renewals or questions about OTC drugs can be handled without revisiting the clinic .
How is that not saving money or even health/lives ?</tokentext>
<sentencetext>Palo Alto medical foundation implemented online system to allow any doctor or patient to access patient's records and exchange e-mails.
If you see a specialist and then go to a primary care physician for annual exam, he/she immediately sees what happened to you and what tests need to be done.
Many routine matters like prescription renewals or questions about OTC drugs can be handled without revisiting the clinic.
How is that not saving money or even health/lives?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280832</id>
	<title>Remote access to specialists</title>
	<author>The Famous Druid</author>
	<datestamp>1259662860000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>2</modscore>
	<htmltext>I recently showed up at the ER late at night, with a broken wrist.<br>
The ER doctor looked at the X-rays, then called the fracture specialist at home, who looked at the X-rays on his home computer,
and passed on his advice to the ER doctor.<br> <br>

Let's see them do that without computers.</htmltext>
<tokenext>I recently showed up at the ER late at night , with a broken wrist .
The ER doctor looked at the X-rays , then called the fracture specialist at home , who looked at the X-rays on his home computer , and passed on his advice to the ER doctor .
Let 's see them do that without computers .</tokentext>
<sentencetext>I recently showed up at the ER late at night, with a broken wrist.
The ER doctor looked at the X-rays, then called the fracture specialist at home, who looked at the X-rays on his home computer,
and passed on his advice to the ER doctor.
Let's see them do that without computers.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282912</id>
	<title>They surveyed the wrong hospitals...</title>
	<author>wzinc</author>
	<datestamp>1259681760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I took a tour of our local hospital's IT facilities. The main thing they've saved money on is not having to reorder blood tests; computers mean less errors reading doctor's handwriting. That, alone, helps save lives by having fast, accurate results. There are several other efficiencies, such as storage and backup of patient data, CT and MRI modeling, etc. Those may not save money (maybe they do), but they make saving lives drastically more efficient.</p><p>They shouldn't make sweeping generalizations that no one is saving money or becoming more efficient.</p></htmltext>
<tokenext>I took a tour of our local hospital 's IT facilities .
The main thing they 've saved money on is not having to reorder blood tests ; computers mean less errors reading doctor 's handwriting .
That , alone , helps save lives by having fast , accurate results .
There are several other efficiencies , such as storage and backup of patient data , CT and MRI modeling , etc .
Those may not save money ( maybe they do ) , but they make saving lives drastically more efficient.They should n't make sweeping generalizations that no one is saving money or becoming more efficient .</tokentext>
<sentencetext>I took a tour of our local hospital's IT facilities.
The main thing they've saved money on is not having to reorder blood tests; computers mean less errors reading doctor's handwriting.
That, alone, helps save lives by having fast, accurate results.
There are several other efficiencies, such as storage and backup of patient data, CT and MRI modeling, etc.
Those may not save money (maybe they do), but they make saving lives drastically more efficient.They shouldn't make sweeping generalizations that no one is saving money or becoming more efficient.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280742</id>
	<title>Re:Let me explain...</title>
	<author>Anonymous</author>
	<datestamp>1259661960000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>5</modscore>
	<htmltext><p>&gt;You: Computers have made my life much easier.<br>&gt;Harvard study: Computers don't save hospitals money.</p><p>&gt;Note the slight difference there?</p><p>yes  - but you missed the bit about efficiency. "Computers have made my life much easier." is usually how we express efficiency.</p><p>Over a decade ago I did a stint at a hospital looking after the pathology database. When it was down and paper records were required then lives were at risk due to the lack of efficiency (time spent accessing paper). It honestly scared me!</p><p>
&nbsp; I'm sure things are much much more reliant on computers now. Computers are not just for the hospital admins.</p></htmltext>
<tokenext>&gt; You : Computers have made my life much easier. &gt; Harvard study : Computers do n't save hospitals money. &gt; Note the slight difference there ? yes - but you missed the bit about efficiency .
" Computers have made my life much easier .
" is usually how we express efficiency.Over a decade ago I did a stint at a hospital looking after the pathology database .
When it was down and paper records were required then lives were at risk due to the lack of efficiency ( time spent accessing paper ) .
It honestly scared me !
  I 'm sure things are much much more reliant on computers now .
Computers are not just for the hospital admins .</tokentext>
<sentencetext>&gt;You: Computers have made my life much easier.&gt;Harvard study: Computers don't save hospitals money.&gt;Note the slight difference there?yes  - but you missed the bit about efficiency.
"Computers have made my life much easier.
" is usually how we express efficiency.Over a decade ago I did a stint at a hospital looking after the pathology database.
When it was down and paper records were required then lives were at risk due to the lack of efficiency (time spent accessing paper).
It honestly scared me!
  I'm sure things are much much more reliant on computers now.
Computers are not just for the hospital admins.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280594</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284086</id>
	<title>Re:Let me explain...</title>
	<author>Anonymous</author>
	<datestamp>1259686860000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>At least part of the difference may be that becoming more efficient can actually cost them money due to fee-for-service.</p></htmltext>
<tokenext>At least part of the difference may be that becoming more efficient can actually cost them money due to fee-for-service .</tokentext>
<sentencetext>At least part of the difference may be that becoming more efficient can actually cost them money due to fee-for-service.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280594</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282434</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259679000000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>Best quote from the article:</p><blockquote><div><p>Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency -- and those hospitals custom-built their systems after computer system architects conducted months of research.</p><p>He pointed to Brigham and Women's Hospital in Boston, Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems. That's because they were intuitive and aimed at clinicians, not administrators.</p><p>Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training. "If you need a manual, then the system doesn't work. If you need training, the system doesn't work," he said.</p></div></blockquote><p>In other words, computers are not a magic bullet.  They only work well when you actually invest the time to find out what you need them to do, and then make them do that.</p></div><p>It's not surprising the systems became cost effective / efficient once they were accurately aimed at the end user, as they should have always been.</p></div>
	</htmltext>
<tokenext>Best quote from the article : Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency -- and those hospitals custom-built their systems after computer system architects conducted months of research.He pointed to Brigham and Women 's Hospital in Boston , Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems .
That 's because they were intuitive and aimed at clinicians , not administrators.Programmers of the successful systems told Himmelstein that they did n't write manuals or offer training .
" If you need a manual , then the system does n't work .
If you need training , the system does n't work , " he said.In other words , computers are not a magic bullet .
They only work well when you actually invest the time to find out what you need them to do , and then make them do that.It 's not surprising the systems became cost effective / efficient once they were accurately aimed at the end user , as they should have always been .</tokentext>
<sentencetext>Best quote from the article:Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency -- and those hospitals custom-built their systems after computer system architects conducted months of research.He pointed to Brigham and Women's Hospital in Boston, Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems.
That's because they were intuitive and aimed at clinicians, not administrators.Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training.
"If you need a manual, then the system doesn't work.
If you need training, the system doesn't work," he said.In other words, computers are not a magic bullet.
They only work well when you actually invest the time to find out what you need them to do, and then make them do that.It's not surprising the systems became cost effective / efficient once they were accurately aimed at the end user, as they should have always been.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280982</id>
	<title>Re:The key being ...</title>
	<author>Antiocheian</author>
	<datestamp>1259664240000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Please back that up.</p></htmltext>
<tokenext>Please back that up .</tokentext>
<sentencetext>Please back that up.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282878</id>
	<title>Paperless office</title>
	<author>p51d007</author>
	<datestamp>1259681580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>In the mid 80's, I first heard the notion of a paperless office.  Friends of mine told me I better find a new line of work (I repair office machines).
Well, here we are 20+ years later &amp; I'm still doing the same thing. Not only did we not get a paperless office, we have MORE.
Every time the government comes up with a new regulation, my business goes UP.  Add to that, these machines are now interconnected
and do multiple tasks.
All a computer does is make it easier for bureaucrats to justify themselves by producing more and more detailed reports on the tookpick
inventory.  Unfortunately, they still don't understand how a computer or interconnected device can help the guys in the trenches do their
job.  Most of my career has been spent inside a large hospital complex, and a few years ago they started computerizing everything.
Now it appears that it takes the nurses longer to do their jobs because of the do-dads they have to carry around and scan everything
they do.  Does it help cut down on mistakes, more than likely, but, if you want to see things really slow down, watch what happens
when the entire system goes down, and the younger nurses/staff don't know how to treat someone the old fashioned way, by writing
everything down and doing everything by hand.
It's the same principal as why teachers require you to "show your work".  You could punch something into a hand held calculator
all day long but if you don't know the basics of how to do something, you're screwed.</htmltext>
<tokenext>In the mid 80 's , I first heard the notion of a paperless office .
Friends of mine told me I better find a new line of work ( I repair office machines ) .
Well , here we are 20 + years later &amp; I 'm still doing the same thing .
Not only did we not get a paperless office , we have MORE .
Every time the government comes up with a new regulation , my business goes UP .
Add to that , these machines are now interconnected and do multiple tasks .
All a computer does is make it easier for bureaucrats to justify themselves by producing more and more detailed reports on the tookpick inventory .
Unfortunately , they still do n't understand how a computer or interconnected device can help the guys in the trenches do their job .
Most of my career has been spent inside a large hospital complex , and a few years ago they started computerizing everything .
Now it appears that it takes the nurses longer to do their jobs because of the do-dads they have to carry around and scan everything they do .
Does it help cut down on mistakes , more than likely , but , if you want to see things really slow down , watch what happens when the entire system goes down , and the younger nurses/staff do n't know how to treat someone the old fashioned way , by writing everything down and doing everything by hand .
It 's the same principal as why teachers require you to " show your work " .
You could punch something into a hand held calculator all day long but if you do n't know the basics of how to do something , you 're screwed .</tokentext>
<sentencetext>In the mid 80's, I first heard the notion of a paperless office.
Friends of mine told me I better find a new line of work (I repair office machines).
Well, here we are 20+ years later &amp; I'm still doing the same thing.
Not only did we not get a paperless office, we have MORE.
Every time the government comes up with a new regulation, my business goes UP.
Add to that, these machines are now interconnected
and do multiple tasks.
All a computer does is make it easier for bureaucrats to justify themselves by producing more and more detailed reports on the tookpick
inventory.
Unfortunately, they still don't understand how a computer or interconnected device can help the guys in the trenches do their
job.
Most of my career has been spent inside a large hospital complex, and a few years ago they started computerizing everything.
Now it appears that it takes the nurses longer to do their jobs because of the do-dads they have to carry around and scan everything
they do.
Does it help cut down on mistakes, more than likely, but, if you want to see things really slow down, watch what happens
when the entire system goes down, and the younger nurses/staff don't know how to treat someone the old fashioned way, by writing
everything down and doing everything by hand.
It's the same principal as why teachers require you to "show your work".
You could punch something into a hand held calculator
all day long but if you don't know the basics of how to do something, you're screwed.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280602</id>
	<title>Re:I would also guess...</title>
	<author>Frosty Piss</author>
	<datestamp>1259660640000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>35+ old fogies that don't know that IE isn't the Intertubes? Good grief! How old are you? Oh, wait, there's a MySpace linky in your sig.</htmltext>
<tokenext>35 + old fogies that do n't know that IE is n't the Intertubes ?
Good grief !
How old are you ?
Oh , wait , there 's a MySpace linky in your sig .</tokentext>
<sentencetext>35+ old fogies that don't know that IE isn't the Intertubes?
Good grief!
How old are you?
Oh, wait, there's a MySpace linky in your sig.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280274</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280946</id>
	<title>So?</title>
	<author>UnixUnix</author>
	<datestamp>1259664000000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>

They save lives, not money.</htmltext>
<tokenext>They save lives , not money .</tokentext>
<sentencetext>

They save lives, not money.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281804</id>
	<title>What b*llsh*t on a stick (forgive my french)</title>
	<author>forgot\_my\_username</author>
	<datestamp>1259673480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>No, they dont save time.<br>
But, they do save people....<br>
Sigh... Vista... the VA's medical informatic system reduced dispensing (medicine) errors by something like 90\%.
<br> <br> <br> <br> <br>


So in the words of my forefathers... Intercourse Efficiency</htmltext>
<tokenext>No , they dont save time .
But , they do save people... . Sigh... Vista... the VA 's medical informatic system reduced dispensing ( medicine ) errors by something like 90 \ % .
So in the words of my forefathers... Intercourse Efficiency</tokentext>
<sentencetext>No, they dont save time.
But, they do save people....
Sigh... Vista... the VA's medical informatic system reduced dispensing (medicine) errors by something like 90\%.
So in the words of my forefathers... Intercourse Efficiency</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282770</id>
	<title>In a related story...</title>
	<author>Halotron1</author>
	<datestamp>1259680800000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>MIT releases research proving that lawyers don't save hospitals money either.</p><p>Suck it Harvard!</p></htmltext>
<tokenext>MIT releases research proving that lawyers do n't save hospitals money either.Suck it Harvard !</tokentext>
<sentencetext>MIT releases research proving that lawyers don't save hospitals money either.Suck it Harvard!</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</id>
	<title>Re:Well</title>
	<author>Anonymous</author>
	<datestamp>1259658300000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>5</modscore>
	<htmltext><p>I work in a hospital as an interpreter, so I see a lot of how people use computers... and how they don't. Generally in the ER, the patient first sees the triage nurse, who asks a series of questions. The answers all get entered into the computer. Then the patient sees their actual nurse, who asks many of the same questions again. This information may or may not get entered in the computer. Then the PA comes in and asks the same questions a third time. This time, the information gets written on a piece of paper, or maybe a tablet computer. Eventually, the attending physician stops in just long enough to ask the same questions a fourth time, and doesn't enter the info anywhere. If the patient is admitted and sent to another department, the process starts over.</p></htmltext>
<tokenext>I work in a hospital as an interpreter , so I see a lot of how people use computers... and how they do n't .
Generally in the ER , the patient first sees the triage nurse , who asks a series of questions .
The answers all get entered into the computer .
Then the patient sees their actual nurse , who asks many of the same questions again .
This information may or may not get entered in the computer .
Then the PA comes in and asks the same questions a third time .
This time , the information gets written on a piece of paper , or maybe a tablet computer .
Eventually , the attending physician stops in just long enough to ask the same questions a fourth time , and does n't enter the info anywhere .
If the patient is admitted and sent to another department , the process starts over .</tokentext>
<sentencetext>I work in a hospital as an interpreter, so I see a lot of how people use computers... and how they don't.
Generally in the ER, the patient first sees the triage nurse, who asks a series of questions.
The answers all get entered into the computer.
Then the patient sees their actual nurse, who asks many of the same questions again.
This information may or may not get entered in the computer.
Then the PA comes in and asks the same questions a third time.
This time, the information gets written on a piece of paper, or maybe a tablet computer.
Eventually, the attending physician stops in just long enough to ask the same questions a fourth time, and doesn't enter the info anywhere.
If the patient is admitted and sent to another department, the process starts over.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280692</id>
	<title>They save lives, not money</title>
	<author>Anonymous</author>
	<datestamp>1259661480000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Remember - Harvard has other agendas beside the public good.</p></htmltext>
<tokenext>Remember - Harvard has other agendas beside the public good .</tokentext>
<sentencetext>Remember - Harvard has other agendas beside the public good.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280532</id>
	<title>Designed for Entrepreneurs</title>
	<author>wrook</author>
	<datestamp>1259659800000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>4</modscore>
	<htmltext><p>Computerized health care systems are not designed for the benefit of hospitals.  They are designed for the benefit of entrepreneurs.</p><p>Health care is a multi-bazillion dollar industry where information is managed via bearskins and stone knives.  Development of an integrated computerized health care system will net the intelligent investor more money than even Microsoft can dream about.</p><p>This is the message that people I will call "serial entrepreneurs" pitch.  Their intent is not to build such a system (that would be nigh on impossible given the absolute chaos of incompatible processes that currently exist in hospitals).  They simply want to build a system that looks close enough that stupid investors will throw millions of dollars at it.  The potential payoff is so big (seemingly) that people will keep throwing money at it even after said entrepreneurs have razed and burned a stack of companies.</p><p>Of course, eventually there *will* be a company that succeeds (mostly by accident).  That company will run suspiciously like SAP where there will be a very complex set of computer programs designed to support an even more complex set of processes.  These processes in turn will have nothing to do with the underlying business of providing health care.  However senior management will be ecstatic that they finally have a unifying computer based process, and the only people who fully realize its true futility will be the people doing the work.  They, of course, will be ignored.</p></htmltext>
<tokenext>Computerized health care systems are not designed for the benefit of hospitals .
They are designed for the benefit of entrepreneurs.Health care is a multi-bazillion dollar industry where information is managed via bearskins and stone knives .
Development of an integrated computerized health care system will net the intelligent investor more money than even Microsoft can dream about.This is the message that people I will call " serial entrepreneurs " pitch .
Their intent is not to build such a system ( that would be nigh on impossible given the absolute chaos of incompatible processes that currently exist in hospitals ) .
They simply want to build a system that looks close enough that stupid investors will throw millions of dollars at it .
The potential payoff is so big ( seemingly ) that people will keep throwing money at it even after said entrepreneurs have razed and burned a stack of companies.Of course , eventually there * will * be a company that succeeds ( mostly by accident ) .
That company will run suspiciously like SAP where there will be a very complex set of computer programs designed to support an even more complex set of processes .
These processes in turn will have nothing to do with the underlying business of providing health care .
However senior management will be ecstatic that they finally have a unifying computer based process , and the only people who fully realize its true futility will be the people doing the work .
They , of course , will be ignored .</tokentext>
<sentencetext>Computerized health care systems are not designed for the benefit of hospitals.
They are designed for the benefit of entrepreneurs.Health care is a multi-bazillion dollar industry where information is managed via bearskins and stone knives.
Development of an integrated computerized health care system will net the intelligent investor more money than even Microsoft can dream about.This is the message that people I will call "serial entrepreneurs" pitch.
Their intent is not to build such a system (that would be nigh on impossible given the absolute chaos of incompatible processes that currently exist in hospitals).
They simply want to build a system that looks close enough that stupid investors will throw millions of dollars at it.
The potential payoff is so big (seemingly) that people will keep throwing money at it even after said entrepreneurs have razed and burned a stack of companies.Of course, eventually there *will* be a company that succeeds (mostly by accident).
That company will run suspiciously like SAP where there will be a very complex set of computer programs designed to support an even more complex set of processes.
These processes in turn will have nothing to do with the underlying business of providing health care.
However senior management will be ecstatic that they finally have a unifying computer based process, and the only people who fully realize its true futility will be the people doing the work.
They, of course, will be ignored.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285924</id>
	<title>Can't support the docs if they won't cooperate.</title>
	<author>Hasai</author>
	<datestamp>1259694480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>"....most of the IT systems were aimed at improving efficiency for hospital management &mdash; not doctors, nurses, and medical technicians...."</p><p>And there's your problem. Ask any hospital chief of staff, and they'll tell you that most doctors think the sun rises and sets over their arses. Trying to get a bunch of them to participate as stakeholders in an IT project is something I wouldn't want to wish on anyone . . . . Except for the twits who wrote this article.</p></htmltext>
<tokenext>" ....most of the IT systems were aimed at improving efficiency for hospital management    not doctors , nurses , and medical technicians.... " And there 's your problem .
Ask any hospital chief of staff , and they 'll tell you that most doctors think the sun rises and sets over their arses .
Trying to get a bunch of them to participate as stakeholders in an IT project is something I would n't want to wish on anyone .
. .
. Except for the twits who wrote this article .</tokentext>
<sentencetext>"....most of the IT systems were aimed at improving efficiency for hospital management — not doctors, nurses, and medical technicians...."And there's your problem.
Ask any hospital chief of staff, and they'll tell you that most doctors think the sun rises and sets over their arses.
Trying to get a bunch of them to participate as stakeholders in an IT project is something I wouldn't want to wish on anyone .
. .
. Except for the twits who wrote this article.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281028</id>
	<title>Maybe in America, but look at Belgium!</title>
	<author>Anonymous</author>
	<datestamp>1259664720000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>Doctors do not hold much power when it comes to IT.</p></div><p>Excuse me? In Belgium, IT transition was bottom-up; it started with the GPs. This is because our health care system is also heavily based on the work of GPs, they are the most basic and essential doctors for a well-working system. There are loads of software companies making tools for keeping track of patient records. In later stages, these companies developed intercommunication protocols, so a follow-up on a patient with another doctor is easy as hell.</p><p>My dad is a GP. He keeps track of all examinations, medication prescribed, etc within an integrated environment. Pharmacists run different software, but intercommunication protocols make sure the GP gets a message when the patient picked up his prescribed pills. When the GP refers someone to a specialist, he gets a detailed report in his software environment about the examination the specialist performed. Same with bloodwork, urine analysis,<nobr> <wbr></nobr>...<br>This software propagated to hospitals, so it is now omni-present throughout all levels of health care. Management probably uses the most basic information from this system to provide financial reports to the government or university.</p><p>Of course, in a country where health care is driven by monetary gain, IT transitions will be driven by management. And will fail horribly. Dr. Himmelstein would do good to look at a country like Belgium; we are regarded as the best, most efficient health-care in Europe. Looks like you Americans finally took your first steps in our direction, but you're still not quite there...</p></div>
	</htmltext>
<tokenext>Doctors do not hold much power when it comes to IT.Excuse me ?
In Belgium , IT transition was bottom-up ; it started with the GPs .
This is because our health care system is also heavily based on the work of GPs , they are the most basic and essential doctors for a well-working system .
There are loads of software companies making tools for keeping track of patient records .
In later stages , these companies developed intercommunication protocols , so a follow-up on a patient with another doctor is easy as hell.My dad is a GP .
He keeps track of all examinations , medication prescribed , etc within an integrated environment .
Pharmacists run different software , but intercommunication protocols make sure the GP gets a message when the patient picked up his prescribed pills .
When the GP refers someone to a specialist , he gets a detailed report in his software environment about the examination the specialist performed .
Same with bloodwork , urine analysis , ...This software propagated to hospitals , so it is now omni-present throughout all levels of health care .
Management probably uses the most basic information from this system to provide financial reports to the government or university.Of course , in a country where health care is driven by monetary gain , IT transitions will be driven by management .
And will fail horribly .
Dr. Himmelstein would do good to look at a country like Belgium ; we are regarded as the best , most efficient health-care in Europe .
Looks like you Americans finally took your first steps in our direction , but you 're still not quite there.. .</tokentext>
<sentencetext>Doctors do not hold much power when it comes to IT.Excuse me?
In Belgium, IT transition was bottom-up; it started with the GPs.
This is because our health care system is also heavily based on the work of GPs, they are the most basic and essential doctors for a well-working system.
There are loads of software companies making tools for keeping track of patient records.
In later stages, these companies developed intercommunication protocols, so a follow-up on a patient with another doctor is easy as hell.My dad is a GP.
He keeps track of all examinations, medication prescribed, etc within an integrated environment.
Pharmacists run different software, but intercommunication protocols make sure the GP gets a message when the patient picked up his prescribed pills.
When the GP refers someone to a specialist, he gets a detailed report in his software environment about the examination the specialist performed.
Same with bloodwork, urine analysis, ...This software propagated to hospitals, so it is now omni-present throughout all levels of health care.
Management probably uses the most basic information from this system to provide financial reports to the government or university.Of course, in a country where health care is driven by monetary gain, IT transitions will be driven by management.
And will fail horribly.
Dr. Himmelstein would do good to look at a country like Belgium; we are regarded as the best, most efficient health-care in Europe.
Looks like you Americans finally took your first steps in our direction, but you're still not quite there...
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283942</id>
	<title>Re:I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259686200000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Should have been.</p><p>You and the first poster are helping to illustrate exactly what the problem is. If done right, computers can greatly improve medical efficiency and accuracy. What this study shows is that most hospitals <em>haven't done it right</em>. The conclusions are spot on for the typical case; Hospitals purchase systems designed by and for accountants and managers instead of systems designed by and for physicians. So you see systems that are well designed for scheduling work hours and billing, but terrible for record keeping and <em>completely counterproductive</em> for scheduling for <em>patients</em> who, surprise, have no responsibility to keep the schedule your software "efficiently" calculated for them.</p><p>To be done right, this "ERP for hospitals" needs to be designed by people with experience working in a hospital, including people with experience from all divisions and occupations in the hospital. M.D.s don't like being told this, but they are not experts on what physical therapy or radiology (as two examples) need any more than an accountant would be.</p><p>It should be common sense: Let experts design the system. But this common sense is, as always, uncommon.</p></htmltext>
<tokenext>Should have been.You and the first poster are helping to illustrate exactly what the problem is .
If done right , computers can greatly improve medical efficiency and accuracy .
What this study shows is that most hospitals have n't done it right .
The conclusions are spot on for the typical case ; Hospitals purchase systems designed by and for accountants and managers instead of systems designed by and for physicians .
So you see systems that are well designed for scheduling work hours and billing , but terrible for record keeping and completely counterproductive for scheduling for patients who , surprise , have no responsibility to keep the schedule your software " efficiently " calculated for them.To be done right , this " ERP for hospitals " needs to be designed by people with experience working in a hospital , including people with experience from all divisions and occupations in the hospital .
M.D.s do n't like being told this , but they are not experts on what physical therapy or radiology ( as two examples ) need any more than an accountant would be.It should be common sense : Let experts design the system .
But this common sense is , as always , uncommon .</tokentext>
<sentencetext>Should have been.You and the first poster are helping to illustrate exactly what the problem is.
If done right, computers can greatly improve medical efficiency and accuracy.
What this study shows is that most hospitals haven't done it right.
The conclusions are spot on for the typical case; Hospitals purchase systems designed by and for accountants and managers instead of systems designed by and for physicians.
So you see systems that are well designed for scheduling work hours and billing, but terrible for record keeping and completely counterproductive for scheduling for patients who, surprise, have no responsibility to keep the schedule your software "efficiently" calculated for them.To be done right, this "ERP for hospitals" needs to be designed by people with experience working in a hospital, including people with experience from all divisions and occupations in the hospital.
M.D.s don't like being told this, but they are not experts on what physical therapy or radiology (as two examples) need any more than an accountant would be.It should be common sense: Let experts design the system.
But this common sense is, as always, uncommon.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280510</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284420</id>
	<title>Re:The key being ...</title>
	<author>jollyreaper</author>
	<datestamp>1259688300000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>In other words, computers are not a magic bullet. They only work well when you actually invest the time to find out what you need them to do, and then make them do that.</p></div><p>That's what I try to tell people at my place. If an EMP hit tomorrow and we were going to move all our business processes back to paper, we'd still be dealing with the same basic theory of information management. Customer ID number? They existed before computers. Why? You tell me which John Smith we're talking about, we've got ten in the files. Double-entry bookkeeping? We had that long before we had computers. Standardizing the records? You'd be doing that with 3x5's and card files. Last name, first name, middle initial, do it the same for all of them.</p><p>You can't automate a broken process. Get the logic working so that you can run it on paper, then we can talk about putting it in a computer. At best all a computer can do with a broken process is fuck it to pieces.</p></div>
	</htmltext>
<tokenext>In other words , computers are not a magic bullet .
They only work well when you actually invest the time to find out what you need them to do , and then make them do that.That 's what I try to tell people at my place .
If an EMP hit tomorrow and we were going to move all our business processes back to paper , we 'd still be dealing with the same basic theory of information management .
Customer ID number ?
They existed before computers .
Why ? You tell me which John Smith we 're talking about , we 've got ten in the files .
Double-entry bookkeeping ?
We had that long before we had computers .
Standardizing the records ?
You 'd be doing that with 3x5 's and card files .
Last name , first name , middle initial , do it the same for all of them.You ca n't automate a broken process .
Get the logic working so that you can run it on paper , then we can talk about putting it in a computer .
At best all a computer can do with a broken process is fuck it to pieces .</tokentext>
<sentencetext>In other words, computers are not a magic bullet.
They only work well when you actually invest the time to find out what you need them to do, and then make them do that.That's what I try to tell people at my place.
If an EMP hit tomorrow and we were going to move all our business processes back to paper, we'd still be dealing with the same basic theory of information management.
Customer ID number?
They existed before computers.
Why? You tell me which John Smith we're talking about, we've got ten in the files.
Double-entry bookkeeping?
We had that long before we had computers.
Standardizing the records?
You'd be doing that with 3x5's and card files.
Last name, first name, middle initial, do it the same for all of them.You can't automate a broken process.
Get the logic working so that you can run it on paper, then we can talk about putting it in a computer.
At best all a computer can do with a broken process is fuck it to pieces.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30286944</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259697960000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>"If you need training, the system doesn't work"</p></div><p>Maybe we should start by getting rid of all these cars, they obviously don't work because they require training to operate<nobr> <wbr></nobr>...</p></div>
	</htmltext>
<tokenext>" If you need training , the system does n't work " Maybe we should start by getting rid of all these cars , they obviously do n't work because they require training to operate .. .</tokentext>
<sentencetext>"If you need training, the system doesn't work"Maybe we should start by getting rid of all these cars, they obviously don't work because they require training to operate ...
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281844</id>
	<title>The question that they forgot to ask ....</title>
	<author>CalcuttaWala</author>
	<datestamp>1259674020000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>was whether the Hospitals could have at all managed to deliver the kind of services WITHOUT the systems that they are using today. We know that hospitals can operate without computer ( there are enough of them where I live, in India ) but the real question is how efficiently do these computer-less hospitals operate ? the queues ? the chaos ? if not the gross corruption ?  We know that computer system cannot solve a problem when the underlying physical system is broken but it sure helps to have a computer around -- a computer is necessary, but not sufficient to solve major business problems.

 And do not expect to calculate a Return-On-Investment on IT systems ( of the kind that can be done with other machines )<nobr> <wbr></nobr>.... consultants and CIO have tried for years to do so and have realised that the answer simply does not exist.</htmltext>
<tokenext>was whether the Hospitals could have at all managed to deliver the kind of services WITHOUT the systems that they are using today .
We know that hospitals can operate without computer ( there are enough of them where I live , in India ) but the real question is how efficiently do these computer-less hospitals operate ?
the queues ?
the chaos ?
if not the gross corruption ?
We know that computer system can not solve a problem when the underlying physical system is broken but it sure helps to have a computer around -- a computer is necessary , but not sufficient to solve major business problems .
And do not expect to calculate a Return-On-Investment on IT systems ( of the kind that can be done with other machines ) .... consultants and CIO have tried for years to do so and have realised that the answer simply does not exist .</tokentext>
<sentencetext>was whether the Hospitals could have at all managed to deliver the kind of services WITHOUT the systems that they are using today.
We know that hospitals can operate without computer ( there are enough of them where I live, in India ) but the real question is how efficiently do these computer-less hospitals operate ?
the queues ?
the chaos ?
if not the gross corruption ?
We know that computer system cannot solve a problem when the underlying physical system is broken but it sure helps to have a computer around -- a computer is necessary, but not sufficient to solve major business problems.
And do not expect to calculate a Return-On-Investment on IT systems ( of the kind that can be done with other machines ) .... consultants and CIO have tried for years to do so and have realised that the answer simply does not exist.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280918</id>
	<title>NHS Comparison</title>
	<author>asc99c</author>
	<datestamp>1259663700000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>For a while in the UK, the government has been spending billions of pounds on NHS IT systems.  There is enormous potential to improve the situation, but so far it just hasn't been used.  The prime example is electronic medical notes as mentioned in the article.</p><p>Currently, I live and work 22 miles apart.  I'm only allowed to use the doctor near my home, even though they are only open during working hours.  The reason for this is my medical notes - f I need an emergency home visit (I never have) they will need my medical notes.  Therefore it's essential my doctor is the one near my home.  The government has spent millions on electronic systems for keeping these medical notes electronically, instead of paper based.  Yet they somehow can't share the notes between two surgeries.  If they could, it would vastly improve patient care.  I could have a half hour trip to the doctor for my asthma checkup, instead of needing half a day off work.  And if I ever visited hospital they would be able to see all notes taken about me by my GP.  Although in my case there's nothing really to know.</p><p>In terms of saving money, I actually agree with the current intended usage.  Computers currently will only be able to save money on administration type work.  I don't think they will be able to significantly help doctors save money on direct patient care.  That task is too difficult for computers right now, which is why we pay doctors a lot of money to do the job.  I suppose it depends on where you draw the line between admin / patient care.  What would scheduling operations, along with marshalling the resources of operating rooms, and correctly trained doctors and nurses fall under?  I'd call that admin and say that it's the sort of thing a computer could probably do better than a person.</p></htmltext>
<tokenext>For a while in the UK , the government has been spending billions of pounds on NHS IT systems .
There is enormous potential to improve the situation , but so far it just has n't been used .
The prime example is electronic medical notes as mentioned in the article.Currently , I live and work 22 miles apart .
I 'm only allowed to use the doctor near my home , even though they are only open during working hours .
The reason for this is my medical notes - f I need an emergency home visit ( I never have ) they will need my medical notes .
Therefore it 's essential my doctor is the one near my home .
The government has spent millions on electronic systems for keeping these medical notes electronically , instead of paper based .
Yet they somehow ca n't share the notes between two surgeries .
If they could , it would vastly improve patient care .
I could have a half hour trip to the doctor for my asthma checkup , instead of needing half a day off work .
And if I ever visited hospital they would be able to see all notes taken about me by my GP .
Although in my case there 's nothing really to know.In terms of saving money , I actually agree with the current intended usage .
Computers currently will only be able to save money on administration type work .
I do n't think they will be able to significantly help doctors save money on direct patient care .
That task is too difficult for computers right now , which is why we pay doctors a lot of money to do the job .
I suppose it depends on where you draw the line between admin / patient care .
What would scheduling operations , along with marshalling the resources of operating rooms , and correctly trained doctors and nurses fall under ?
I 'd call that admin and say that it 's the sort of thing a computer could probably do better than a person .</tokentext>
<sentencetext>For a while in the UK, the government has been spending billions of pounds on NHS IT systems.
There is enormous potential to improve the situation, but so far it just hasn't been used.
The prime example is electronic medical notes as mentioned in the article.Currently, I live and work 22 miles apart.
I'm only allowed to use the doctor near my home, even though they are only open during working hours.
The reason for this is my medical notes - f I need an emergency home visit (I never have) they will need my medical notes.
Therefore it's essential my doctor is the one near my home.
The government has spent millions on electronic systems for keeping these medical notes electronically, instead of paper based.
Yet they somehow can't share the notes between two surgeries.
If they could, it would vastly improve patient care.
I could have a half hour trip to the doctor for my asthma checkup, instead of needing half a day off work.
And if I ever visited hospital they would be able to see all notes taken about me by my GP.
Although in my case there's nothing really to know.In terms of saving money, I actually agree with the current intended usage.
Computers currently will only be able to save money on administration type work.
I don't think they will be able to significantly help doctors save money on direct patient care.
That task is too difficult for computers right now, which is why we pay doctors a lot of money to do the job.
I suppose it depends on where you draw the line between admin / patient care.
What would scheduling operations, along with marshalling the resources of operating rooms, and correctly trained doctors and nurses fall under?
I'd call that admin and say that it's the sort of thing a computer could probably do better than a person.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282258</id>
	<title>Re:The key being ...</title>
	<author>indiechild</author>
	<datestamp>1259677980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>The "magic bullet" is usability. Those who understand the power of usability and high quality user-friendly interfaces are those who succeed in an otherwise mediocre marketplace.</p></htmltext>
<tokenext>The " magic bullet " is usability .
Those who understand the power of usability and high quality user-friendly interfaces are those who succeed in an otherwise mediocre marketplace .</tokentext>
<sentencetext>The "magic bullet" is usability.
Those who understand the power of usability and high quality user-friendly interfaces are those who succeed in an otherwise mediocre marketplace.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280846</id>
	<title>How you save money in the health system</title>
	<author>prefec2</author>
	<datestamp>1259662980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Honestly if you want to increase the average health care, which means the health care for most people and only pay 50\% of what you pay now, just change your health care system to any system in West Europe (except the British one). Even the German one is better and that still sucks. BTW computer can be a helpful tool to manage data, but that is often not the real problem. In most cases it is bad management, induced by the wrong goals.</p></htmltext>
<tokenext>Honestly if you want to increase the average health care , which means the health care for most people and only pay 50 \ % of what you pay now , just change your health care system to any system in West Europe ( except the British one ) .
Even the German one is better and that still sucks .
BTW computer can be a helpful tool to manage data , but that is often not the real problem .
In most cases it is bad management , induced by the wrong goals .</tokentext>
<sentencetext>Honestly if you want to increase the average health care, which means the health care for most people and only pay 50\% of what you pay now, just change your health care system to any system in West Europe (except the British one).
Even the German one is better and that still sucks.
BTW computer can be a helpful tool to manage data, but that is often not the real problem.
In most cases it is bad management, induced by the wrong goals.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281696</id>
	<title>possible reasons why</title>
	<author>viralMeme</author>
	<datestamp>1259672340000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext>"The study also showed most of the IT systems were aimed at improving efficiency for hospital management -- not doctors, nurses, and medical technicians"</htmltext>
<tokenext>" The study also showed most of the IT systems were aimed at improving efficiency for hospital management -- not doctors , nurses , and medical technicians "</tokentext>
<sentencetext>"The study also showed most of the IT systems were aimed at improving efficiency for hospital management -- not doctors, nurses, and medical technicians"</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283916</id>
	<title>Re:Well</title>
	<author>pnutjam</author>
	<datestamp>1259686080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><b> <i>cognitive drift</i></b><nobr> <wbr></nobr>...<br>
The story of my life...</htmltext>
<tokenext>cognitive drift .. . The story of my life.. .</tokentext>
<sentencetext> cognitive drift ...
The story of my life...</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30335652</id>
	<title>Ideally</title>
	<author>Geminii</author>
	<datestamp>1260034440000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Short of a full-hospital AI, there needs to be some way to allow doctors and other medical staff to call up any relevant information for a given case - potentially meaning anything at all which has been presented to hospital staff or approved external medical channels. Every question asked, every scan done with any instrument, every moment that a patient is on a security, ER, or ambulance camera, needs to be able to be summoned up with a snap of the fingers or a flicker of the eye. Information is no good if it never goes anywhere, or goes into a dead end in some physical or digital filing cabinet.
</p><p>
Staff could even have their infocloud viewpoint personalised based on their hospital function, personal qualifications, and previous patterns of search/use, edged with additional data drawn from likely helpful sources based on the use-patterns of other staff, the similarities between positions and processes between them, and even a patient's particular medical history. That way, a fresh newbie with a particular job title would start with a default set of views based on the averages of other people who have been doing the job for a while, and which would rapidly adjust and speed up as they establish personal methodologies.</p></htmltext>
<tokenext>Short of a full-hospital AI , there needs to be some way to allow doctors and other medical staff to call up any relevant information for a given case - potentially meaning anything at all which has been presented to hospital staff or approved external medical channels .
Every question asked , every scan done with any instrument , every moment that a patient is on a security , ER , or ambulance camera , needs to be able to be summoned up with a snap of the fingers or a flicker of the eye .
Information is no good if it never goes anywhere , or goes into a dead end in some physical or digital filing cabinet .
Staff could even have their infocloud viewpoint personalised based on their hospital function , personal qualifications , and previous patterns of search/use , edged with additional data drawn from likely helpful sources based on the use-patterns of other staff , the similarities between positions and processes between them , and even a patient 's particular medical history .
That way , a fresh newbie with a particular job title would start with a default set of views based on the averages of other people who have been doing the job for a while , and which would rapidly adjust and speed up as they establish personal methodologies .</tokentext>
<sentencetext>Short of a full-hospital AI, there needs to be some way to allow doctors and other medical staff to call up any relevant information for a given case - potentially meaning anything at all which has been presented to hospital staff or approved external medical channels.
Every question asked, every scan done with any instrument, every moment that a patient is on a security, ER, or ambulance camera, needs to be able to be summoned up with a snap of the fingers or a flicker of the eye.
Information is no good if it never goes anywhere, or goes into a dead end in some physical or digital filing cabinet.
Staff could even have their infocloud viewpoint personalised based on their hospital function, personal qualifications, and previous patterns of search/use, edged with additional data drawn from likely helpful sources based on the use-patterns of other staff, the similarities between positions and processes between them, and even a patient's particular medical history.
That way, a fresh newbie with a particular job title would start with a default set of views based on the averages of other people who have been doing the job for a while, and which would rapidly adjust and speed up as they establish personal methodologies.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283926</id>
	<title>Money?</title>
	<author>DarthVain</author>
	<datestamp>1259686080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I'm from Soviet Canuckistan you insensitive clods!</p><p>Seriously though, I would think that IT and the health industry would be about increased service (say in patient records) not about saving money.</p></htmltext>
<tokenext>I 'm from Soviet Canuckistan you insensitive clods ! Seriously though , I would think that IT and the health industry would be about increased service ( say in patient records ) not about saving money .</tokentext>
<sentencetext>I'm from Soviet Canuckistan you insensitive clods!Seriously though, I would think that IT and the health industry would be about increased service (say in patient records) not about saving money.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281292</id>
	<title>Re:Well</title>
	<author>Anonymous</author>
	<datestamp>1259667600000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>And another anecdotal data point: 20 plus years ago, a cerebral aneurysm took me down hard - while still conscious, I had to explain my entire medical history and personal symptoms to SIX consecutive attendants, from the ambulance drivers through ER and finally the neurosurgeon, all whilst in quite uncomfortable pain. And there weren't any computers to speak of at all at the time. The computers slow it all down even further, BUT would be much more convenient in the scenario had I fallen unconscious after the first such inquiry. As others have remarked, though, the computer system screw-ups are more often a combination of officiousness, inefficiencies, poor design, poor management decisions and bad implementation through poor commissioning and training procedures. Not to forget that medical info is a BIG ball of wax and getting everyone in a modern hospital to sing from the same song sheet is nigh impossible in the first place.</p></htmltext>
<tokenext>And another anecdotal data point : 20 plus years ago , a cerebral aneurysm took me down hard - while still conscious , I had to explain my entire medical history and personal symptoms to SIX consecutive attendants , from the ambulance drivers through ER and finally the neurosurgeon , all whilst in quite uncomfortable pain .
And there were n't any computers to speak of at all at the time .
The computers slow it all down even further , BUT would be much more convenient in the scenario had I fallen unconscious after the first such inquiry .
As others have remarked , though , the computer system screw-ups are more often a combination of officiousness , inefficiencies , poor design , poor management decisions and bad implementation through poor commissioning and training procedures .
Not to forget that medical info is a BIG ball of wax and getting everyone in a modern hospital to sing from the same song sheet is nigh impossible in the first place .</tokentext>
<sentencetext>And another anecdotal data point: 20 plus years ago, a cerebral aneurysm took me down hard - while still conscious, I had to explain my entire medical history and personal symptoms to SIX consecutive attendants, from the ambulance drivers through ER and finally the neurosurgeon, all whilst in quite uncomfortable pain.
And there weren't any computers to speak of at all at the time.
The computers slow it all down even further, BUT would be much more convenient in the scenario had I fallen unconscious after the first such inquiry.
As others have remarked, though, the computer system screw-ups are more often a combination of officiousness, inefficiencies, poor design, poor management decisions and bad implementation through poor commissioning and training procedures.
Not to forget that medical info is a BIG ball of wax and getting everyone in a modern hospital to sing from the same song sheet is nigh impossible in the first place.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282920</id>
	<title>Re:The key being ...</title>
	<author>evilRhino</author>
	<datestamp>1259681820000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>This article ignores the free-market aspect of how much things cost. If administrative costs can be billed at $X, it doesn't matter if it really is more efficient, it will still cost $X. It does however state that there is a modest improvement in *quality* of the data, which is a win.</htmltext>
<tokenext>This article ignores the free-market aspect of how much things cost .
If administrative costs can be billed at $ X , it does n't matter if it really is more efficient , it will still cost $ X .
It does however state that there is a modest improvement in * quality * of the data , which is a win .</tokentext>
<sentencetext>This article ignores the free-market aspect of how much things cost.
If administrative costs can be billed at $X, it doesn't matter if it really is more efficient, it will still cost $X.
It does however state that there is a modest improvement in *quality* of the data, which is a win.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280472</id>
	<title>The crux of the matter</title>
	<author>stimpleton</author>
	<datestamp>1259658660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Larger modern health care environments such as large hospitals, regional health committees, working groups etc, largely boil down to two  Us-and-Them viewpoints.
<br> <br>One is Management and  the other is doctors/nurses, the later arguing they should make the health care decisions, and essentially have primary say in the implementation of said environment.<br> <br>The result from an Information Systems viewpoint is that it is pushed from management with little buy-in from health professionals.<br> <br>With all due respect to Dr Himmelstein he firmly sits in the second camp - doctors should have the say in the running of a hospital. He is also against "administrative waste" - the old "too many admins in the hospital" arguement.<br> <br>Thats all well and good, but when the balloon goes up, and there are questions to answer, administrator's administrate, while doctors do what they should be doing: patient facing time.</htmltext>
<tokenext>Larger modern health care environments such as large hospitals , regional health committees , working groups etc , largely boil down to two Us-and-Them viewpoints .
One is Management and the other is doctors/nurses , the later arguing they should make the health care decisions , and essentially have primary say in the implementation of said environment .
The result from an Information Systems viewpoint is that it is pushed from management with little buy-in from health professionals .
With all due respect to Dr Himmelstein he firmly sits in the second camp - doctors should have the say in the running of a hospital .
He is also against " administrative waste " - the old " too many admins in the hospital " arguement .
Thats all well and good , but when the balloon goes up , and there are questions to answer , administrator 's administrate , while doctors do what they should be doing : patient facing time .</tokentext>
<sentencetext>Larger modern health care environments such as large hospitals, regional health committees, working groups etc, largely boil down to two  Us-and-Them viewpoints.
One is Management and  the other is doctors/nurses, the later arguing they should make the health care decisions, and essentially have primary say in the implementation of said environment.
The result from an Information Systems viewpoint is that it is pushed from management with little buy-in from health professionals.
With all due respect to Dr Himmelstein he firmly sits in the second camp - doctors should have the say in the running of a hospital.
He is also against "administrative waste" - the old "too many admins in the hospital" arguement.
Thats all well and good, but when the balloon goes up, and there are questions to answer, administrator's administrate, while doctors do what they should be doing: patient facing time.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30286072</id>
	<title>The reason for inefficiency</title>
	<author>Anonymous</author>
	<datestamp>1259695020000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>is that the doctors are rewarded for inefficiency.</p><p>Today doctors are being paid on a "per visit" basis. So, doctors get paid more if they take a long time to diagnose.</p><p>Given that this is a problem with the doctors, EMR or no EMR, the efficiency will not increase.</p><p>System should move towards the British NHS approach. Doctors need to get paid on a "Per person/per Year" basis. The "Per person" approach will ensure that the doctor has no incentive to treat you forever. The "Per year" clause will ensure that the patient can switch doctors in case he is not happy.</p></htmltext>
<tokenext>is that the doctors are rewarded for inefficiency.Today doctors are being paid on a " per visit " basis .
So , doctors get paid more if they take a long time to diagnose.Given that this is a problem with the doctors , EMR or no EMR , the efficiency will not increase.System should move towards the British NHS approach .
Doctors need to get paid on a " Per person/per Year " basis .
The " Per person " approach will ensure that the doctor has no incentive to treat you forever .
The " Per year " clause will ensure that the patient can switch doctors in case he is not happy .</tokentext>
<sentencetext>is that the doctors are rewarded for inefficiency.Today doctors are being paid on a "per visit" basis.
So, doctors get paid more if they take a long time to diagnose.Given that this is a problem with the doctors, EMR or no EMR, the efficiency will not increase.System should move towards the British NHS approach.
Doctors need to get paid on a "Per person/per Year" basis.
The "Per person" approach will ensure that the doctor has no incentive to treat you forever.
The "Per year" clause will ensure that the patient can switch doctors in case he is not happy.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281946</id>
	<title>False premise...</title>
	<author>PinchDuck</author>
	<datestamp>1259674980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>in the title. I've been around Hospital IT quite a bit in my career, and have never seen a system sold on saving money. They're sold on getting clinical data to the physician as soon as possible. A computer system and network costs far more money than a slip of paper, but I still want my lab results stored and transmitted electronically because it is faster and more efficient, both in a particular moment and over the span of various visits.</p></htmltext>
<tokenext>in the title .
I 've been around Hospital IT quite a bit in my career , and have never seen a system sold on saving money .
They 're sold on getting clinical data to the physician as soon as possible .
A computer system and network costs far more money than a slip of paper , but I still want my lab results stored and transmitted electronically because it is faster and more efficient , both in a particular moment and over the span of various visits .</tokentext>
<sentencetext>in the title.
I've been around Hospital IT quite a bit in my career, and have never seen a system sold on saving money.
They're sold on getting clinical data to the physician as soon as possible.
A computer system and network costs far more money than a slip of paper, but I still want my lab results stored and transmitted electronically because it is faster and more efficient, both in a particular moment and over the span of various visits.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283176</id>
	<title>They don't have "money"</title>
	<author>agentc0re</author>
	<datestamp>1259682840000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I work in a clinic that is inside of a Hospital.  Our Docs have Hospital duty, basically on call during the day/nights and weekends.  So what i see in the clinic could be different than a Hospital but i bet you it boils down to the same old thing.  Money.<br><br>I was very lucky this year and finally received the 'OK' to upgrade my servers from Server 2000, to Server 2008.  It took me several years to buy the two servers necessary to host the new 2008 servers(will be virtual servers).  With Medicare cut's, echo, cath, nuc, we'll even have more of a hard time with that.  Anything labeled "Medical" is 30x more expensive.  And Doctors tend to work as much as they want.  This is a huge problem since if they are okay with earning 50k, 100k less than the company as a whole suffers.  There are multiple docs like this.  You can't tell them what to do because it's their company.<br><br>Our EMR software is more guided to our line of work as well.  However it still has major flaws and could preform better.  The problem with it is that it was designed by doctors.  At first it sounds good until you see the SQL end.  Doctors designed that too.  So the whole program, designed by these docs(not mine some can barely can turn on a PC), really is a mess that no one can fix but they just keep piling on to it.  It's bloated to all hell.<br><br>I think the key to success is to break the EMR system down to individual sectional needs.  Like a TV.  a TV isn't built (or a good one at least) with a DVD/blu-ray player, xbox306, ps3, wii, cable tuner, etc. etc., inside of it.  No it has ports to link it all to the TV.  EMR software should be similar in the fact that there should be a standard "Link" so that when you have your Cardio EMR and you need to link it to your Lab EMR, you can.  The billing side of all of this is probably the worst joke as i would say it's the hardest of all of this.</htmltext>
<tokenext>I work in a clinic that is inside of a Hospital .
Our Docs have Hospital duty , basically on call during the day/nights and weekends .
So what i see in the clinic could be different than a Hospital but i bet you it boils down to the same old thing .
Money.I was very lucky this year and finally received the 'OK ' to upgrade my servers from Server 2000 , to Server 2008 .
It took me several years to buy the two servers necessary to host the new 2008 servers ( will be virtual servers ) .
With Medicare cut 's , echo , cath , nuc , we 'll even have more of a hard time with that .
Anything labeled " Medical " is 30x more expensive .
And Doctors tend to work as much as they want .
This is a huge problem since if they are okay with earning 50k , 100k less than the company as a whole suffers .
There are multiple docs like this .
You ca n't tell them what to do because it 's their company.Our EMR software is more guided to our line of work as well .
However it still has major flaws and could preform better .
The problem with it is that it was designed by doctors .
At first it sounds good until you see the SQL end .
Doctors designed that too .
So the whole program , designed by these docs ( not mine some can barely can turn on a PC ) , really is a mess that no one can fix but they just keep piling on to it .
It 's bloated to all hell.I think the key to success is to break the EMR system down to individual sectional needs .
Like a TV .
a TV is n't built ( or a good one at least ) with a DVD/blu-ray player , xbox306 , ps3 , wii , cable tuner , etc .
etc. , inside of it .
No it has ports to link it all to the TV .
EMR software should be similar in the fact that there should be a standard " Link " so that when you have your Cardio EMR and you need to link it to your Lab EMR , you can .
The billing side of all of this is probably the worst joke as i would say it 's the hardest of all of this .</tokentext>
<sentencetext>I work in a clinic that is inside of a Hospital.
Our Docs have Hospital duty, basically on call during the day/nights and weekends.
So what i see in the clinic could be different than a Hospital but i bet you it boils down to the same old thing.
Money.I was very lucky this year and finally received the 'OK' to upgrade my servers from Server 2000, to Server 2008.
It took me several years to buy the two servers necessary to host the new 2008 servers(will be virtual servers).
With Medicare cut's, echo, cath, nuc, we'll even have more of a hard time with that.
Anything labeled "Medical" is 30x more expensive.
And Doctors tend to work as much as they want.
This is a huge problem since if they are okay with earning 50k, 100k less than the company as a whole suffers.
There are multiple docs like this.
You can't tell them what to do because it's their company.Our EMR software is more guided to our line of work as well.
However it still has major flaws and could preform better.
The problem with it is that it was designed by doctors.
At first it sounds good until you see the SQL end.
Doctors designed that too.
So the whole program, designed by these docs(not mine some can barely can turn on a PC), really is a mess that no one can fix but they just keep piling on to it.
It's bloated to all hell.I think the key to success is to break the EMR system down to individual sectional needs.
Like a TV.
a TV isn't built (or a good one at least) with a DVD/blu-ray player, xbox306, ps3, wii, cable tuner, etc.
etc., inside of it.
No it has ports to link it all to the TV.
EMR software should be similar in the fact that there should be a standard "Link" so that when you have your Cardio EMR and you need to link it to your Lab EMR, you can.
The billing side of all of this is probably the worst joke as i would say it's the hardest of all of this.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284668</id>
	<title>Get a real job</title>
	<author>Anonymous</author>
	<datestamp>1259689440000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext>What would Harvard know about saving money? It's easy to tell other people how to do it if you just get hand-outs from the government and 'generous donations' from parents of students who otherwise wouldn't graduate high-school. Besides, I would like to see a hospital make a profit after they get sued by the family of a patient because someone misplaced a clipboard or an X-ray. Oh, and I wonder if Harvard heard of HIPAA and HiTRUST - good luck protecting patient records by encrypting paper copies. Can you believe someone up there gets paid to suck stuff like this out of their finger?</htmltext>
<tokenext>What would Harvard know about saving money ?
It 's easy to tell other people how to do it if you just get hand-outs from the government and 'generous donations ' from parents of students who otherwise would n't graduate high-school .
Besides , I would like to see a hospital make a profit after they get sued by the family of a patient because someone misplaced a clipboard or an X-ray .
Oh , and I wonder if Harvard heard of HIPAA and HiTRUST - good luck protecting patient records by encrypting paper copies .
Can you believe someone up there gets paid to suck stuff like this out of their finger ?</tokentext>
<sentencetext>What would Harvard know about saving money?
It's easy to tell other people how to do it if you just get hand-outs from the government and 'generous donations' from parents of students who otherwise wouldn't graduate high-school.
Besides, I would like to see a hospital make a profit after they get sued by the family of a patient because someone misplaced a clipboard or an X-ray.
Oh, and I wonder if Harvard heard of HIPAA and HiTRUST - good luck protecting patient records by encrypting paper copies.
Can you believe someone up there gets paid to suck stuff like this out of their finger?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281062</id>
	<title>Re:Well</title>
	<author>martin-boundary</author>
	<datestamp>1259665140000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Could you explain why this is a bad thing? The way you describe it, there
are four people who each independently verify the information,
instead of what? One person who enters some data into the computer and three
people who read it back?
<p>
If each person has a 25\% misdiagnostic rate, then four independent people
asking questions gives a combined misdiagnostic rate of less than 1\%.
If three people trust the diagnosis of the first person, then the combined rate
is 25\%. Regardless of the actual numbers involved, many people talking to the patient
independently should improve the chance of a successful treatment.</p></htmltext>
<tokenext>Could you explain why this is a bad thing ?
The way you describe it , there are four people who each independently verify the information , instead of what ?
One person who enters some data into the computer and three people who read it back ?
If each person has a 25 \ % misdiagnostic rate , then four independent people asking questions gives a combined misdiagnostic rate of less than 1 \ % .
If three people trust the diagnosis of the first person , then the combined rate is 25 \ % .
Regardless of the actual numbers involved , many people talking to the patient independently should improve the chance of a successful treatment .</tokentext>
<sentencetext>Could you explain why this is a bad thing?
The way you describe it, there
are four people who each independently verify the information,
instead of what?
One person who enters some data into the computer and three
people who read it back?
If each person has a 25\% misdiagnostic rate, then four independent people
asking questions gives a combined misdiagnostic rate of less than 1\%.
If three people trust the diagnosis of the first person, then the combined rate
is 25\%.
Regardless of the actual numbers involved, many people talking to the patient
independently should improve the chance of a successful treatment.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284800</id>
	<title>EHR's do some things better, but not saving money.</title>
	<author>Gerakon</author>
	<datestamp>1259689920000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Electronic Health Records are generally not marketed as a way to save money. They make it easier to get reports and make it safer for the patient. Whether or not this is enough to justify the cost, who knows.</p><p>Things EHRs do better than paper charts -<br>With paper charts it's much easier to lose or miss place a chart - This probably happens more than you think.</p><p>Drug interaction checking with an EHR can make sure that a med someone put you on a year ago and didn't get into the chart is less likely to conflict a new med because the EHR will tell the doc that when he/she tries to prescribe it.</p><p>Making sure that people with chronic problems such as diabetes are scheduled to get in for they're check ups rather than slipping through the cracks. This also generates more revenue for the hospital.</p></htmltext>
<tokenext>Electronic Health Records are generally not marketed as a way to save money .
They make it easier to get reports and make it safer for the patient .
Whether or not this is enough to justify the cost , who knows.Things EHRs do better than paper charts -With paper charts it 's much easier to lose or miss place a chart - This probably happens more than you think.Drug interaction checking with an EHR can make sure that a med someone put you on a year ago and did n't get into the chart is less likely to conflict a new med because the EHR will tell the doc that when he/she tries to prescribe it.Making sure that people with chronic problems such as diabetes are scheduled to get in for they 're check ups rather than slipping through the cracks .
This also generates more revenue for the hospital .</tokentext>
<sentencetext>Electronic Health Records are generally not marketed as a way to save money.
They make it easier to get reports and make it safer for the patient.
Whether or not this is enough to justify the cost, who knows.Things EHRs do better than paper charts -With paper charts it's much easier to lose or miss place a chart - This probably happens more than you think.Drug interaction checking with an EHR can make sure that a med someone put you on a year ago and didn't get into the chart is less likely to conflict a new med because the EHR will tell the doc that when he/she tries to prescribe it.Making sure that people with chronic problems such as diabetes are scheduled to get in for they're check ups rather than slipping through the cracks.
This also generates more revenue for the hospital.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282800</id>
	<title>The Meaning of Life</title>
	<author>Snufu</author>
	<datestamp>1259680980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Of course the hospitals in the study could not afford good software. They spent all their money on "the machine that goes 'ping'".</htmltext>
<tokenext>Of course the hospitals in the study could not afford good software .
They spent all their money on " the machine that goes 'ping ' " .</tokentext>
<sentencetext>Of course the hospitals in the study could not afford good software.
They spent all their money on "the machine that goes 'ping'".</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</id>
	<title>Well</title>
	<author>Anonymous</author>
	<datestamp>1259699700000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>5</modscore>
	<htmltext><p>Here's a relevant quote from "Superfreakonomics" :</p><p>The diagnosis was clear: the WHC emergency department had a severe case of "datapenia," or low data counts. (Feied invented this word as well, stealing the suffix from "leucopenia," or low white-blood-cell counts.) Doctors were spending about 60 percent of their time on "information management," and only 15 percent on direct patient care. This was a sickening ratio. "Emergency medicine is a specialty defined not by an organ of the body or by an age group but by time," says Mark Smith. "It's about what you do in the first sixty minutes."</p><p>Smith and Feied discovered more than three hundred data sources in the hospital that didn't talk to one another, including a mainframe system, handwritten notes, scanned images, lab results, streaming video from cardiac angiograms, and an infection-control tracking system that lived on one person's computer on an Excel spreadsheet. "And if she went on vacation, God help you if you're trying to track a TB outbreak," says Feied.</p><p>To give the ER doctors and nurses what they really needed, a computer system had to be built from the ground up. It had to be encyclopedic (one missing piece of key data would defeat the purpose); it had to be muscular (a single MRI, for instance, ate up a massive amount of data capacity); and it had to be flexible (a system that couldn't incorporate any data from any department in any hospital in the past, present, or future was useless).</p><p>It also had to be really, really fast. Not only because slowness kills in an ER but because, as Feied had learned from the scientific literature, a person using a computer experiences "cognitive drift" if more than one second elapses between clicking the mouse and seeing new data on the screen. If ten seconds pass, the person's mind is somewhere else entirely. That's how medical errors are made.</p><p>END QUOTE<br>I agree wholeheatedly with the last bit : I can't count how many times I've been to a doctors office or library or other institution and had to wait for a person to pull up my information on "the system".  If you're gonna build a friggin computer system to handle local records, for the love of God don't scrimp on the hardware!  Optimize the software!  It should be INSTANTANEOUSLY fast!</p></div>
	</htmltext>
<tokenext>Here 's a relevant quote from " Superfreakonomics " : The diagnosis was clear : the WHC emergency department had a severe case of " datapenia , " or low data counts .
( Feied invented this word as well , stealing the suffix from " leucopenia , " or low white-blood-cell counts .
) Doctors were spending about 60 percent of their time on " information management , " and only 15 percent on direct patient care .
This was a sickening ratio .
" Emergency medicine is a specialty defined not by an organ of the body or by an age group but by time , " says Mark Smith .
" It 's about what you do in the first sixty minutes .
" Smith and Feied discovered more than three hundred data sources in the hospital that did n't talk to one another , including a mainframe system , handwritten notes , scanned images , lab results , streaming video from cardiac angiograms , and an infection-control tracking system that lived on one person 's computer on an Excel spreadsheet .
" And if she went on vacation , God help you if you 're trying to track a TB outbreak , " says Feied.To give the ER doctors and nurses what they really needed , a computer system had to be built from the ground up .
It had to be encyclopedic ( one missing piece of key data would defeat the purpose ) ; it had to be muscular ( a single MRI , for instance , ate up a massive amount of data capacity ) ; and it had to be flexible ( a system that could n't incorporate any data from any department in any hospital in the past , present , or future was useless ) .It also had to be really , really fast .
Not only because slowness kills in an ER but because , as Feied had learned from the scientific literature , a person using a computer experiences " cognitive drift " if more than one second elapses between clicking the mouse and seeing new data on the screen .
If ten seconds pass , the person 's mind is somewhere else entirely .
That 's how medical errors are made.END QUOTEI agree wholeheatedly with the last bit : I ca n't count how many times I 've been to a doctors office or library or other institution and had to wait for a person to pull up my information on " the system " .
If you 're gon na build a friggin computer system to handle local records , for the love of God do n't scrimp on the hardware !
Optimize the software !
It should be INSTANTANEOUSLY fast !</tokentext>
<sentencetext>Here's a relevant quote from "Superfreakonomics" :The diagnosis was clear: the WHC emergency department had a severe case of "datapenia," or low data counts.
(Feied invented this word as well, stealing the suffix from "leucopenia," or low white-blood-cell counts.
) Doctors were spending about 60 percent of their time on "information management," and only 15 percent on direct patient care.
This was a sickening ratio.
"Emergency medicine is a specialty defined not by an organ of the body or by an age group but by time," says Mark Smith.
"It's about what you do in the first sixty minutes.
"Smith and Feied discovered more than three hundred data sources in the hospital that didn't talk to one another, including a mainframe system, handwritten notes, scanned images, lab results, streaming video from cardiac angiograms, and an infection-control tracking system that lived on one person's computer on an Excel spreadsheet.
"And if she went on vacation, God help you if you're trying to track a TB outbreak," says Feied.To give the ER doctors and nurses what they really needed, a computer system had to be built from the ground up.
It had to be encyclopedic (one missing piece of key data would defeat the purpose); it had to be muscular (a single MRI, for instance, ate up a massive amount of data capacity); and it had to be flexible (a system that couldn't incorporate any data from any department in any hospital in the past, present, or future was useless).It also had to be really, really fast.
Not only because slowness kills in an ER but because, as Feied had learned from the scientific literature, a person using a computer experiences "cognitive drift" if more than one second elapses between clicking the mouse and seeing new data on the screen.
If ten seconds pass, the person's mind is somewhere else entirely.
That's how medical errors are made.END QUOTEI agree wholeheatedly with the last bit : I can't count how many times I've been to a doctors office or library or other institution and had to wait for a person to pull up my information on "the system".
If you're gonna build a friggin computer system to handle local records, for the love of God don't scrimp on the hardware!
Optimize the software!
It should be INSTANTANEOUSLY fast!
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280240</id>
	<title>Transferability</title>
	<author>Anonymous</author>
	<datestamp>1259699520000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>5</modscore>
	<htmltext>Well, that's mouthful, but with electronic records you can at least switch doctors without having to take X-rays, tests, and other records again.  No?</htmltext>
<tokenext>Well , that 's mouthful , but with electronic records you can at least switch doctors without having to take X-rays , tests , and other records again .
No ?</tokentext>
<sentencetext>Well, that's mouthful, but with electronic records you can at least switch doctors without having to take X-rays, tests, and other records again.
No?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281652</id>
	<title>Claims</title>
	<author>Bel Riose</author>
	<datestamp>1259671920000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>"So the first thing we need to do is stop claiming things there's no evidence for."</p></div><p>That would rule out 99 \% of all claims.</p></div>
	</htmltext>
<tokenext>" So the first thing we need to do is stop claiming things there 's no evidence for .
" That would rule out 99 \ % of all claims .</tokentext>
<sentencetext>"So the first thing we need to do is stop claiming things there's no evidence for.
"That would rule out 99 \% of all claims.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282120</id>
	<title>Medical record ownership</title>
	<author>sjbe</author>
	<datestamp>1259676840000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>Your records belong to you.</p></div><p> <a href="http://en.wikipedia.org/wiki/Medical\_records#Ownership" title="wikipedia.org">Not really.</a> [wikipedia.org]  In the United States the DATA in your medical record belongs to you.  The physical medium on which the record is stored belongs to the entity responsible for maintaining that record.  A close analogy is that you own the copyright but they own the physical copy.  You have a right to inspect your medical record and petition your health care provider to correct factually incorrect data.</p><p>In the United Kingdom NHS medical records belong to the Department of Health.</p></div>
	</htmltext>
<tokenext>Your records belong to you .
Not really .
[ wikipedia.org ] In the United States the DATA in your medical record belongs to you .
The physical medium on which the record is stored belongs to the entity responsible for maintaining that record .
A close analogy is that you own the copyright but they own the physical copy .
You have a right to inspect your medical record and petition your health care provider to correct factually incorrect data.In the United Kingdom NHS medical records belong to the Department of Health .</tokentext>
<sentencetext>Your records belong to you.
Not really.
[wikipedia.org]  In the United States the DATA in your medical record belongs to you.
The physical medium on which the record is stored belongs to the entity responsible for maintaining that record.
A close analogy is that you own the copyright but they own the physical copy.
You have a right to inspect your medical record and petition your health care provider to correct factually incorrect data.In the United Kingdom NHS medical records belong to the Department of Health.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280252</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30287008</id>
	<title>Hello kids</title>
	<author>blue\_teeth</author>
	<datestamp>1259698200000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Implementation of Information Systems is not just technology, cool displays, reports and widgets.

Repeat after me:  It is CHANGE MANAGEMENT!

Your lowest common denominator user can fail the system if the change is not managed.</htmltext>
<tokenext>Implementation of Information Systems is not just technology , cool displays , reports and widgets .
Repeat after me : It is CHANGE MANAGEMENT !
Your lowest common denominator user can fail the system if the change is not managed .</tokentext>
<sentencetext>Implementation of Information Systems is not just technology, cool displays, reports and widgets.
Repeat after me:  It is CHANGE MANAGEMENT!
Your lowest common denominator user can fail the system if the change is not managed.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283456</id>
	<title>Re:Let me explain...</title>
	<author>colinrichardday</author>
	<datestamp>1259683860000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><i>When it was down and paper records were required then lives were at risk due to the lack of efficiency (time spent accessing paper). It honestly scared me!</i></p><p><i>I'm sure things are much much more reliant on computers now.</i></p><p>Except when the computers go down.</p></htmltext>
<tokenext>When it was down and paper records were required then lives were at risk due to the lack of efficiency ( time spent accessing paper ) .
It honestly scared me ! I 'm sure things are much much more reliant on computers now.Except when the computers go down .</tokentext>
<sentencetext>When it was down and paper records were required then lives were at risk due to the lack of efficiency (time spent accessing paper).
It honestly scared me!I'm sure things are much much more reliant on computers now.Except when the computers go down.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280742</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283704</id>
	<title>Bullshit</title>
	<author>Anonymous</author>
	<datestamp>1259685180000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I work for a company which provides a unique remote ICU solution.  We have proven that it signifigantly reduces mortality, and shortens length of stay, as well as allowing more beds to be monitored with fewer intensivists.</p><p>If you're simply talking about 'electronic records' a la Obama, well yeah, that's a load of hooey and is more about the government having easier access to your data (for non health purposes).</p></htmltext>
<tokenext>I work for a company which provides a unique remote ICU solution .
We have proven that it signifigantly reduces mortality , and shortens length of stay , as well as allowing more beds to be monitored with fewer intensivists.If you 're simply talking about 'electronic records ' a la Obama , well yeah , that 's a load of hooey and is more about the government having easier access to your data ( for non health purposes ) .</tokentext>
<sentencetext>I work for a company which provides a unique remote ICU solution.
We have proven that it signifigantly reduces mortality, and shortens length of stay, as well as allowing more beds to be monitored with fewer intensivists.If you're simply talking about 'electronic records' a la Obama, well yeah, that's a load of hooey and is more about the government having easier access to your data (for non health purposes).</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280274</id>
	<title>I would also guess...</title>
	<author>Anonymous</author>
	<datestamp>1259700000000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>1</modscore>
	<htmltext><p>That some of this has to do with the staff being largely of the 35+ crowd and the propensity of that crowd to not know how to use computers even remotely as well as, say, a 16 year old kid does right now.</p><p>Computers take more work to use when you don't have a nice grasp on not only the software or function you're doing, but the regular logical deductions you make from repeated observation and experience.</p><p>From my experience in life, most older people have somehow adapted themselves to 'get by' with technology, but without actually knowing what is really going on.  Many will think the monitor is the computer.  Many have no idea what the basic components are.  And, hell, many are even clueless at the overly-simplified layouts of hardware nowadays with color coding and the square-peg-square-hole approach to basically everything.</p><p>Make the majority of a staff fill this description and you can be damned sure plenty of time is being spent moving the mouse around cautiously while looking down the nose in deep confusion and wonder.</p><p>question: is a hotkey actually hot?  which one is it?</p></htmltext>
<tokenext>That some of this has to do with the staff being largely of the 35 + crowd and the propensity of that crowd to not know how to use computers even remotely as well as , say , a 16 year old kid does right now.Computers take more work to use when you do n't have a nice grasp on not only the software or function you 're doing , but the regular logical deductions you make from repeated observation and experience.From my experience in life , most older people have somehow adapted themselves to 'get by ' with technology , but without actually knowing what is really going on .
Many will think the monitor is the computer .
Many have no idea what the basic components are .
And , hell , many are even clueless at the overly-simplified layouts of hardware nowadays with color coding and the square-peg-square-hole approach to basically everything.Make the majority of a staff fill this description and you can be damned sure plenty of time is being spent moving the mouse around cautiously while looking down the nose in deep confusion and wonder.question : is a hotkey actually hot ?
which one is it ?</tokentext>
<sentencetext>That some of this has to do with the staff being largely of the 35+ crowd and the propensity of that crowd to not know how to use computers even remotely as well as, say, a 16 year old kid does right now.Computers take more work to use when you don't have a nice grasp on not only the software or function you're doing, but the regular logical deductions you make from repeated observation and experience.From my experience in life, most older people have somehow adapted themselves to 'get by' with technology, but without actually knowing what is really going on.
Many will think the monitor is the computer.
Many have no idea what the basic components are.
And, hell, many are even clueless at the overly-simplified layouts of hardware nowadays with color coding and the square-peg-square-hole approach to basically everything.Make the majority of a staff fill this description and you can be damned sure plenty of time is being spent moving the mouse around cautiously while looking down the nose in deep confusion and wonder.question: is a hotkey actually hot?
which one is it?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283374</id>
	<title>Re:I work in a major hospital</title>
	<author>tsstahl</author>
	<datestamp>1259683500000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>You would think.  However, a surprising number of people object to being tattooed with a bar code.  Especially older folks with accents.  Go figure.<nobr> <wbr></nobr>/sarcasm</htmltext>
<tokenext>You would think .
However , a surprising number of people object to being tattooed with a bar code .
Especially older folks with accents .
Go figure .
/sarcasm</tokentext>
<sentencetext>You would think.
However, a surprising number of people object to being tattooed with a bar code.
Especially older folks with accents.
Go figure.
/sarcasm</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280510</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284706</id>
	<title>Computers in medicine</title>
	<author>Anonymous</author>
	<datestamp>1259689560000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I'm a practicing surgeon - I graduated from medical school in 1985 and have seen a lot of change in those 2+ decades.  (I'm also a C programmer and maintainer of a couple of widely-used OSS projects - basically spent lots of time wondering whether I should have continued in CS instead of going to medical school).</p><p>The real improvements I see are:<br>1. Dramatically faster/easier access to patients' lab results, imaging, and previous reports and consults.  As a student, I used to have to walk to the basement and copy numbers from printouts posted on a wall, swipe the X rays for my attendings to look at, etc.  I know it sounds like "walking five miles to school in the snow", but anyone who denies that computers make clinical info more accessible is really full of it.  I'm not so certain that the better access to records has always improved medical decisions, but it certainly hasn't hurt.<br>2. Mind-boggling advances in imaging technology - CT, MRI, ultrasound - the speed and quality of modern imaging would have seemed like something straight out of science fiction years ago.  Again, the better pictures don't always lead to better decisions, but they often are really helpful, and provide answers that used to require much more invasive or painful studies.<br>3. Surgical technology - laparoscopy and related advances.</p><p>So computers haven't saved hospitals money?  Well, they haven't eliminated world hunger or global warming, either.  I think this study has the wrong end point.</p></htmltext>
<tokenext>I 'm a practicing surgeon - I graduated from medical school in 1985 and have seen a lot of change in those 2 + decades .
( I 'm also a C programmer and maintainer of a couple of widely-used OSS projects - basically spent lots of time wondering whether I should have continued in CS instead of going to medical school ) .The real improvements I see are : 1 .
Dramatically faster/easier access to patients ' lab results , imaging , and previous reports and consults .
As a student , I used to have to walk to the basement and copy numbers from printouts posted on a wall , swipe the X rays for my attendings to look at , etc .
I know it sounds like " walking five miles to school in the snow " , but anyone who denies that computers make clinical info more accessible is really full of it .
I 'm not so certain that the better access to records has always improved medical decisions , but it certainly has n't hurt.2 .
Mind-boggling advances in imaging technology - CT , MRI , ultrasound - the speed and quality of modern imaging would have seemed like something straight out of science fiction years ago .
Again , the better pictures do n't always lead to better decisions , but they often are really helpful , and provide answers that used to require much more invasive or painful studies.3 .
Surgical technology - laparoscopy and related advances.So computers have n't saved hospitals money ?
Well , they have n't eliminated world hunger or global warming , either .
I think this study has the wrong end point .</tokentext>
<sentencetext>I'm a practicing surgeon - I graduated from medical school in 1985 and have seen a lot of change in those 2+ decades.
(I'm also a C programmer and maintainer of a couple of widely-used OSS projects - basically spent lots of time wondering whether I should have continued in CS instead of going to medical school).The real improvements I see are:1.
Dramatically faster/easier access to patients' lab results, imaging, and previous reports and consults.
As a student, I used to have to walk to the basement and copy numbers from printouts posted on a wall, swipe the X rays for my attendings to look at, etc.
I know it sounds like "walking five miles to school in the snow", but anyone who denies that computers make clinical info more accessible is really full of it.
I'm not so certain that the better access to records has always improved medical decisions, but it certainly hasn't hurt.2.
Mind-boggling advances in imaging technology - CT, MRI, ultrasound - the speed and quality of modern imaging would have seemed like something straight out of science fiction years ago.
Again, the better pictures don't always lead to better decisions, but they often are really helpful, and provide answers that used to require much more invasive or painful studies.3.
Surgical technology - laparoscopy and related advances.So computers haven't saved hospitals money?
Well, they haven't eliminated world hunger or global warming, either.
I think this study has the wrong end point.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30286940</id>
	<title>Re:Remote access to specialists</title>
	<author>winwar</author>
	<datestamp>1259697960000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>"The ER doctor looked at the X-rays, then called the fracture specialist at home, who looked at the X-rays on his home computer, and passed on his advice to the ER doctor.</p><p>Let's see them do that without computers."</p><p>You do realize that they successfully treated wrist fractures all the time before computers?  My brother was one of them.  Of course, in the "olden days" doctors didn't need an expensive online consult to do their job.  I don't recall my brother needing an ER doctor and a fracture specialist for a routine fracture.  Perhaps they should spend less on tech and more on good doctors....</p></htmltext>
<tokenext>" The ER doctor looked at the X-rays , then called the fracture specialist at home , who looked at the X-rays on his home computer , and passed on his advice to the ER doctor.Let 's see them do that without computers .
" You do realize that they successfully treated wrist fractures all the time before computers ?
My brother was one of them .
Of course , in the " olden days " doctors did n't need an expensive online consult to do their job .
I do n't recall my brother needing an ER doctor and a fracture specialist for a routine fracture .
Perhaps they should spend less on tech and more on good doctors... .</tokentext>
<sentencetext>"The ER doctor looked at the X-rays, then called the fracture specialist at home, who looked at the X-rays on his home computer, and passed on his advice to the ER doctor.Let's see them do that without computers.
"You do realize that they successfully treated wrist fractures all the time before computers?
My brother was one of them.
Of course, in the "olden days" doctors didn't need an expensive online consult to do their job.
I don't recall my brother needing an ER doctor and a fracture specialist for a routine fracture.
Perhaps they should spend less on tech and more on good doctors....</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280832</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282914</id>
	<title>Anyone who's surprised by this...</title>
	<author>JonStewartMill</author>
	<datestamp>1259681760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><nobr> <wbr></nobr>... has never been involved in an IT project in a medium-to-large organization.  The sheer overhead involved in "managing" a project invariably sucks up any potential cost savings that might be realized.  Combine people's natural desire to get paid handsomely for a job that consists solely of going to meetings with IT leadership's quixotic attempts to turn their department into a revenue source, and you have a recipe for inertia that 19th-century Russian bureaucrats would envy.</htmltext>
<tokenext>... has never been involved in an IT project in a medium-to-large organization .
The sheer overhead involved in " managing " a project invariably sucks up any potential cost savings that might be realized .
Combine people 's natural desire to get paid handsomely for a job that consists solely of going to meetings with IT leadership 's quixotic attempts to turn their department into a revenue source , and you have a recipe for inertia that 19th-century Russian bureaucrats would envy .</tokentext>
<sentencetext> ... has never been involved in an IT project in a medium-to-large organization.
The sheer overhead involved in "managing" a project invariably sucks up any potential cost savings that might be realized.
Combine people's natural desire to get paid handsomely for a job that consists solely of going to meetings with IT leadership's quixotic attempts to turn their department into a revenue source, and you have a recipe for inertia that 19th-century Russian bureaucrats would envy.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281618</id>
	<title>Variables...</title>
	<author>Bert64</author>
	<datestamp>1259671680000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext><p>There are too many variables...</p><p>Computers installed and maintained in a competent fashion, running software which is appropriate to the job at hand and being used by staff who are proficient with that software can save money, potentially a lot of it...</p><p>On the other hand, many IT projects are terribly mismanaged, poorly budgeted, installed by cheap unqualified staff, running unsuitable software which expects people to adapt to its way of doing things rather than the other way round, and used by staff who are unsure how to use the system correctly and are often too fearful to touch it unless forced to..<br>Ask the average joe on the street, and they will tell you that computers are extremely unreliable black boxes, they have no idea how they work and are very fearful of touching them incase they break, especially at work where they're likely to face disciplinary action for breaking the computers.</p><p>In a lot of cases, computers are simply not appropriate, and in many more cases computers in the form that get installed are completely unsuitable for the task and are actually inferior to what they replaced.</p><p>You also have the attitude of third party suppliers and corrupt people high up in the client organizations where the situation changes from "what do we need" to "how can we justify purchasing something from "... IT is one of the worst affected industries for this, because people generally have less understanding and are therefore easier to fool.</p><p>The goals of these people is not to save money, it's not their money to save, it's someone else's money that they are in charge of, and their primary goal is to siphon as much of it out and into their own pockets as possible.</p></htmltext>
<tokenext>There are too many variables...Computers installed and maintained in a competent fashion , running software which is appropriate to the job at hand and being used by staff who are proficient with that software can save money , potentially a lot of it...On the other hand , many IT projects are terribly mismanaged , poorly budgeted , installed by cheap unqualified staff , running unsuitable software which expects people to adapt to its way of doing things rather than the other way round , and used by staff who are unsure how to use the system correctly and are often too fearful to touch it unless forced to..Ask the average joe on the street , and they will tell you that computers are extremely unreliable black boxes , they have no idea how they work and are very fearful of touching them incase they break , especially at work where they 're likely to face disciplinary action for breaking the computers.In a lot of cases , computers are simply not appropriate , and in many more cases computers in the form that get installed are completely unsuitable for the task and are actually inferior to what they replaced.You also have the attitude of third party suppliers and corrupt people high up in the client organizations where the situation changes from " what do we need " to " how can we justify purchasing something from " ... IT is one of the worst affected industries for this , because people generally have less understanding and are therefore easier to fool.The goals of these people is not to save money , it 's not their money to save , it 's someone else 's money that they are in charge of , and their primary goal is to siphon as much of it out and into their own pockets as possible .</tokentext>
<sentencetext>There are too many variables...Computers installed and maintained in a competent fashion, running software which is appropriate to the job at hand and being used by staff who are proficient with that software can save money, potentially a lot of it...On the other hand, many IT projects are terribly mismanaged, poorly budgeted, installed by cheap unqualified staff, running unsuitable software which expects people to adapt to its way of doing things rather than the other way round, and used by staff who are unsure how to use the system correctly and are often too fearful to touch it unless forced to..Ask the average joe on the street, and they will tell you that computers are extremely unreliable black boxes, they have no idea how they work and are very fearful of touching them incase they break, especially at work where they're likely to face disciplinary action for breaking the computers.In a lot of cases, computers are simply not appropriate, and in many more cases computers in the form that get installed are completely unsuitable for the task and are actually inferior to what they replaced.You also have the attitude of third party suppliers and corrupt people high up in the client organizations where the situation changes from "what do we need" to "how can we justify purchasing something from "... IT is one of the worst affected industries for this, because people generally have less understanding and are therefore easier to fool.The goals of these people is not to save money, it's not their money to save, it's someone else's money that they are in charge of, and their primary goal is to siphon as much of it out and into their own pockets as possible.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30282756</id>
	<title>Re:I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259680740000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>And have significant responsibilities for patient care and management.  Computers have made my life much easier.  With electronic charting I can follow all of my patients directly from a terminal that I carry with me.  The charting software we have includes basic spreadsheet and summary functions that are highly customizable.  I am able to track trends and make decisions for my patients based on sight and intuition rather than having to sort through paper charts and bad handwriting.  Its all at my fingertips.  I don't know where Dr. harvard did his research but maybe he just has bad software.  My computer system is outstanding and I honestly don't know if I'll ever be able to work in another hospital.</p></div><p>What system are you using at your hospital?  You guys should write a rebuttal to this guys claim and share the info of your success!</p></div>
	</htmltext>
<tokenext>And have significant responsibilities for patient care and management .
Computers have made my life much easier .
With electronic charting I can follow all of my patients directly from a terminal that I carry with me .
The charting software we have includes basic spreadsheet and summary functions that are highly customizable .
I am able to track trends and make decisions for my patients based on sight and intuition rather than having to sort through paper charts and bad handwriting .
Its all at my fingertips .
I do n't know where Dr. harvard did his research but maybe he just has bad software .
My computer system is outstanding and I honestly do n't know if I 'll ever be able to work in another hospital.What system are you using at your hospital ?
You guys should write a rebuttal to this guys claim and share the info of your success !</tokentext>
<sentencetext>And have significant responsibilities for patient care and management.
Computers have made my life much easier.
With electronic charting I can follow all of my patients directly from a terminal that I carry with me.
The charting software we have includes basic spreadsheet and summary functions that are highly customizable.
I am able to track trends and make decisions for my patients based on sight and intuition rather than having to sort through paper charts and bad handwriting.
Its all at my fingertips.
I don't know where Dr. harvard did his research but maybe he just has bad software.
My computer system is outstanding and I honestly don't know if I'll ever be able to work in another hospital.What system are you using at your hospital?
You guys should write a rebuttal to this guys claim and share the info of your success!
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30288784</id>
	<title>Re:Well</title>
	<author>ShooterNeo</author>
	<datestamp>1259661600000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Think about the problem for a moment.  The basic action of healthcare is to bring up the records for only one patient, read the records to learn what you need to learn, and then to perform an intervention to slow the rate that the patient is dying at.  After you perform the intervention, you should report your findings by adding more information to the patient's record.</p><p>So, this already radically makes the problem easier.  It doesn't have to contain all human knowledge : your database should be able to put on the screen of the termnal the records for JUST THAT PATIENT within 1 second.  So no expensive, slow searches of all the records.</p><p>In addition, it doesn't even need to bring up large files like the MRI right away.  The way the software should work, once a user requests the records of a patient, the software should immediatly put up a summary screen with the information organized by priority.  For MRIs and videos and such, only a preview of the full image need be displayed unless the user actually clicks it.</p><p>If I were designing the software, I would have it start downloading the full patient record in the background, with a low priority quality of service designation on the packets, to cache in the client machine.  That way if a user left a patient record open for a while (say on a computer that's at a nurse's station) then browsing around the record would become instantaneous.</p><p>For the server side : I'd use idle cycles on the server hardware to optimize the layout on the hard disks and to pre-calculate things like preview images.</p><p>Anyways, I'm not a software developer, but I think it's obvious that if extremely high performance from the perspective of a user were a design goal, it would be possible to deliver.</p></htmltext>
<tokenext>Think about the problem for a moment .
The basic action of healthcare is to bring up the records for only one patient , read the records to learn what you need to learn , and then to perform an intervention to slow the rate that the patient is dying at .
After you perform the intervention , you should report your findings by adding more information to the patient 's record.So , this already radically makes the problem easier .
It does n't have to contain all human knowledge : your database should be able to put on the screen of the termnal the records for JUST THAT PATIENT within 1 second .
So no expensive , slow searches of all the records.In addition , it does n't even need to bring up large files like the MRI right away .
The way the software should work , once a user requests the records of a patient , the software should immediatly put up a summary screen with the information organized by priority .
For MRIs and videos and such , only a preview of the full image need be displayed unless the user actually clicks it.If I were designing the software , I would have it start downloading the full patient record in the background , with a low priority quality of service designation on the packets , to cache in the client machine .
That way if a user left a patient record open for a while ( say on a computer that 's at a nurse 's station ) then browsing around the record would become instantaneous.For the server side : I 'd use idle cycles on the server hardware to optimize the layout on the hard disks and to pre-calculate things like preview images.Anyways , I 'm not a software developer , but I think it 's obvious that if extremely high performance from the perspective of a user were a design goal , it would be possible to deliver .</tokentext>
<sentencetext>Think about the problem for a moment.
The basic action of healthcare is to bring up the records for only one patient, read the records to learn what you need to learn, and then to perform an intervention to slow the rate that the patient is dying at.
After you perform the intervention, you should report your findings by adding more information to the patient's record.So, this already radically makes the problem easier.
It doesn't have to contain all human knowledge : your database should be able to put on the screen of the termnal the records for JUST THAT PATIENT within 1 second.
So no expensive, slow searches of all the records.In addition, it doesn't even need to bring up large files like the MRI right away.
The way the software should work, once a user requests the records of a patient, the software should immediatly put up a summary screen with the information organized by priority.
For MRIs and videos and such, only a preview of the full image need be displayed unless the user actually clicks it.If I were designing the software, I would have it start downloading the full patient record in the background, with a low priority quality of service designation on the packets, to cache in the client machine.
That way if a user left a patient record open for a while (say on a computer that's at a nurse's station) then browsing around the record would become instantaneous.For the server side : I'd use idle cycles on the server hardware to optimize the layout on the hard disks and to pre-calculate things like preview images.Anyways, I'm not a software developer, but I think it's obvious that if extremely high performance from the perspective of a user were a design goal, it would be possible to deliver.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30288502</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280730</id>
	<title>Computers let you employ dumber, cheaper people</title>
	<author>petes\_PoV</author>
	<datestamp>1259661840000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Most IT is about dumbing down. It lets you shed highly trained, expensive staff who are hard to recruit by replacing them with some electronic "brains" and a pair of minimum-wage hands to carry out the machine's orders. For most organisations the key driver is not cost (no matter what they tell you), it's risk. Risk that people will fail, risk that someone else will get to market before them, risk that their tame geek will walk away and take all their I.P. with them, risk that they aren't <i>seen</i> to be using "best practice" and risk that the shareholders will ask why they're doing what everyone else is doing. If that means following the herd and computerising everything - then so be it.
<p>
It's a bit like having an autopilot on a plane, it does most of the work (thank god) and only needs a pilot to make sure everything is running properly and to reassure the pax that there's a credible-looking face at the pointy end of the plane.
</p><p>
There are a few places were employing IT has, genuinely made things faster or reduced their cost to a point where they can be deployed more readily. Crime detection: fingerprints, DNA and surveillance cameras (with facial recognition) are the most ovbious. Whether that can be considered progress, is however, another question entirely.</p></htmltext>
<tokenext>Most IT is about dumbing down .
It lets you shed highly trained , expensive staff who are hard to recruit by replacing them with some electronic " brains " and a pair of minimum-wage hands to carry out the machine 's orders .
For most organisations the key driver is not cost ( no matter what they tell you ) , it 's risk .
Risk that people will fail , risk that someone else will get to market before them , risk that their tame geek will walk away and take all their I.P .
with them , risk that they are n't seen to be using " best practice " and risk that the shareholders will ask why they 're doing what everyone else is doing .
If that means following the herd and computerising everything - then so be it .
It 's a bit like having an autopilot on a plane , it does most of the work ( thank god ) and only needs a pilot to make sure everything is running properly and to reassure the pax that there 's a credible-looking face at the pointy end of the plane .
There are a few places were employing IT has , genuinely made things faster or reduced their cost to a point where they can be deployed more readily .
Crime detection : fingerprints , DNA and surveillance cameras ( with facial recognition ) are the most ovbious .
Whether that can be considered progress , is however , another question entirely .</tokentext>
<sentencetext>Most IT is about dumbing down.
It lets you shed highly trained, expensive staff who are hard to recruit by replacing them with some electronic "brains" and a pair of minimum-wage hands to carry out the machine's orders.
For most organisations the key driver is not cost (no matter what they tell you), it's risk.
Risk that people will fail, risk that someone else will get to market before them, risk that their tame geek will walk away and take all their I.P.
with them, risk that they aren't seen to be using "best practice" and risk that the shareholders will ask why they're doing what everyone else is doing.
If that means following the herd and computerising everything - then so be it.
It's a bit like having an autopilot on a plane, it does most of the work (thank god) and only needs a pilot to make sure everything is running properly and to reassure the pax that there's a credible-looking face at the pointy end of the plane.
There are a few places were employing IT has, genuinely made things faster or reduced their cost to a point where they can be deployed more readily.
Crime detection: fingerprints, DNA and surveillance cameras (with facial recognition) are the most ovbious.
Whether that can be considered progress, is however, another question entirely.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283532</id>
	<title>Watered-down quality results?</title>
	<author>yamfry</author>
	<datestamp>1259684400000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I read the linked Harvard study (I know, unprecedented!). I found the measurements a little misleading -- and I'd appreciate any contrary opinions on this. The degree of computerization was measured by taking the number of electronic systems that the hospital uses and dividing it by 24 (the total number of computer systems they measured). These computer systems included things like "patient billing", "staff scheduling", and "materials management". Not that those things are unimportant in and of themselves, but when we count those towards being a "computerized" hospital, it tends to water down the importance of other computer systems. For example, a hospital that uses a computer to make their nurse schedules and credit collection is considered as computerized as a hospital that uses computerized physician order entry (CPOE) and electronic medical records (EMR). I don't think you can group those two together and say they belong in the same category when analyzing quality of healthcare at a hospital.<br>
The study actually presents a sub-analysis of quality measures for hospital that use CPOE and EMR and shows that there are significant quality improvements when these systems are used. I think that when we talk about computerizing hospital processes, these are the systems that we consider -- not whether HR uses computers for payroll. I think it is a little disengenuous for the conclusions of this study (and reporting thereof) to state that there is no relationship between computerization and quality of care.<br>
Disclaimer: Without CPOE and EMR, I would be unemployed<nobr> <wbr></nobr>:)</htmltext>
<tokenext>I read the linked Harvard study ( I know , unprecedented ! ) .
I found the measurements a little misleading -- and I 'd appreciate any contrary opinions on this .
The degree of computerization was measured by taking the number of electronic systems that the hospital uses and dividing it by 24 ( the total number of computer systems they measured ) .
These computer systems included things like " patient billing " , " staff scheduling " , and " materials management " .
Not that those things are unimportant in and of themselves , but when we count those towards being a " computerized " hospital , it tends to water down the importance of other computer systems .
For example , a hospital that uses a computer to make their nurse schedules and credit collection is considered as computerized as a hospital that uses computerized physician order entry ( CPOE ) and electronic medical records ( EMR ) .
I do n't think you can group those two together and say they belong in the same category when analyzing quality of healthcare at a hospital .
The study actually presents a sub-analysis of quality measures for hospital that use CPOE and EMR and shows that there are significant quality improvements when these systems are used .
I think that when we talk about computerizing hospital processes , these are the systems that we consider -- not whether HR uses computers for payroll .
I think it is a little disengenuous for the conclusions of this study ( and reporting thereof ) to state that there is no relationship between computerization and quality of care .
Disclaimer : Without CPOE and EMR , I would be unemployed : )</tokentext>
<sentencetext>I read the linked Harvard study (I know, unprecedented!).
I found the measurements a little misleading -- and I'd appreciate any contrary opinions on this.
The degree of computerization was measured by taking the number of electronic systems that the hospital uses and dividing it by 24 (the total number of computer systems they measured).
These computer systems included things like "patient billing", "staff scheduling", and "materials management".
Not that those things are unimportant in and of themselves, but when we count those towards being a "computerized" hospital, it tends to water down the importance of other computer systems.
For example, a hospital that uses a computer to make their nurse schedules and credit collection is considered as computerized as a hospital that uses computerized physician order entry (CPOE) and electronic medical records (EMR).
I don't think you can group those two together and say they belong in the same category when analyzing quality of healthcare at a hospital.
The study actually presents a sub-analysis of quality measures for hospital that use CPOE and EMR and shows that there are significant quality improvements when these systems are used.
I think that when we talk about computerizing hospital processes, these are the systems that we consider -- not whether HR uses computers for payroll.
I think it is a little disengenuous for the conclusions of this study (and reporting thereof) to state that there is no relationship between computerization and quality of care.
Disclaimer: Without CPOE and EMR, I would be unemployed :)</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284178</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259687220000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>Doctors and other medical personnel do not typically hold much power<br>when it comes to IT.</p></div><p>You do not work in a hospital environment do you?  Right now I am scanning a doctors laptop for viruses, instead of working on a important project (anesthesia related), just so he can continue surfing porn.  Remember that the Doctors are the breadwinners for hospitals, so their words hold much sway.</p><p><div class="quote"><p>Software vendors aim to please management, they are the ones who take<br>the purchasing decisions.</p></div><p>This is true, more accurately it is accounting that does this.  But after they buy the software, its up to the staff to dictate what you do with your schedule after.</p></div>
	</htmltext>
<tokenext>Doctors and other medical personnel do not typically hold much powerwhen it comes to IT.You do not work in a hospital environment do you ?
Right now I am scanning a doctors laptop for viruses , instead of working on a important project ( anesthesia related ) , just so he can continue surfing porn .
Remember that the Doctors are the breadwinners for hospitals , so their words hold much sway.Software vendors aim to please management , they are the ones who takethe purchasing decisions.This is true , more accurately it is accounting that does this .
But after they buy the software , its up to the staff to dictate what you do with your schedule after .</tokentext>
<sentencetext>Doctors and other medical personnel do not typically hold much powerwhen it comes to IT.You do not work in a hospital environment do you?
Right now I am scanning a doctors laptop for viruses, instead of working on a important project (anesthesia related), just so he can continue surfing porn.
Remember that the Doctors are the breadwinners for hospitals, so their words hold much sway.Software vendors aim to please management, they are the ones who takethe purchasing decisions.This is true, more accurately it is accounting that does this.
But after they buy the software, its up to the staff to dictate what you do with your schedule after.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280618</id>
	<title>Wrong question addressed in study:</title>
	<author>oDDmON oUT</author>
	<datestamp>1259660760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Background/true story:</p><p>Mid 1990s.</p><p>Large hospital invests in an extremely expensive computerized charting system.</p><p>Staff were not paid to chart after their shift concluded.  Instead, despite being overworked, they were expected to chart as they went through the day.</p><p>Said charting system had a key combination called "Magic Lookup", whereby pressing two keys for a given patient data field inserted the value put there from a previous charting input (i.e. temperature, blood pressure, ambulated, etc., etc., etc.).  When used, this combo would give an audible chirp, of a quite different sound than that of regular input.</p><p>At the end of shift one could stand in the hallway and listen, while a five minute or so chorus of crickets erupted as staff made heavy use of "Magic Lookup" in order to get the hell out the door.</p><p>This was an excellent opportunity for such charting f*ck ups such as "Ambulated = YES" a bilateral stroke patient to occur.</p><p>It was also an excellent reason for my choosing a career in IT, rather than the nursing degree I was going for at the time.</p><p>I would love to see Yale do a study measuring the negative patient outcomes affected by IT systems put in place by hospital administrators who've been served vendor Kool-Aid&#174; over the last 15 years.</p></htmltext>
<tokenext>Background/true story : Mid 1990s.Large hospital invests in an extremely expensive computerized charting system.Staff were not paid to chart after their shift concluded .
Instead , despite being overworked , they were expected to chart as they went through the day.Said charting system had a key combination called " Magic Lookup " , whereby pressing two keys for a given patient data field inserted the value put there from a previous charting input ( i.e .
temperature , blood pressure , ambulated , etc. , etc. , etc. ) .
When used , this combo would give an audible chirp , of a quite different sound than that of regular input.At the end of shift one could stand in the hallway and listen , while a five minute or so chorus of crickets erupted as staff made heavy use of " Magic Lookup " in order to get the hell out the door.This was an excellent opportunity for such charting f * ck ups such as " Ambulated = YES " a bilateral stroke patient to occur.It was also an excellent reason for my choosing a career in IT , rather than the nursing degree I was going for at the time.I would love to see Yale do a study measuring the negative patient outcomes affected by IT systems put in place by hospital administrators who 've been served vendor Kool-Aid   over the last 15 years .</tokentext>
<sentencetext>Background/true story:Mid 1990s.Large hospital invests in an extremely expensive computerized charting system.Staff were not paid to chart after their shift concluded.
Instead, despite being overworked, they were expected to chart as they went through the day.Said charting system had a key combination called "Magic Lookup", whereby pressing two keys for a given patient data field inserted the value put there from a previous charting input (i.e.
temperature, blood pressure, ambulated, etc., etc., etc.).
When used, this combo would give an audible chirp, of a quite different sound than that of regular input.At the end of shift one could stand in the hallway and listen, while a five minute or so chorus of crickets erupted as staff made heavy use of "Magic Lookup" in order to get the hell out the door.This was an excellent opportunity for such charting f*ck ups such as "Ambulated = YES" a bilateral stroke patient to occur.It was also an excellent reason for my choosing a career in IT, rather than the nursing degree I was going for at the time.I would love to see Yale do a study measuring the negative patient outcomes affected by IT systems put in place by hospital administrators who've been served vendor Kool-Aid® over the last 15 years.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285154</id>
	<title>Re:I would also guess...</title>
	<author>joocemann</author>
	<datestamp>1259691480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>*Wooooooooooooooooosh*</p></htmltext>
<tokenext>* Wooooooooooooooooosh *</tokentext>
<sentencetext>*Wooooooooooooooooosh*</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280500</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280584</id>
	<title>Timing</title>
	<author>snorris01</author>
	<datestamp>1259660400000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>This study sure seems conveniently timed in relation to the current healthcared 'debate'.</p><p>Here's to hoping it is good science and not mostly partisan.</p><p>I'm getting tired of that crap.</p></htmltext>
<tokenext>This study sure seems conveniently timed in relation to the current healthcared 'debate'.Here 's to hoping it is good science and not mostly partisan.I 'm getting tired of that crap .</tokentext>
<sentencetext>This study sure seems conveniently timed in relation to the current healthcared 'debate'.Here's to hoping it is good science and not mostly partisan.I'm getting tired of that crap.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280854</id>
	<title>Re:I would also guess...</title>
	<author>Spliffster</author>
	<datestamp>1259663100000</datestamp>
	<modclass>Informativ</modclass>
	<modscore>2</modscore>
	<htmltext><p><div class="quote"><p>That some of this has to do with the staff being largely of the 35+ crowd and the propensity of that crowd to not know how to use computers even remotely as well as, say, a 16 year old kid does right now.</p></div><p>This is exactly what I witness. I am working as a Software developer in a University Hospital in Europe. Just an example:</p><p>It often happens here, That some one enters data into a system. Then another devision needs said data and guess what they do? Data is printed out, faxed internally to another devision and usually a subset of the data is entered manually into another system again. Despite the fact that all involved users have access to both systems and if they'd use the systems appropriate, data would be exchanged automatically between theses systems (data exchange doesn't always happen automatically for several logical or obscure reasons).</p><p>As it looks like (from talks with IT stuff from other hospitals) we are not a special case. Especially non academic employees in a hospital are really resistant in learning how to use these "new" technologies (it works much better with younger employees).</p></div>
	</htmltext>
<tokenext>That some of this has to do with the staff being largely of the 35 + crowd and the propensity of that crowd to not know how to use computers even remotely as well as , say , a 16 year old kid does right now.This is exactly what I witness .
I am working as a Software developer in a University Hospital in Europe .
Just an example : It often happens here , That some one enters data into a system .
Then another devision needs said data and guess what they do ?
Data is printed out , faxed internally to another devision and usually a subset of the data is entered manually into another system again .
Despite the fact that all involved users have access to both systems and if they 'd use the systems appropriate , data would be exchanged automatically between theses systems ( data exchange does n't always happen automatically for several logical or obscure reasons ) .As it looks like ( from talks with IT stuff from other hospitals ) we are not a special case .
Especially non academic employees in a hospital are really resistant in learning how to use these " new " technologies ( it works much better with younger employees ) .</tokentext>
<sentencetext>That some of this has to do with the staff being largely of the 35+ crowd and the propensity of that crowd to not know how to use computers even remotely as well as, say, a 16 year old kid does right now.This is exactly what I witness.
I am working as a Software developer in a University Hospital in Europe.
Just an example:It often happens here, That some one enters data into a system.
Then another devision needs said data and guess what they do?
Data is printed out, faxed internally to another devision and usually a subset of the data is entered manually into another system again.
Despite the fact that all involved users have access to both systems and if they'd use the systems appropriate, data would be exchanged automatically between theses systems (data exchange doesn't always happen automatically for several logical or obscure reasons).As it looks like (from talks with IT stuff from other hospitals) we are not a special case.
Especially non academic employees in a hospital are really resistant in learning how to use these "new" technologies (it works much better with younger employees).
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280274</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280948</id>
	<title>Re:I work in a major hospital</title>
	<author>jma05</author>
	<datestamp>1259664000000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>If they were big help, nurses would not be *working around* them.</p><p><a href="http://scholar.google.com/scholar?q=Workarounds+to+Barcode+Medication+Administration+Systems" title="google.com">http://scholar.google.com/scholar?q=Workarounds+to+Barcode+Medication+Administration+Systems</a> [google.com]</p><p>The trouble is... clinical care settings are not like business systems. Solutions that work in one place don't transfer over.</p></htmltext>
<tokenext>If they were big help , nurses would not be * working around * them.http : //scholar.google.com/scholar ? q = Workarounds + to + Barcode + Medication + Administration + Systems [ google.com ] The trouble is... clinical care settings are not like business systems .
Solutions that work in one place do n't transfer over .</tokentext>
<sentencetext>If they were big help, nurses would not be *working around* them.http://scholar.google.com/scholar?q=Workarounds+to+Barcode+Medication+Administration+Systems [google.com]The trouble is... clinical care settings are not like business systems.
Solutions that work in one place don't transfer over.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280510</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280500</id>
	<title>Re:I would also guess...</title>
	<author>Anonymous</author>
	<datestamp>1259659260000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>3</modscore>
	<htmltext><p>&gt; That some of this has to do with the staff being largely of the 35+ crowd and the propensity of that crowd to not know how to use computers even remotely as well as, say, a 16 year old kid does right now.</p><p>That used to be a favorite argument to explain away poor clinical system adoption. But it does not hold true anymore. An average doctor today is at least as computer savvy as an average teenager. They may not use SMS, twitter or use facebook as much as the teens, but they certainly know how a computer works. This isn't the 90s when computers were optional in life.</p><p>&gt; Computers take more work to use when you don't have a nice grasp on not only the software or function you're doing, but the regular logical deductions you make from repeated observation and experience.</p><p>Good clinical software should not need you to be an expert in computers... just that software... the one they use for several hours each day. And if it takes considerable experience to get up to speed... that's a usability problem... not a user problem.</p></htmltext>
<tokenext>&gt; That some of this has to do with the staff being largely of the 35 + crowd and the propensity of that crowd to not know how to use computers even remotely as well as , say , a 16 year old kid does right now.That used to be a favorite argument to explain away poor clinical system adoption .
But it does not hold true anymore .
An average doctor today is at least as computer savvy as an average teenager .
They may not use SMS , twitter or use facebook as much as the teens , but they certainly know how a computer works .
This is n't the 90s when computers were optional in life. &gt; Computers take more work to use when you do n't have a nice grasp on not only the software or function you 're doing , but the regular logical deductions you make from repeated observation and experience.Good clinical software should not need you to be an expert in computers... just that software... the one they use for several hours each day .
And if it takes considerable experience to get up to speed... that 's a usability problem... not a user problem .</tokentext>
<sentencetext>&gt; That some of this has to do with the staff being largely of the 35+ crowd and the propensity of that crowd to not know how to use computers even remotely as well as, say, a 16 year old kid does right now.That used to be a favorite argument to explain away poor clinical system adoption.
But it does not hold true anymore.
An average doctor today is at least as computer savvy as an average teenager.
They may not use SMS, twitter or use facebook as much as the teens, but they certainly know how a computer works.
This isn't the 90s when computers were optional in life.&gt; Computers take more work to use when you don't have a nice grasp on not only the software or function you're doing, but the regular logical deductions you make from repeated observation and experience.Good clinical software should not need you to be an expert in computers... just that software... the one they use for several hours each day.
And if it takes considerable experience to get up to speed... that's a usability problem... not a user problem.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280274</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280718</id>
	<title>Re:I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259661720000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Speaking as a pharmacy technician, barcodes have not improved my job in the slightest (at least, not as currently implemented).</p><p>Our buyer always seems to be shifting brands of drugs according to what is available and what is cheapest, and all those new drugs have to be inputted into the system before you can properly use them.</p><p>Plus, the scanners we have to use are slow and unreliable; this past weekend, all but one of them were broken.</p><p>Using the new system is at best not any more efficient than the old system, and often takes me about twice as long.</p></htmltext>
<tokenext>Speaking as a pharmacy technician , barcodes have not improved my job in the slightest ( at least , not as currently implemented ) .Our buyer always seems to be shifting brands of drugs according to what is available and what is cheapest , and all those new drugs have to be inputted into the system before you can properly use them.Plus , the scanners we have to use are slow and unreliable ; this past weekend , all but one of them were broken.Using the new system is at best not any more efficient than the old system , and often takes me about twice as long .</tokentext>
<sentencetext>Speaking as a pharmacy technician, barcodes have not improved my job in the slightest (at least, not as currently implemented).Our buyer always seems to be shifting brands of drugs according to what is available and what is cheapest, and all those new drugs have to be inputted into the system before you can properly use them.Plus, the scanners we have to use are slow and unreliable; this past weekend, all but one of them were broken.Using the new system is at best not any more efficient than the old system, and often takes me about twice as long.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280510</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30293244</id>
	<title>Yet another reason not to send my kid to Harvard?</title>
	<author>watsonoo7</author>
	<datestamp>1259686380000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Yeah.  Let's just drop kick all of those pesky little clinical applications that help the care givers deliver the right medications to the right patients.  It's probably a lot cheaper just to pay the attorneys and plaintiffs.

I'll admit it.  I haven't read the Harvard report.  Nor will I.  Nothing personal against Harvard but if the report is actually as stupid as the slashdot teaser indicates then it would be just a waste of time.

While we're at it let's get rid of all of the technological devices that dump our medical data into the clinical apps too.  Those really expensive MRI machines are only creating huge data files that make the clinical applications even more inefficient and expensive.</htmltext>
<tokenext>Yeah .
Let 's just drop kick all of those pesky little clinical applications that help the care givers deliver the right medications to the right patients .
It 's probably a lot cheaper just to pay the attorneys and plaintiffs .
I 'll admit it .
I have n't read the Harvard report .
Nor will I. Nothing personal against Harvard but if the report is actually as stupid as the slashdot teaser indicates then it would be just a waste of time .
While we 're at it let 's get rid of all of the technological devices that dump our medical data into the clinical apps too .
Those really expensive MRI machines are only creating huge data files that make the clinical applications even more inefficient and expensive .</tokentext>
<sentencetext>Yeah.
Let's just drop kick all of those pesky little clinical applications that help the care givers deliver the right medications to the right patients.
It's probably a lot cheaper just to pay the attorneys and plaintiffs.
I'll admit it.
I haven't read the Harvard report.
Nor will I.  Nothing personal against Harvard but if the report is actually as stupid as the slashdot teaser indicates then it would be just a waste of time.
While we're at it let's get rid of all of the technological devices that dump our medical data into the clinical apps too.
Those really expensive MRI machines are only creating huge data files that make the clinical applications even more inefficient and expensive.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280488</id>
	<title>Yeah but...</title>
	<author>zenasprime</author>
	<datestamp>1259659080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>...have you actually seen the so called "software" that hospitals are running their businesses with?  I'm lucky if our software doesn't crash, lag, not save records, etc while I'm trying to do my work.  And don't even get me started on our "administrator", who routinely doesn't even bother to test whether or not an upgrade is going to work on the test server, if they even had a test server (which they don't).</p></htmltext>
<tokenext>...have you actually seen the so called " software " that hospitals are running their businesses with ?
I 'm lucky if our software does n't crash , lag , not save records , etc while I 'm trying to do my work .
And do n't even get me started on our " administrator " , who routinely does n't even bother to test whether or not an upgrade is going to work on the test server , if they even had a test server ( which they do n't ) .</tokentext>
<sentencetext>...have you actually seen the so called "software" that hospitals are running their businesses with?
I'm lucky if our software doesn't crash, lag, not save records, etc while I'm trying to do my work.
And don't even get me started on our "administrator", who routinely doesn't even bother to test whether or not an upgrade is going to work on the test server, if they even had a test server (which they don't).</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280594</id>
	<title>Let me explain...</title>
	<author>Anonymous</author>
	<datestamp>1259660580000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>4</modscore>
	<htmltext><p>You: Computers have made my life much easier.<br>Harvard study: Computers don't save hospitals money.</p><p>Note the slight difference there?</p></htmltext>
<tokenext>You : Computers have made my life much easier.Harvard study : Computers do n't save hospitals money.Note the slight difference there ?</tokentext>
<sentencetext>You: Computers have made my life much easier.Harvard study: Computers don't save hospitals money.Note the slight difference there?</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283824</id>
	<title>Try the Scientific Method</title>
	<author>Rambo Tribble</author>
	<datestamp>1259685660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>To test this theory, go into a hospital and unplug all the IT systems. I'm willing to bet costs go up.</htmltext>
<tokenext>To test this theory , go into a hospital and unplug all the IT systems .
I 'm willing to bet costs go up .</tokentext>
<sentencetext>To test this theory, go into a hospital and unplug all the IT systems.
I'm willing to bet costs go up.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280510</id>
	<title>Re:I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259659320000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Ya, I don't understand the conclusion either.</p><p>I have nothing to do w/health care, but bar codes alone should have been a big help.</p></htmltext>
<tokenext>Ya , I do n't understand the conclusion either.I have nothing to do w/health care , but bar codes alone should have been a big help .</tokentext>
<sentencetext>Ya, I don't understand the conclusion either.I have nothing to do w/health care, but bar codes alone should have been a big help.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30288502</id>
	<title>Re:Well</title>
	<author>CodeBuster</author>
	<datestamp>1259660520000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>So lets recap here: really fast, can handle any data from any time, and a complete compendium of all human knowledge. How much did you say was budgeted for this system again? If you have a practically unlimited budget then such a system might be possible, but if you want to get it done before some time next century and at a reasonable price there have to be compromises.</htmltext>
<tokenext>So lets recap here : really fast , can handle any data from any time , and a complete compendium of all human knowledge .
How much did you say was budgeted for this system again ?
If you have a practically unlimited budget then such a system might be possible , but if you want to get it done before some time next century and at a reasonable price there have to be compromises .</tokentext>
<sentencetext>So lets recap here: really fast, can handle any data from any time, and a complete compendium of all human knowledge.
How much did you say was budgeted for this system again?
If you have a practically unlimited budget then such a system might be possible, but if you want to get it done before some time next century and at a reasonable price there have to be compromises.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</id>
	<title>I work in a major hospital</title>
	<author>Anonymous</author>
	<datestamp>1259699640000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>4</modscore>
	<htmltext><p>And have significant responsibilities for patient care and management.  Computers have made my life much easier.  With electronic charting I can follow all of my patients directly from a terminal that I carry with me.  The charting software we have includes basic spreadsheet and summary functions that are highly customizable.  I am able to track trends and make decisions for my patients based on sight and intuition rather than having to sort through paper charts and bad handwriting.  Its all at my fingertips.  I don't know where Dr. harvard did his research but maybe he just has bad software.  My computer system is outstanding and I honestly don't know if I'll ever be able to work in another hospital.</p></htmltext>
<tokenext>And have significant responsibilities for patient care and management .
Computers have made my life much easier .
With electronic charting I can follow all of my patients directly from a terminal that I carry with me .
The charting software we have includes basic spreadsheet and summary functions that are highly customizable .
I am able to track trends and make decisions for my patients based on sight and intuition rather than having to sort through paper charts and bad handwriting .
Its all at my fingertips .
I do n't know where Dr. harvard did his research but maybe he just has bad software .
My computer system is outstanding and I honestly do n't know if I 'll ever be able to work in another hospital .</tokentext>
<sentencetext>And have significant responsibilities for patient care and management.
Computers have made my life much easier.
With electronic charting I can follow all of my patients directly from a terminal that I carry with me.
The charting software we have includes basic spreadsheet and summary functions that are highly customizable.
I am able to track trends and make decisions for my patients based on sight and intuition rather than having to sort through paper charts and bad handwriting.
Its all at my fingertips.
I don't know where Dr. harvard did his research but maybe he just has bad software.
My computer system is outstanding and I honestly don't know if I'll ever be able to work in another hospital.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30286596</id>
	<title>Re:Well</title>
	<author>demonlapin</author>
	<datestamp>1259696880000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>It should be INSTANTANEOUSLY fast!</p></div><p>Don't get me started. In our EHR, changing the visit # (which is needed to make sure that that patient is billed correctly, i.e. the charge for anesthesia isn't associated with your clinic visit but instead with your actual surgery) takes almost twenty seconds of waiting for the system.  The actual clicking part takes less than five.</p></div>
	</htmltext>
<tokenext>It should be INSTANTANEOUSLY fast ! Do n't get me started .
In our EHR , changing the visit # ( which is needed to make sure that that patient is billed correctly , i.e .
the charge for anesthesia is n't associated with your clinic visit but instead with your actual surgery ) takes almost twenty seconds of waiting for the system .
The actual clicking part takes less than five .</tokentext>
<sentencetext>It should be INSTANTANEOUSLY fast!Don't get me started.
In our EHR, changing the visit # (which is needed to make sure that that patient is billed correctly, i.e.
the charge for anesthesia isn't associated with your clinic visit but instead with your actual surgery) takes almost twenty seconds of waiting for the system.
The actual clicking part takes less than five.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30287124</id>
	<title>Re:Well</title>
	<author>Anonymous</author>
	<datestamp>1259698500000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>But then I thought - perhaps it's actually quicker for those doctors to simply ask the question again, rather than to find a workstation and query the patient record.</p></div><p>That's why patients have wristbands, and why you can get a PDA or tablet with an attached bar code reader. (Or, these days, RFID scanner.)</p></div>
	</htmltext>
<tokenext>But then I thought - perhaps it 's actually quicker for those doctors to simply ask the question again , rather than to find a workstation and query the patient record.That 's why patients have wristbands , and why you can get a PDA or tablet with an attached bar code reader .
( Or , these days , RFID scanner .
)</tokentext>
<sentencetext>But then I thought - perhaps it's actually quicker for those doctors to simply ask the question again, rather than to find a workstation and query the patient record.That's why patients have wristbands, and why you can get a PDA or tablet with an attached bar code reader.
(Or, these days, RFID scanner.
)
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281534</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283934</id>
	<title>Re:Well</title>
	<author>pnutjam</author>
	<datestamp>1259686140000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>ding..ding..ding, it not that there isn't room to improve, it's just that nobody does...</htmltext>
<tokenext>ding..ding..ding , it not that there is n't room to improve , it 's just that nobody does.. .</tokentext>
<sentencetext>ding..ding..ding, it not that there isn't room to improve, it's just that nobody does...</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281348</id>
	<title>Re:Let me explain...</title>
	<author>Anonymous</author>
	<datestamp>1259668380000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>"much easier" would save them more money if absolutely nothing changed besides removing the paper and adding the computers.</p><p>But considering how they are capable of taking on more patients in a shorter time thanks to the more efficient method of computing, more money will obviously be spent.</p><p>I can spend barely 5-15 minutes seeing the doctor if i'm a little ill, previously that would have been much higher.<br>And with cancellations taken in to consideration, the amount of wasted time would be far worse.<br>Not to mention that the fast access time of computing databases for patients in emergencies, all those seconds count.</p><p>(mind you, this is from the UK here, not sure if that would count)</p></htmltext>
<tokenext>" much easier " would save them more money if absolutely nothing changed besides removing the paper and adding the computers.But considering how they are capable of taking on more patients in a shorter time thanks to the more efficient method of computing , more money will obviously be spent.I can spend barely 5-15 minutes seeing the doctor if i 'm a little ill , previously that would have been much higher.And with cancellations taken in to consideration , the amount of wasted time would be far worse.Not to mention that the fast access time of computing databases for patients in emergencies , all those seconds count .
( mind you , this is from the UK here , not sure if that would count )</tokentext>
<sentencetext>"much easier" would save them more money if absolutely nothing changed besides removing the paper and adding the computers.But considering how they are capable of taking on more patients in a shorter time thanks to the more efficient method of computing, more money will obviously be spent.I can spend barely 5-15 minutes seeing the doctor if i'm a little ill, previously that would have been much higher.And with cancellations taken in to consideration, the amount of wasted time would be far worse.Not to mention that the fast access time of computing databases for patients in emergencies, all those seconds count.
(mind you, this is from the UK here, not sure if that would count)</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280594</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284058</id>
	<title>Re:Well</title>
	<author>curare19</author>
	<datestamp>1259686620000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I'm an EMT.  When I was first certified, we had to go through a practical test of asking the patient medical history, what happened, allergies, medications, etc.  Through the course of the test, we probably asked "what happened" two or three times.  I knew the ER would ask again.  And again.  I thought it was wasteful and said so.<p>

The EMT who was training us explained that stories often change through those multiple askings.  My experience confirmed her explanation.  As another commenter mentioned, the truth GRADUALLY comes out.  Though many people will answer "What's your medical history?" accurately each time, some will change the story based on who is there, how much time they've had to think about it, once they've calmed down, and whether something else you've said reminded them.
</p><p>
"Do you have any medications or history I should know about?" once turned from "No" into "I have a chronic medical condition and take numerous medications for the condition" based on some gentle reminders.  "Could you be pregnant?" turns from "No" into "Yes" once family members are no longer within hearing range.</p><p>

A lot of medical inefficiencies make more sense when the soft squishy human side is taken into account.</p></htmltext>
<tokenext>I 'm an EMT .
When I was first certified , we had to go through a practical test of asking the patient medical history , what happened , allergies , medications , etc .
Through the course of the test , we probably asked " what happened " two or three times .
I knew the ER would ask again .
And again .
I thought it was wasteful and said so .
The EMT who was training us explained that stories often change through those multiple askings .
My experience confirmed her explanation .
As another commenter mentioned , the truth GRADUALLY comes out .
Though many people will answer " What 's your medical history ?
" accurately each time , some will change the story based on who is there , how much time they 've had to think about it , once they 've calmed down , and whether something else you 've said reminded them .
" Do you have any medications or history I should know about ?
" once turned from " No " into " I have a chronic medical condition and take numerous medications for the condition " based on some gentle reminders .
" Could you be pregnant ?
" turns from " No " into " Yes " once family members are no longer within hearing range .
A lot of medical inefficiencies make more sense when the soft squishy human side is taken into account .</tokentext>
<sentencetext>I'm an EMT.
When I was first certified, we had to go through a practical test of asking the patient medical history, what happened, allergies, medications, etc.
Through the course of the test, we probably asked "what happened" two or three times.
I knew the ER would ask again.
And again.
I thought it was wasteful and said so.
The EMT who was training us explained that stories often change through those multiple askings.
My experience confirmed her explanation.
As another commenter mentioned, the truth GRADUALLY comes out.
Though many people will answer "What's your medical history?
" accurately each time, some will change the story based on who is there, how much time they've had to think about it, once they've calmed down, and whether something else you've said reminded them.
"Do you have any medications or history I should know about?
" once turned from "No" into "I have a chronic medical condition and take numerous medications for the condition" based on some gentle reminders.
"Could you be pregnant?
" turns from "No" into "Yes" once family members are no longer within hearing range.
A lot of medical inefficiencies make more sense when the soft squishy human side is taken into account.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281892</id>
	<title>I recall a similar study on household appliances</title>
	<author>erroneus</author>
	<datestamp>1259674440000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Many many years ago, a study over the modernization of household appliances and stuff affected the workload of the average housewife.  In the end, it showed the amount of work that could be done in a day was just about the same.</p></htmltext>
<tokenext>Many many years ago , a study over the modernization of household appliances and stuff affected the workload of the average housewife .
In the end , it showed the amount of work that could be done in a day was just about the same .</tokentext>
<sentencetext>Many many years ago, a study over the modernization of household appliances and stuff affected the workload of the average housewife.
In the end, it showed the amount of work that could be done in a day was just about the same.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30317080</id>
	<title>Somthing's Wrong...</title>
	<author>Anonymous</author>
	<datestamp>1259837700000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>"Computers Don't Save Hospitals Money"</p><p>let me fix that for you....</p><p>"Crappy Software Doesn't Save Hospitals Money"</p><p>there, that's better</p></htmltext>
<tokenext>" Computers Do n't Save Hospitals Money " let me fix that for you.... " Crappy Software Does n't Save Hospitals Money " there , that 's better</tokentext>
<sentencetext>"Computers Don't Save Hospitals Money"let me fix that for you...."Crappy Software Doesn't Save Hospitals Money"there, that's better</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281482</id>
	<title>The title is acurate</title>
	<author>Cawas</author>
	<datestamp>1259669760000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>But the whole text is not.</p><p>If you go to the original post linked in it from computerworld, you'll have a different impression on that research. I am amazed nobody commented about this so far (although I haven't read all comments). Regardless of it all being well done or not, it is very sensate if you read it through, unlike the slashdot text from Lucas, which generated some angry comments.</p><p>It is true the research showed computers don't save money for hospitals. Absolute majority of them, but not all. And Dr. David Himmelstein quote is also there, but in the end, after everything else was explained. Anyway I don't blame Lucas123 for the same reason I won't try to sum it up. It is a complicated subject. Just wanted to point people to actually go and read the source.</p><p>I will just say that it is evident computers are bluntly necessary nowadays and there is no way for any research to show otherwise. Of course the only way to truly show computers are not a good option, in that case, is to have at least two similar hospitals running side by side, one computer-less. And nobody will do this as it is clear water that the second won't be sustainable.</p></div>
	</htmltext>
<tokenext>But the whole text is not.If you go to the original post linked in it from computerworld , you 'll have a different impression on that research .
I am amazed nobody commented about this so far ( although I have n't read all comments ) .
Regardless of it all being well done or not , it is very sensate if you read it through , unlike the slashdot text from Lucas , which generated some angry comments.It is true the research showed computers do n't save money for hospitals .
Absolute majority of them , but not all .
And Dr. David Himmelstein quote is also there , but in the end , after everything else was explained .
Anyway I do n't blame Lucas123 for the same reason I wo n't try to sum it up .
It is a complicated subject .
Just wanted to point people to actually go and read the source.I will just say that it is evident computers are bluntly necessary nowadays and there is no way for any research to show otherwise .
Of course the only way to truly show computers are not a good option , in that case , is to have at least two similar hospitals running side by side , one computer-less .
And nobody will do this as it is clear water that the second wo n't be sustainable .</tokentext>
<sentencetext>But the whole text is not.If you go to the original post linked in it from computerworld, you'll have a different impression on that research.
I am amazed nobody commented about this so far (although I haven't read all comments).
Regardless of it all being well done or not, it is very sensate if you read it through, unlike the slashdot text from Lucas, which generated some angry comments.It is true the research showed computers don't save money for hospitals.
Absolute majority of them, but not all.
And Dr. David Himmelstein quote is also there, but in the end, after everything else was explained.
Anyway I don't blame Lucas123 for the same reason I won't try to sum it up.
It is a complicated subject.
Just wanted to point people to actually go and read the source.I will just say that it is evident computers are bluntly necessary nowadays and there is no way for any research to show otherwise.
Of course the only way to truly show computers are not a good option, in that case, is to have at least two similar hospitals running side by side, one computer-less.
And nobody will do this as it is clear water that the second won't be sustainable.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280644</id>
	<title>Parkinson's laws</title>
	<author>Anonymous</author>
	<datestamp>1259661180000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>5</modscore>
	<htmltext>Results like these shouldn't surprise anyone aware of Parkinson's laws. From <a href="http://www.berglas.org/Articles/ImportantThatSoftwareFails/ImportantThatSoftwareFails.html" title="berglas.org" rel="nofollow">Why it is Important that Software Projects Fail</a> [berglas.org]:<p><div class="quote"><p>The boundless creativity of politicians and bureaucrats to develop new and more complex regulation is bounded only by the bureaucracy's inability to implement them.  The absolute size of the bureaucracy is constrained by external factors, so the only effect of automation can be to increase bureaucratic complexity.</p></div><p>Parkinson's laws are as valid and insightful as always. If someone by chance have missed them, here they are:</p><p><div class="quote"><p> <strong>Parkinson's First Law:</strong> <br>
Work expands or contracts in order to fill the time available.<br> <br>

<strong>Parkinson's Second Law:</strong> <br>
Expenditures rise to meet income.<br> <br>

<strong>Parkinson's Third Law:</strong> <br>
Expansion means complexity; and complexity decay.<br> <br>

<strong>Parkinson's Fourth Law:</strong> <br>
The number of people in any working group tends to increase regardless of the amount of work to be done.<br> <br>

<strong>Parkinson's Fifth Law:</strong> <br>
If there is a way to delay an important decision the good bureaucracy, public or private, will find it.<br> <br>

<strong>Parkinson's Law of Delay:</strong> <br>
Delay is the deadliest form of denial.<br> <br>

<strong>Parkinson's Law of Triviality:</strong> <br>
The time spent in a meeting on an item is inversely proportional to its value (up to a limit).<br> <br>

<strong>Parkinson's Law of 1,000:</strong> <br>
An enterprise employing more than 1,000 people becomes a self-perpetuating empire, creating so much internal work that it no longer needs any contact with the outside world.<br> <br>

<strong>Parkinson's Coefficient of Inefficiency:</strong> <br>
The size of a committee or other decision-making body grows at which it becomes completely inefficient.</p></div></div>
	</htmltext>
<tokenext>Results like these should n't surprise anyone aware of Parkinson 's laws .
From Why it is Important that Software Projects Fail [ berglas.org ] : The boundless creativity of politicians and bureaucrats to develop new and more complex regulation is bounded only by the bureaucracy 's inability to implement them .
The absolute size of the bureaucracy is constrained by external factors , so the only effect of automation can be to increase bureaucratic complexity.Parkinson 's laws are as valid and insightful as always .
If someone by chance have missed them , here they are : Parkinson 's First Law : Work expands or contracts in order to fill the time available .
Parkinson 's Second Law : Expenditures rise to meet income .
Parkinson 's Third Law : Expansion means complexity ; and complexity decay .
Parkinson 's Fourth Law : The number of people in any working group tends to increase regardless of the amount of work to be done .
Parkinson 's Fifth Law : If there is a way to delay an important decision the good bureaucracy , public or private , will find it .
Parkinson 's Law of Delay : Delay is the deadliest form of denial .
Parkinson 's Law of Triviality : The time spent in a meeting on an item is inversely proportional to its value ( up to a limit ) .
Parkinson 's Law of 1,000 : An enterprise employing more than 1,000 people becomes a self-perpetuating empire , creating so much internal work that it no longer needs any contact with the outside world .
Parkinson 's Coefficient of Inefficiency : The size of a committee or other decision-making body grows at which it becomes completely inefficient .</tokentext>
<sentencetext>Results like these shouldn't surprise anyone aware of Parkinson's laws.
From Why it is Important that Software Projects Fail [berglas.org]:The boundless creativity of politicians and bureaucrats to develop new and more complex regulation is bounded only by the bureaucracy's inability to implement them.
The absolute size of the bureaucracy is constrained by external factors, so the only effect of automation can be to increase bureaucratic complexity.Parkinson's laws are as valid and insightful as always.
If someone by chance have missed them, here they are: Parkinson's First Law: 
Work expands or contracts in order to fill the time available.
Parkinson's Second Law: 
Expenditures rise to meet income.
Parkinson's Third Law: 
Expansion means complexity; and complexity decay.
Parkinson's Fourth Law: 
The number of people in any working group tends to increase regardless of the amount of work to be done.
Parkinson's Fifth Law: 
If there is a way to delay an important decision the good bureaucracy, public or private, will find it.
Parkinson's Law of Delay: 
Delay is the deadliest form of denial.
Parkinson's Law of Triviality: 
The time spent in a meeting on an item is inversely proportional to its value (up to a limit).
Parkinson's Law of 1,000: 
An enterprise employing more than 1,000 people becomes a self-perpetuating empire, creating so much internal work that it no longer needs any contact with the outside world.
Parkinson's Coefficient of Inefficiency: 
The size of a committee or other decision-making body grows at which it becomes completely inefficient.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30286376</id>
	<title>Re:Let me explain...</title>
	<author>Anonymous</author>
	<datestamp>1259696100000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Answer: Bureaucracy, and keeping too many people employed who are not part of the primary function of the business.</p><p>These same numbnuts are busy buying things they know nothing about.</p></htmltext>
<tokenext>Answer : Bureaucracy , and keeping too many people employed who are not part of the primary function of the business.These same numbnuts are busy buying things they know nothing about .</tokentext>
<sentencetext>Answer: Bureaucracy, and keeping too many people employed who are not part of the primary function of the business.These same numbnuts are busy buying things they know nothing about.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280594</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285146</id>
	<title>Harvard MBA's fail again.</title>
	<author>fast turtle</author>
	<datestamp>1259691480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>No I didn't RTFA, just the damn summary yet it looks as though Harvard's MBA's screwed up another investigation. Instead of looking for hospitals where patient care had been improved, they cut costs and screwed the entire study by looking at how computers helped save money. Stupid Gits. Even I know that if you look at how computers saved money, you aint going to get anything on how the computers improved patient care. As an example, my local hospital has dramatically upgraded their entire IT infrastructure and gone to E-records. My mothers primary care doc, is part of this system and has 24/7 access to all lab reports, X-Rays/MRI's/CatScans and anything else that's in the sytem, which has helped tremendously and this is an example of how computers and IT has improved patient care. Yes the evidence is ancedotal but it certainly has improved things for her.</p><p>As others have said, the systems are out there and it's just a matter of knowing who's got them. If we bother taking the time to really learn from those who've improved levels of care, we might finally be able to get some type of Universal health care that provides basic coverage in the United States, which should improve the overall health of the country. Yea I know, wishful thinking as to many people want access to those records.</p></htmltext>
<tokenext>No I did n't RTFA , just the damn summary yet it looks as though Harvard 's MBA 's screwed up another investigation .
Instead of looking for hospitals where patient care had been improved , they cut costs and screwed the entire study by looking at how computers helped save money .
Stupid Gits .
Even I know that if you look at how computers saved money , you aint going to get anything on how the computers improved patient care .
As an example , my local hospital has dramatically upgraded their entire IT infrastructure and gone to E-records .
My mothers primary care doc , is part of this system and has 24/7 access to all lab reports , X-Rays/MRI 's/CatScans and anything else that 's in the sytem , which has helped tremendously and this is an example of how computers and IT has improved patient care .
Yes the evidence is ancedotal but it certainly has improved things for her.As others have said , the systems are out there and it 's just a matter of knowing who 's got them .
If we bother taking the time to really learn from those who 've improved levels of care , we might finally be able to get some type of Universal health care that provides basic coverage in the United States , which should improve the overall health of the country .
Yea I know , wishful thinking as to many people want access to those records .</tokentext>
<sentencetext>No I didn't RTFA, just the damn summary yet it looks as though Harvard's MBA's screwed up another investigation.
Instead of looking for hospitals where patient care had been improved, they cut costs and screwed the entire study by looking at how computers helped save money.
Stupid Gits.
Even I know that if you look at how computers saved money, you aint going to get anything on how the computers improved patient care.
As an example, my local hospital has dramatically upgraded their entire IT infrastructure and gone to E-records.
My mothers primary care doc, is part of this system and has 24/7 access to all lab reports, X-Rays/MRI's/CatScans and anything else that's in the sytem, which has helped tremendously and this is an example of how computers and IT has improved patient care.
Yes the evidence is ancedotal but it certainly has improved things for her.As others have said, the systems are out there and it's just a matter of knowing who's got them.
If we bother taking the time to really learn from those who've improved levels of care, we might finally be able to get some type of Universal health care that provides basic coverage in the United States, which should improve the overall health of the country.
Yea I know, wishful thinking as to many people want access to those records.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283960</id>
	<title>Re:Well</title>
	<author>pnutjam</author>
	<datestamp>1259686320000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Your misdiagnosis rates don't stack that way.  They are not proofing the previous asker's entry, like they would be if they were reading the answers and asking the patient to verify.  They are not even sharing what they learn.</htmltext>
<tokenext>Your misdiagnosis rates do n't stack that way .
They are not proofing the previous asker 's entry , like they would be if they were reading the answers and asking the patient to verify .
They are not even sharing what they learn .</tokentext>
<sentencetext>Your misdiagnosis rates don't stack that way.
They are not proofing the previous asker's entry, like they would be if they were reading the answers and asking the patient to verify.
They are not even sharing what they learn.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281062</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281294</id>
	<title>But they save lives !!!!</title>
	<author>tommeke100</author>
	<datestamp>1259667660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>When "computerizing" medical facilities, the argument is not about how much cheaper treatment is going to be, but how much better it will be for the patients.<br>
So, computers are "bad", right?<br>
How about scanners, computerized microscopes, computer assisted operation tools and/or any other monitoring system?<br>
Sure, they cost more than if they were not used/purchased, but aren't all these meant for BETTER healthcare, and not cost reduction ???</htmltext>
<tokenext>When " computerizing " medical facilities , the argument is not about how much cheaper treatment is going to be , but how much better it will be for the patients .
So , computers are " bad " , right ?
How about scanners , computerized microscopes , computer assisted operation tools and/or any other monitoring system ?
Sure , they cost more than if they were not used/purchased , but are n't all these meant for BETTER healthcare , and not cost reduction ? ?
?</tokentext>
<sentencetext>When "computerizing" medical facilities, the argument is not about how much cheaper treatment is going to be, but how much better it will be for the patients.
So, computers are "bad", right?
How about scanners, computerized microscopes, computer assisted operation tools and/or any other monitoring system?
Sure, they cost more than if they were not used/purchased, but aren't all these meant for BETTER healthcare, and not cost reduction ??
?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30287608</id>
	<title>Re:Let me add to this</title>
	<author>demonlapin</author>
	<datestamp>1259700180000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>don't want to learn a different system for keeping records.</p></div><p>Well, isn't it obvious? Many private-practice physicians work at multiple hospitals as well as their own clinics.  They get little or no benefit from electronic records, but there is a very definite cost in having to learn how that hospital's system works, remembering their username/password (often username is assigned by IT and passwords have differing requirements for complexity, frequency of change, etc.), where certain pieces of information have to be entered...<br> <br>By contrast a paper chart is simple and straightforward; the only difference is whether it's front-to-back or back-to-front for oldest to most recent notes.  <br> <br>I can easily get everything I need from a dictated clinic note or admission/discharge note, which is already available in the EHR - so why would I make my life harder by becoming a typist as well as a physician?</p></div>
	</htmltext>
<tokenext>do n't want to learn a different system for keeping records.Well , is n't it obvious ?
Many private-practice physicians work at multiple hospitals as well as their own clinics .
They get little or no benefit from electronic records , but there is a very definite cost in having to learn how that hospital 's system works , remembering their username/password ( often username is assigned by IT and passwords have differing requirements for complexity , frequency of change , etc .
) , where certain pieces of information have to be entered... By contrast a paper chart is simple and straightforward ; the only difference is whether it 's front-to-back or back-to-front for oldest to most recent notes .
I can easily get everything I need from a dictated clinic note or admission/discharge note , which is already available in the EHR - so why would I make my life harder by becoming a typist as well as a physician ?</tokentext>
<sentencetext>don't want to learn a different system for keeping records.Well, isn't it obvious?
Many private-practice physicians work at multiple hospitals as well as their own clinics.
They get little or no benefit from electronic records, but there is a very definite cost in having to learn how that hospital's system works, remembering their username/password (often username is assigned by IT and passwords have differing requirements for complexity, frequency of change, etc.
), where certain pieces of information have to be entered... By contrast a paper chart is simple and straightforward; the only difference is whether it's front-to-back or back-to-front for oldest to most recent notes.
I can easily get everything I need from a dictated clinic note or admission/discharge note, which is already available in the EHR - so why would I make my life harder by becoming a typist as well as a physician?
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280470</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284098</id>
	<title>Re:Well</title>
	<author>Anonymous</author>
	<datestamp>1259686860000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>There seems to be many ways to implement the features they want too.  My hospital has all digital records and their solution to MRI storage is have the MRI interpreted on the spot and draft a text report on the findings.  One page of text versus a huge MRI.  The actual MRI itself is probably deleted and only the text remains after the "case is closed".</p><p>This also means that when i visit a distant lab they can pull up my "MRI" instantly because all the important facts are there in a tiny text file.</p></htmltext>
<tokenext>There seems to be many ways to implement the features they want too .
My hospital has all digital records and their solution to MRI storage is have the MRI interpreted on the spot and draft a text report on the findings .
One page of text versus a huge MRI .
The actual MRI itself is probably deleted and only the text remains after the " case is closed " .This also means that when i visit a distant lab they can pull up my " MRI " instantly because all the important facts are there in a tiny text file .</tokentext>
<sentencetext>There seems to be many ways to implement the features they want too.
My hospital has all digital records and their solution to MRI storage is have the MRI interpreted on the spot and draft a text report on the findings.
One page of text versus a huge MRI.
The actual MRI itself is probably deleted and only the text remains after the "case is closed".This also means that when i visit a distant lab they can pull up my "MRI" instantly because all the important facts are there in a tiny text file.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30288202</id>
	<title>Smell The Freakin' Java</title>
	<author>DynaSoar</author>
	<datestamp>1259659380000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>During the process of getting 3 degrees and a state state practice certification, I also go an MHA. That's a master's in healthcare administration, an MBA for health care industry (as opposed to providers) management. So I know whereof TFA speaks. I was also a charter member of the international professional group concerned with healthcare IT and associated things, the HIMMS <a href="http://www.himss.org/ASP/index.asp" title="himss.org">http://www.himss.org/ASP/index.asp</a> [himss.org] Take a peek for yourself and see whether you think they're relevant. TFA did beause they use HIMMS data collected with HIMMS analytics tools. In my over-educated opinion, they did pretty much all the right things for getting data and making use of it to answer their question. But.</p><p>I often admit to having signed up for a neuroscience program before even finishing the MHA because I knew I had a defect that prevented me from making use of it as a functioning member of the health care "industry" -- a conscience. And it's true. And that only came about because of what they taught me. Some of that stuff explains why things are as they are, and why TFA failed to note it.</p><p>The health are industry became a larger piece of our GNP than defense decades ago. It did so because it was wanted, so people offered it, and made a lot of money. They made more and better care available, and it got used, and they made lots more money. This continued until it got to the size it is now. There was never any intention of making it cheaper. It was a growth economy of its own no different in principle than the economy of an emerging nation. It would be irresponsible to build a tidal pool into the cash flow, and ridiculous to build a pocket of poverty into the model when one is not needed. What is needed is maximized growth. Right about now folks from all sorts of different viewpoints wave their arms like they're putting out a fire in their hair, and making a shape with their pie hole so it can make noises about, well whatever is their rant du jour. But they are not in possession of all the facts. Those come from geriatric and population epidemiology, and are related to the "boomer bulge" or 'greying' of the population.</p><p>The health care industry has grown around the population and its needs ever since it was allowed to privatize (as opposed to prior government and churches' subsidies). It would be ridiculous to expect otherwise. And it did so by people who already had their eye on the future. The conditions there were so skewed that the industry had to prepare itself or vanish. Losing money is no big deal. The big piles are already hidden under someone else's mattress. But to vanish from the users' grasp -- that could not be allowed.</p><p>Picture it. A cake chart. A horizontal line is made on the bottom row, centered, its width representing the people born that year. The next year the same happens, the first gets pushed up. Repeat every year. When there's no more people in an age bracket, that line disappears. The result, in a growing population, is a pyramid. There's more people born every year than the one before. In a stable population, it'd have parallel, vertical sides. Fine. So the US had this pyramid cake going until WW II. Afterwards, from around 1945 to 1965 there were far more babies born than fit the pyramid, and that year's line stuck out too far. After these 20 years was over and the birth rate was brought back down, there was a large bulge in the pyramid. Year by year this moved up. The bulge is now placed about where the people from within it are retiring (or of that age). And now comes the fun part.</p><p>As the boomers leave the work force, the income available for taxing or paying for health care drops. These people begin to pile into the already overburdened government subsidized programs for social security and medicare. There will be less income per yer due to more boomers going into the 'retired' bracket, more money required for more treatment for more people who are living longer than ever before, and fewer to draw on.</p><p>From 2030 to 2050 there will</p></htmltext>
<tokenext>During the process of getting 3 degrees and a state state practice certification , I also go an MHA .
That 's a master 's in healthcare administration , an MBA for health care industry ( as opposed to providers ) management .
So I know whereof TFA speaks .
I was also a charter member of the international professional group concerned with healthcare IT and associated things , the HIMMS http : //www.himss.org/ASP/index.asp [ himss.org ] Take a peek for yourself and see whether you think they 're relevant .
TFA did beause they use HIMMS data collected with HIMMS analytics tools .
In my over-educated opinion , they did pretty much all the right things for getting data and making use of it to answer their question .
But.I often admit to having signed up for a neuroscience program before even finishing the MHA because I knew I had a defect that prevented me from making use of it as a functioning member of the health care " industry " -- a conscience .
And it 's true .
And that only came about because of what they taught me .
Some of that stuff explains why things are as they are , and why TFA failed to note it.The health are industry became a larger piece of our GNP than defense decades ago .
It did so because it was wanted , so people offered it , and made a lot of money .
They made more and better care available , and it got used , and they made lots more money .
This continued until it got to the size it is now .
There was never any intention of making it cheaper .
It was a growth economy of its own no different in principle than the economy of an emerging nation .
It would be irresponsible to build a tidal pool into the cash flow , and ridiculous to build a pocket of poverty into the model when one is not needed .
What is needed is maximized growth .
Right about now folks from all sorts of different viewpoints wave their arms like they 're putting out a fire in their hair , and making a shape with their pie hole so it can make noises about , well whatever is their rant du jour .
But they are not in possession of all the facts .
Those come from geriatric and population epidemiology , and are related to the " boomer bulge " or 'greying ' of the population.The health care industry has grown around the population and its needs ever since it was allowed to privatize ( as opposed to prior government and churches ' subsidies ) .
It would be ridiculous to expect otherwise .
And it did so by people who already had their eye on the future .
The conditions there were so skewed that the industry had to prepare itself or vanish .
Losing money is no big deal .
The big piles are already hidden under someone else 's mattress .
But to vanish from the users ' grasp -- that could not be allowed.Picture it .
A cake chart .
A horizontal line is made on the bottom row , centered , its width representing the people born that year .
The next year the same happens , the first gets pushed up .
Repeat every year .
When there 's no more people in an age bracket , that line disappears .
The result , in a growing population , is a pyramid .
There 's more people born every year than the one before .
In a stable population , it 'd have parallel , vertical sides .
Fine. So the US had this pyramid cake going until WW II .
Afterwards , from around 1945 to 1965 there were far more babies born than fit the pyramid , and that year 's line stuck out too far .
After these 20 years was over and the birth rate was brought back down , there was a large bulge in the pyramid .
Year by year this moved up .
The bulge is now placed about where the people from within it are retiring ( or of that age ) .
And now comes the fun part.As the boomers leave the work force , the income available for taxing or paying for health care drops .
These people begin to pile into the already overburdened government subsidized programs for social security and medicare .
There will be less income per yer due to more boomers going into the 'retired ' bracket , more money required for more treatment for more people who are living longer than ever before , and fewer to draw on.From 2030 to 2050 there will</tokentext>
<sentencetext>During the process of getting 3 degrees and a state state practice certification, I also go an MHA.
That's a master's in healthcare administration, an MBA for health care industry (as opposed to providers) management.
So I know whereof TFA speaks.
I was also a charter member of the international professional group concerned with healthcare IT and associated things, the HIMMS http://www.himss.org/ASP/index.asp [himss.org] Take a peek for yourself and see whether you think they're relevant.
TFA did beause they use HIMMS data collected with HIMMS analytics tools.
In my over-educated opinion, they did pretty much all the right things for getting data and making use of it to answer their question.
But.I often admit to having signed up for a neuroscience program before even finishing the MHA because I knew I had a defect that prevented me from making use of it as a functioning member of the health care "industry" -- a conscience.
And it's true.
And that only came about because of what they taught me.
Some of that stuff explains why things are as they are, and why TFA failed to note it.The health are industry became a larger piece of our GNP than defense decades ago.
It did so because it was wanted, so people offered it, and made a lot of money.
They made more and better care available, and it got used, and they made lots more money.
This continued until it got to the size it is now.
There was never any intention of making it cheaper.
It was a growth economy of its own no different in principle than the economy of an emerging nation.
It would be irresponsible to build a tidal pool into the cash flow, and ridiculous to build a pocket of poverty into the model when one is not needed.
What is needed is maximized growth.
Right about now folks from all sorts of different viewpoints wave their arms like they're putting out a fire in their hair, and making a shape with their pie hole so it can make noises about, well whatever is their rant du jour.
But they are not in possession of all the facts.
Those come from geriatric and population epidemiology, and are related to the "boomer bulge" or 'greying' of the population.The health care industry has grown around the population and its needs ever since it was allowed to privatize (as opposed to prior government and churches' subsidies).
It would be ridiculous to expect otherwise.
And it did so by people who already had their eye on the future.
The conditions there were so skewed that the industry had to prepare itself or vanish.
Losing money is no big deal.
The big piles are already hidden under someone else's mattress.
But to vanish from the users' grasp -- that could not be allowed.Picture it.
A cake chart.
A horizontal line is made on the bottom row, centered, its width representing the people born that year.
The next year the same happens, the first gets pushed up.
Repeat every year.
When there's no more people in an age bracket, that line disappears.
The result, in a growing population, is a pyramid.
There's more people born every year than the one before.
In a stable population, it'd have parallel, vertical sides.
Fine. So the US had this pyramid cake going until WW II.
Afterwards, from around 1945 to 1965 there were far more babies born than fit the pyramid, and that year's line stuck out too far.
After these 20 years was over and the birth rate was brought back down, there was a large bulge in the pyramid.
Year by year this moved up.
The bulge is now placed about where the people from within it are retiring (or of that age).
And now comes the fun part.As the boomers leave the work force, the income available for taxing or paying for health care drops.
These people begin to pile into the already overburdened government subsidized programs for social security and medicare.
There will be less income per yer due to more boomers going into the 'retired' bracket, more money required for more treatment for more people who are living longer than ever before, and fewer to draw on.From 2030 to 2050 there will</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280868</id>
	<title>Re:The crux of the matter</title>
	<author>Another, completely</author>
	<datestamp>1259663220000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Maybe I'm misinformed, but don't most (private) U.S. hospitals treat doctors like customers?  In several computer systems that I saw in New York state, they were providing different report styles and different input methods (from e-mail to hand-written) for the different doctors.  The reason I was given was that they had to do this, since doctors who didn't feel the hospital system suited their unique requirements would suggest different hospitals to their patients.  The resulting computer systems were very inefficient, compared with what they could be with more cohesive planning.</p><p>Also, isn't a large part of paperwork involved with billing, and filing the right forms with the various payers?  I don't suppose the insurance and government agencies publish WSDL interfaces for their claims, so that probably needs to be transcribed to paper, right?  What portion of administrative cost goes to copying data by hand from the computer?</p><p>It would be interesting to see the same study in a single-payer environment; or even in a simpler mixed-payer environment where supplementary coverage claims are filed by the patient, rather than the hospital, and the competition between hospitals for the preference of independent doctors is a bit less fierce.  It may be that the U.S. healthcare system is just an extreme case.</p></htmltext>
<tokenext>Maybe I 'm misinformed , but do n't most ( private ) U.S. hospitals treat doctors like customers ?
In several computer systems that I saw in New York state , they were providing different report styles and different input methods ( from e-mail to hand-written ) for the different doctors .
The reason I was given was that they had to do this , since doctors who did n't feel the hospital system suited their unique requirements would suggest different hospitals to their patients .
The resulting computer systems were very inefficient , compared with what they could be with more cohesive planning.Also , is n't a large part of paperwork involved with billing , and filing the right forms with the various payers ?
I do n't suppose the insurance and government agencies publish WSDL interfaces for their claims , so that probably needs to be transcribed to paper , right ?
What portion of administrative cost goes to copying data by hand from the computer ? It would be interesting to see the same study in a single-payer environment ; or even in a simpler mixed-payer environment where supplementary coverage claims are filed by the patient , rather than the hospital , and the competition between hospitals for the preference of independent doctors is a bit less fierce .
It may be that the U.S. healthcare system is just an extreme case .</tokentext>
<sentencetext>Maybe I'm misinformed, but don't most (private) U.S. hospitals treat doctors like customers?
In several computer systems that I saw in New York state, they were providing different report styles and different input methods (from e-mail to hand-written) for the different doctors.
The reason I was given was that they had to do this, since doctors who didn't feel the hospital system suited their unique requirements would suggest different hospitals to their patients.
The resulting computer systems were very inefficient, compared with what they could be with more cohesive planning.Also, isn't a large part of paperwork involved with billing, and filing the right forms with the various payers?
I don't suppose the insurance and government agencies publish WSDL interfaces for their claims, so that probably needs to be transcribed to paper, right?
What portion of administrative cost goes to copying data by hand from the computer?It would be interesting to see the same study in a single-payer environment; or even in a simpler mixed-payer environment where supplementary coverage claims are filed by the patient, rather than the hospital, and the competition between hospitals for the preference of independent doctors is a bit less fierce.
It may be that the U.S. healthcare system is just an extreme case.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280472</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280980</id>
	<title>Hospitals implement tech badly. Lose benefits</title>
	<author>syousef</author>
	<datestamp>1259664240000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>News at 11.</p><p>Seriously, if you don't have improved efficiency after a tech implementation, you've done it wrong. Try tying vendor's and staff's earnings to efficiency.</p></htmltext>
<tokenext>News at 11.Seriously , if you do n't have improved efficiency after a tech implementation , you 've done it wrong .
Try tying vendor 's and staff 's earnings to efficiency .</tokentext>
<sentencetext>News at 11.Seriously, if you don't have improved efficiency after a tech implementation, you've done it wrong.
Try tying vendor's and staff's earnings to efficiency.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283380</id>
	<title>The survey says...</title>
	<author>Anonymous</author>
	<datestamp>1259683560000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>So this is all based on survey data that hasn't been verified as true.  So, based on the PERCEPTIONS of the people taking the survey this might be true, but I have a real hard time believing that the "old way" was as efficient as using computers. Every other industry has benefited from computerization so why has the medical field not?</p></htmltext>
<tokenext>So this is all based on survey data that has n't been verified as true .
So , based on the PERCEPTIONS of the people taking the survey this might be true , but I have a real hard time believing that the " old way " was as efficient as using computers .
Every other industry has benefited from computerization so why has the medical field not ?</tokentext>
<sentencetext>So this is all based on survey data that hasn't been verified as true.
So, based on the PERCEPTIONS of the people taking the survey this might be true, but I have a real hard time believing that the "old way" was as efficient as using computers.
Every other industry has benefited from computerization so why has the medical field not?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281534</id>
	<title>Re:Well</title>
	<author>Angostura</author>
	<datestamp>1259670660000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>That's an interesting comment and it made me think. Initially my thought was that that the system you describe sounds silly and wasteful (I'm an IT-focussed guy and I hate the thought of information being captured multiple times and rekeyed).</p><p>But then I thought - perhaps it's actually quicker for those doctors to simply ask the question again, rather than to find a workstation and query the patient record. Perhaps by asking the question themselves they garner additional information from the way that the patient reponds. Perhaps the initial triage nurse was entering data for hospital; adminstrivia, whereas the doctor needs to interact directly with the patient to make an informed diagnosis. Would the triage nurse's data help him/her? Perhaps, marginally, but perhaps it's quicker and more human to say "Good Morning Mrs Jones, what seems to be the problem?".</p><p>The repeated questioning is undoubtedly annoying for the patient but it seems inefficient prima facie - but perhaps it isn't *actually* inefficient.</p><p>Hmmm.</p></htmltext>
<tokenext>That 's an interesting comment and it made me think .
Initially my thought was that that the system you describe sounds silly and wasteful ( I 'm an IT-focussed guy and I hate the thought of information being captured multiple times and rekeyed ) .But then I thought - perhaps it 's actually quicker for those doctors to simply ask the question again , rather than to find a workstation and query the patient record .
Perhaps by asking the question themselves they garner additional information from the way that the patient reponds .
Perhaps the initial triage nurse was entering data for hospital ; adminstrivia , whereas the doctor needs to interact directly with the patient to make an informed diagnosis .
Would the triage nurse 's data help him/her ?
Perhaps , marginally , but perhaps it 's quicker and more human to say " Good Morning Mrs Jones , what seems to be the problem ?
" .The repeated questioning is undoubtedly annoying for the patient but it seems inefficient prima facie - but perhaps it is n't * actually * inefficient.Hmmm .</tokentext>
<sentencetext>That's an interesting comment and it made me think.
Initially my thought was that that the system you describe sounds silly and wasteful (I'm an IT-focussed guy and I hate the thought of information being captured multiple times and rekeyed).But then I thought - perhaps it's actually quicker for those doctors to simply ask the question again, rather than to find a workstation and query the patient record.
Perhaps by asking the question themselves they garner additional information from the way that the patient reponds.
Perhaps the initial triage nurse was entering data for hospital; adminstrivia, whereas the doctor needs to interact directly with the patient to make an informed diagnosis.
Would the triage nurse's data help him/her?
Perhaps, marginally, but perhaps it's quicker and more human to say "Good Morning Mrs Jones, what seems to be the problem?
".The repeated questioning is undoubtedly annoying for the patient but it seems inefficient prima facie - but perhaps it isn't *actually* inefficient.Hmmm.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285678</id>
	<title>Missed the point of hospital systems</title>
	<author>smammon</author>
	<datestamp>1259693640000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>I've been in IT for more than 20 years and very very rarely have I seen automation be a money saver.  No matter the industry.</p><p>Automation does enable other things however.  Many businesses would not be possible without automation.  For example global overnight shipping...and large hospitals.  I work for an average size metropolitan hospital and I can tell you - even at our modest size - the business of tracking patients, all their meds, tests and even what room they are in would not be possible.  At least not without a staff that would dwarf what we currently have.  Processing the mess that is the medical "reimbursement" system in the US is a whole other topic.  Even WITH automation that requires a staff of about a third as many individuals as we have inpatients.</p><p>Health care IT is finally starting to get to the point where there is a definite direct benefit to the patient too.  For example - medical imaging has reached a point where it's virtually all digital.  The patients studies are pushed back and forth between providers (hospitals).  In our case we recieve patient transfers from a very wide rural area.  The smaller hospitals and clinics send us the patients scans digitally and most of the time the surgeons at our hospital have been able to plan treatment before the patient even arrives.</p><p>We also have IV pumps that know the safe levels of the drugs they are putting into the patients.  If a nurse makes a mistake - say not moving a decimal appropriately when she is setting up the infusion rate (very common error) - the pump will not allow her to put 10x the drug into your vein...  We can also get the infusion information pulled back to the patient record and even locate where the pumps physically are thanks to their wireless connection.</p><p>Saving money is truly the last thing that should be considered for hospital automation.</p></htmltext>
<tokenext>I 've been in IT for more than 20 years and very very rarely have I seen automation be a money saver .
No matter the industry.Automation does enable other things however .
Many businesses would not be possible without automation .
For example global overnight shipping...and large hospitals .
I work for an average size metropolitan hospital and I can tell you - even at our modest size - the business of tracking patients , all their meds , tests and even what room they are in would not be possible .
At least not without a staff that would dwarf what we currently have .
Processing the mess that is the medical " reimbursement " system in the US is a whole other topic .
Even WITH automation that requires a staff of about a third as many individuals as we have inpatients.Health care IT is finally starting to get to the point where there is a definite direct benefit to the patient too .
For example - medical imaging has reached a point where it 's virtually all digital .
The patients studies are pushed back and forth between providers ( hospitals ) .
In our case we recieve patient transfers from a very wide rural area .
The smaller hospitals and clinics send us the patients scans digitally and most of the time the surgeons at our hospital have been able to plan treatment before the patient even arrives.We also have IV pumps that know the safe levels of the drugs they are putting into the patients .
If a nurse makes a mistake - say not moving a decimal appropriately when she is setting up the infusion rate ( very common error ) - the pump will not allow her to put 10x the drug into your vein... We can also get the infusion information pulled back to the patient record and even locate where the pumps physically are thanks to their wireless connection.Saving money is truly the last thing that should be considered for hospital automation .</tokentext>
<sentencetext>I've been in IT for more than 20 years and very very rarely have I seen automation be a money saver.
No matter the industry.Automation does enable other things however.
Many businesses would not be possible without automation.
For example global overnight shipping...and large hospitals.
I work for an average size metropolitan hospital and I can tell you - even at our modest size - the business of tracking patients, all their meds, tests and even what room they are in would not be possible.
At least not without a staff that would dwarf what we currently have.
Processing the mess that is the medical "reimbursement" system in the US is a whole other topic.
Even WITH automation that requires a staff of about a third as many individuals as we have inpatients.Health care IT is finally starting to get to the point where there is a definite direct benefit to the patient too.
For example - medical imaging has reached a point where it's virtually all digital.
The patients studies are pushed back and forth between providers (hospitals).
In our case we recieve patient transfers from a very wide rural area.
The smaller hospitals and clinics send us the patients scans digitally and most of the time the surgeons at our hospital have been able to plan treatment before the patient even arrives.We also have IV pumps that know the safe levels of the drugs they are putting into the patients.
If a nurse makes a mistake - say not moving a decimal appropriately when she is setting up the infusion rate (very common error) - the pump will not allow her to put 10x the drug into your vein...  We can also get the infusion information pulled back to the patient record and even locate where the pumps physically are thanks to their wireless connection.Saving money is truly the last thing that should be considered for hospital automation.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280990</id>
	<title>What is the cost of a life ?</title>
	<author>oneguess</author>
	<datestamp>1259664360000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Firstly, like most statistical analysis this one is also flawed because it does not take into effect any other increase in costs. e.g. Population increase, inflation, swine flu, etc..
Secondly there is no analysis of the value of the information being provided by computerisation. What is the value of BI?
Thirdly most CIO's are poor at managing IT and its costs. In my experience they have no idea how much it should cost and pay millions/billions for a person in a nice suit to rip them off. The price being paid for the computerisation is too high.
Fourthly computers are only useful if they are made useful to all users and it is used by all users. In my experience the product is dropped and everyone else is expected to pick up pieces while the people at the top enjoys the credit and bonuses.
Finally what is the price of a life or the price of a mistake? How many are saved or made by computerisation ?

This is only one study and provides more questions than answers. However it may open some eyes and force people to improve their computerisation or maybe just their CIO ?</htmltext>
<tokenext>Firstly , like most statistical analysis this one is also flawed because it does not take into effect any other increase in costs .
e.g. Population increase , inflation , swine flu , etc. . Secondly there is no analysis of the value of the information being provided by computerisation .
What is the value of BI ?
Thirdly most CIO 's are poor at managing IT and its costs .
In my experience they have no idea how much it should cost and pay millions/billions for a person in a nice suit to rip them off .
The price being paid for the computerisation is too high .
Fourthly computers are only useful if they are made useful to all users and it is used by all users .
In my experience the product is dropped and everyone else is expected to pick up pieces while the people at the top enjoys the credit and bonuses .
Finally what is the price of a life or the price of a mistake ?
How many are saved or made by computerisation ?
This is only one study and provides more questions than answers .
However it may open some eyes and force people to improve their computerisation or maybe just their CIO ?</tokentext>
<sentencetext>Firstly, like most statistical analysis this one is also flawed because it does not take into effect any other increase in costs.
e.g. Population increase, inflation, swine flu, etc..
Secondly there is no analysis of the value of the information being provided by computerisation.
What is the value of BI?
Thirdly most CIO's are poor at managing IT and its costs.
In my experience they have no idea how much it should cost and pay millions/billions for a person in a nice suit to rip them off.
The price being paid for the computerisation is too high.
Fourthly computers are only useful if they are made useful to all users and it is used by all users.
In my experience the product is dropped and everyone else is expected to pick up pieces while the people at the top enjoys the credit and bonuses.
Finally what is the price of a life or the price of a mistake?
How many are saved or made by computerisation ?
This is only one study and provides more questions than answers.
However it may open some eyes and force people to improve their computerisation or maybe just their CIO ?</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280484</id>
	<title>It is all really a pretty rainbow?</title>
	<author>Anonymous</author>
	<datestamp>1259659020000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I wanna know the specs for a computerized hospital wide system, service interruptions (hardware failure,<nobr> <wbr></nobr>...)? My life is not just in the hands of a doctor, a 7 year or so trained medical professional, but a misanthropic programmer that drinks to much coffee. All i am saying there are cons to a computer system as well.</p></htmltext>
<tokenext>I wan na know the specs for a computerized hospital wide system , service interruptions ( hardware failure , ... ) ?
My life is not just in the hands of a doctor , a 7 year or so trained medical professional , but a misanthropic programmer that drinks to much coffee .
All i am saying there are cons to a computer system as well .</tokentext>
<sentencetext>I wanna know the specs for a computerized hospital wide system, service interruptions (hardware failure, ...)?
My life is not just in the hands of a doctor, a 7 year or so trained medical professional, but a misanthropic programmer that drinks to much coffee.
All i am saying there are cons to a computer system as well.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283150</id>
	<title>A conspiracy? A "Solution"?</title>
	<author>mhollis</author>
	<datestamp>1259682720000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Did nobody read Nicholas Negroponte's <em> <a href="http://www.amazon.com/Being-Digital-Nicholas-Negroponte/dp/0679762906" title="amazon.com">Being Digital</a> [amazon.com] </em>? I think I re-read his book once every two years just to remind myself why this computing stuff is not intuitive and to remember that I have developed a skill set that does not relate to any reality other than that of the computer.</p><p>I don't want to take anything away from physicians. They're smart people and every one I have been to recently is capable of dealing with a personal computer. Some have dedicated touchscreen systems to help to record patient information and to write prescriptions. Others use computers to reduce the need for office staff to push paperwork. Still others have gone "paperless," and are trying to keep all records electronically so that they don't have to have a room just for patient records.</p><p>I also don't want to take anything away from hospital administrators who have to handle the tremendous losses of an emergency room with 9 to 12\% of cases coming in with no insurance and no ability to pay for necessary treatment, combined with a mandate that they take all comers, regardless of whether or not the hospital will wind up picking up the tab. They're trying to reduce the steps necessary to manage a pretty large organization that must be large in order to be able to stay afloat.</p><p>But I'm looking at this Harvard study in the same way that I've been looking at the Women's breast exam and mammography study as well as the recent pap smear study where statistics are being slightly misused. And <strong>the end result of this study will be used to invalidate the Administration's claims that computerization will result in a savings</strong>, just as the last two studies have been used to claim that any health insurance reform that passes the House and Senate will be used to <em>limit</em> care. Never mind that it's false.</p><p>The administration's computerization proposal is all about patient care and not administration. The Harvard study covered computerization of administrative tasks. Will there be a savings? That is yet to be seen.</p><p>A computer application needs to be easy to use. It needs to be so analogous to the types of everyday tasks that the nurses, doctors and support staff does that they can readily understand and work with it. That's Negroponte's point. Furthermore, <strong>any application (and user interface) written to streamline patient care needs to actually make things easier to provide patient care than the methods currently being used.</strong> If this is not the case, it will take a long time for any savings to be seen because adoption will be very slow.</p><p>If you are a programmer and you are working on something like this, you need to spend a day with a nurse. You need to spend a day with a doctor. You need to observe their procedures and really understand them, which means they need to explain things that they did to you. And that's a problem because no nurse or doctor really has time in their day "for this nonsense." So, what's probably needed here is a programmer who actually studied medicine, which is probably a seriously small subset of all programmers out there.</p><p>I work in television. And I remember when the first computerized video editors came out that changed the editing paradigm for us. they were pretty slow. It took a long time to load material into them and then the end result had such low resolution that you could not determined whether or not the camera's focus was properly pulled. You had to take the end result and go into a very expensive suite and reassemble everything with a computer list created for that purpose. Of course personal computers got faster. And their capabilities got better. And compression of pictures got a lot better. Today, there are a number of video editing tools out there that enable us to do our jobs very well and everyone understands the worth of loading material into the systems. Additionally, there are different editing systems available that use different paradigms for e</p></htmltext>
<tokenext>Did nobody read Nicholas Negroponte 's Being Digital [ amazon.com ] ?
I think I re-read his book once every two years just to remind myself why this computing stuff is not intuitive and to remember that I have developed a skill set that does not relate to any reality other than that of the computer.I do n't want to take anything away from physicians .
They 're smart people and every one I have been to recently is capable of dealing with a personal computer .
Some have dedicated touchscreen systems to help to record patient information and to write prescriptions .
Others use computers to reduce the need for office staff to push paperwork .
Still others have gone " paperless , " and are trying to keep all records electronically so that they do n't have to have a room just for patient records.I also do n't want to take anything away from hospital administrators who have to handle the tremendous losses of an emergency room with 9 to 12 \ % of cases coming in with no insurance and no ability to pay for necessary treatment , combined with a mandate that they take all comers , regardless of whether or not the hospital will wind up picking up the tab .
They 're trying to reduce the steps necessary to manage a pretty large organization that must be large in order to be able to stay afloat.But I 'm looking at this Harvard study in the same way that I 've been looking at the Women 's breast exam and mammography study as well as the recent pap smear study where statistics are being slightly misused .
And the end result of this study will be used to invalidate the Administration 's claims that computerization will result in a savings , just as the last two studies have been used to claim that any health insurance reform that passes the House and Senate will be used to limit care .
Never mind that it 's false.The administration 's computerization proposal is all about patient care and not administration .
The Harvard study covered computerization of administrative tasks .
Will there be a savings ?
That is yet to be seen.A computer application needs to be easy to use .
It needs to be so analogous to the types of everyday tasks that the nurses , doctors and support staff does that they can readily understand and work with it .
That 's Negroponte 's point .
Furthermore , any application ( and user interface ) written to streamline patient care needs to actually make things easier to provide patient care than the methods currently being used .
If this is not the case , it will take a long time for any savings to be seen because adoption will be very slow.If you are a programmer and you are working on something like this , you need to spend a day with a nurse .
You need to spend a day with a doctor .
You need to observe their procedures and really understand them , which means they need to explain things that they did to you .
And that 's a problem because no nurse or doctor really has time in their day " for this nonsense .
" So , what 's probably needed here is a programmer who actually studied medicine , which is probably a seriously small subset of all programmers out there.I work in television .
And I remember when the first computerized video editors came out that changed the editing paradigm for us .
they were pretty slow .
It took a long time to load material into them and then the end result had such low resolution that you could not determined whether or not the camera 's focus was properly pulled .
You had to take the end result and go into a very expensive suite and reassemble everything with a computer list created for that purpose .
Of course personal computers got faster .
And their capabilities got better .
And compression of pictures got a lot better .
Today , there are a number of video editing tools out there that enable us to do our jobs very well and everyone understands the worth of loading material into the systems .
Additionally , there are different editing systems available that use different paradigms for e</tokentext>
<sentencetext>Did nobody read Nicholas Negroponte's  Being Digital [amazon.com] ?
I think I re-read his book once every two years just to remind myself why this computing stuff is not intuitive and to remember that I have developed a skill set that does not relate to any reality other than that of the computer.I don't want to take anything away from physicians.
They're smart people and every one I have been to recently is capable of dealing with a personal computer.
Some have dedicated touchscreen systems to help to record patient information and to write prescriptions.
Others use computers to reduce the need for office staff to push paperwork.
Still others have gone "paperless," and are trying to keep all records electronically so that they don't have to have a room just for patient records.I also don't want to take anything away from hospital administrators who have to handle the tremendous losses of an emergency room with 9 to 12\% of cases coming in with no insurance and no ability to pay for necessary treatment, combined with a mandate that they take all comers, regardless of whether or not the hospital will wind up picking up the tab.
They're trying to reduce the steps necessary to manage a pretty large organization that must be large in order to be able to stay afloat.But I'm looking at this Harvard study in the same way that I've been looking at the Women's breast exam and mammography study as well as the recent pap smear study where statistics are being slightly misused.
And the end result of this study will be used to invalidate the Administration's claims that computerization will result in a savings, just as the last two studies have been used to claim that any health insurance reform that passes the House and Senate will be used to limit care.
Never mind that it's false.The administration's computerization proposal is all about patient care and not administration.
The Harvard study covered computerization of administrative tasks.
Will there be a savings?
That is yet to be seen.A computer application needs to be easy to use.
It needs to be so analogous to the types of everyday tasks that the nurses, doctors and support staff does that they can readily understand and work with it.
That's Negroponte's point.
Furthermore, any application (and user interface) written to streamline patient care needs to actually make things easier to provide patient care than the methods currently being used.
If this is not the case, it will take a long time for any savings to be seen because adoption will be very slow.If you are a programmer and you are working on something like this, you need to spend a day with a nurse.
You need to spend a day with a doctor.
You need to observe their procedures and really understand them, which means they need to explain things that they did to you.
And that's a problem because no nurse or doctor really has time in their day "for this nonsense.
" So, what's probably needed here is a programmer who actually studied medicine, which is probably a seriously small subset of all programmers out there.I work in television.
And I remember when the first computerized video editors came out that changed the editing paradigm for us.
they were pretty slow.
It took a long time to load material into them and then the end result had such low resolution that you could not determined whether or not the camera's focus was properly pulled.
You had to take the end result and go into a very expensive suite and reassemble everything with a computer list created for that purpose.
Of course personal computers got faster.
And their capabilities got better.
And compression of pictures got a lot better.
Today, there are a number of video editing tools out there that enable us to do our jobs very well and everyone understands the worth of loading material into the systems.
Additionally, there are different editing systems available that use different paradigms for e</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284484</id>
	<title>Re:I work in a major hospital</title>
	<author>Bourdain</author>
	<datestamp>1259688540000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>what hospital is this even?</htmltext>
<tokenext>what hospital is this even ?</tokentext>
<sentencetext>what hospital is this even?</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280246</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284974</id>
	<title>Re:Well</title>
	<author>Anomalyst</author>
	<datestamp>1259690580000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>I'm sorry, what were we talking about?</htmltext>
<tokenext>I 'm sorry , what were we talking about ?</tokentext>
<sentencetext>I'm sorry, what were we talking about?</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283916</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283582</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259684700000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>It doesn't help that they only typical want IT folk with experience in the medical field.  It's just a process and data guys, might get better result if the didn't subset the IT labor pool.  Just a thought.</p></htmltext>
<tokenext>It does n't help that they only typical want IT folk with experience in the medical field .
It 's just a process and data guys , might get better result if the did n't subset the IT labor pool .
Just a thought .</tokentext>
<sentencetext>It doesn't help that they only typical want IT folk with experience in the medical field.
It's just a process and data guys, might get better result if the didn't subset the IT labor pool.
Just a thought.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281084</id>
	<title>Difficult measure</title>
	<author>OpenSourced</author>
	<datestamp>1259665200000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>How to say if computers save money to a hospital? Do you take into account reduction in errors, perhaps malpractice errors that could cost millions? Do you take into account expanded possibilities? If you now have a service that wouldn't be possible without computers, are the profits of that service included in the study?</p><p>I once made a program for a manufacturing company, that sequenced the production in the different machines. They had at the time one person making the sequence for the machines manually. They had like 14 machines, and things were starting to go a bit out of hand, so the program idea. Now the company has grown, they have two different plants and about 40 machines, that work much faster than before, so the workload is even bigger. There are now two persons making the sequence. They have payed a lot for the program and changes and maintenance through the years. They have saved a lot also by reduced inventories and less errors. They have one person more, but probably they'd have needed more if it weren't for the program. But more important than that, is that they have changed procedures \_because\_ they had the program. They have reduced the size of manufacturing runs. They have achieved some quality certifications that have won them (who knows how many?) clients. I'm not just trying to say that computers save money, but that I wouldn't know even how to start to measure how much. I much fear that the study is a bit shallow. A similar study could conclude that this company has lost money by getting the program because they have doubled the personnel costs. As the article is skimpy on details of procedure, one is left to wonder, but my main idea is that it's practically impossible to conduct a meaningful study in search of that answer.</p></htmltext>
<tokenext>How to say if computers save money to a hospital ?
Do you take into account reduction in errors , perhaps malpractice errors that could cost millions ?
Do you take into account expanded possibilities ?
If you now have a service that would n't be possible without computers , are the profits of that service included in the study ? I once made a program for a manufacturing company , that sequenced the production in the different machines .
They had at the time one person making the sequence for the machines manually .
They had like 14 machines , and things were starting to go a bit out of hand , so the program idea .
Now the company has grown , they have two different plants and about 40 machines , that work much faster than before , so the workload is even bigger .
There are now two persons making the sequence .
They have payed a lot for the program and changes and maintenance through the years .
They have saved a lot also by reduced inventories and less errors .
They have one person more , but probably they 'd have needed more if it were n't for the program .
But more important than that , is that they have changed procedures \ _because \ _ they had the program .
They have reduced the size of manufacturing runs .
They have achieved some quality certifications that have won them ( who knows how many ?
) clients .
I 'm not just trying to say that computers save money , but that I would n't know even how to start to measure how much .
I much fear that the study is a bit shallow .
A similar study could conclude that this company has lost money by getting the program because they have doubled the personnel costs .
As the article is skimpy on details of procedure , one is left to wonder , but my main idea is that it 's practically impossible to conduct a meaningful study in search of that answer .</tokentext>
<sentencetext>How to say if computers save money to a hospital?
Do you take into account reduction in errors, perhaps malpractice errors that could cost millions?
Do you take into account expanded possibilities?
If you now have a service that wouldn't be possible without computers, are the profits of that service included in the study?I once made a program for a manufacturing company, that sequenced the production in the different machines.
They had at the time one person making the sequence for the machines manually.
They had like 14 machines, and things were starting to go a bit out of hand, so the program idea.
Now the company has grown, they have two different plants and about 40 machines, that work much faster than before, so the workload is even bigger.
There are now two persons making the sequence.
They have payed a lot for the program and changes and maintenance through the years.
They have saved a lot also by reduced inventories and less errors.
They have one person more, but probably they'd have needed more if it weren't for the program.
But more important than that, is that they have changed procedures \_because\_ they had the program.
They have reduced the size of manufacturing runs.
They have achieved some quality certifications that have won them (who knows how many?
) clients.
I'm not just trying to say that computers save money, but that I wouldn't know even how to start to measure how much.
I much fear that the study is a bit shallow.
A similar study could conclude that this company has lost money by getting the program because they have doubled the personnel costs.
As the article is skimpy on details of procedure, one is left to wonder, but my main idea is that it's practically impossible to conduct a meaningful study in search of that answer.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30284316</id>
	<title>Regulations</title>
	<author>Anonymous</author>
	<datestamp>1259687820000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Another false argument.  The author fails to account for the massive increases in regulations and the resultant paperwork it produces. He's living in a dreamworld where everything has been the same for 45 years especially with regard to drugs and compounding.  You can call his research poor at best.  He's the type of doctor that prescribes medications having no idea what their effects are resulting in an immediate call from the pharmacist downstairs, "Dr., you can't prescribe that medication X when he's still taking Y.  We went over this last week.  It will kill your patient."  "Oh well, just fix it then."</p></htmltext>
<tokenext>Another false argument .
The author fails to account for the massive increases in regulations and the resultant paperwork it produces .
He 's living in a dreamworld where everything has been the same for 45 years especially with regard to drugs and compounding .
You can call his research poor at best .
He 's the type of doctor that prescribes medications having no idea what their effects are resulting in an immediate call from the pharmacist downstairs , " Dr. , you ca n't prescribe that medication X when he 's still taking Y. We went over this last week .
It will kill your patient .
" " Oh well , just fix it then .
"</tokentext>
<sentencetext>Another false argument.
The author fails to account for the massive increases in regulations and the resultant paperwork it produces.
He's living in a dreamworld where everything has been the same for 45 years especially with regard to drugs and compounding.
You can call his research poor at best.
He's the type of doctor that prescribes medications having no idea what their effects are resulting in an immediate call from the pharmacist downstairs, "Dr., you can't prescribe that medication X when he's still taking Y.  We went over this last week.
It will kill your patient.
"  "Oh well, just fix it then.
"</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30292512</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259680140000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>That is exactly what my teachers tried to jam into my brain the first day I showed up for a medical informatics course.</p><p>As a doctor / tech geek myself, I believe any IT system should also cater to the doctor's and nurse's needs.</p></htmltext>
<tokenext>That is exactly what my teachers tried to jam into my brain the first day I showed up for a medical informatics course.As a doctor / tech geek myself , I believe any IT system should also cater to the doctor 's and nurse 's needs .</tokentext>
<sentencetext>That is exactly what my teachers tried to jam into my brain the first day I showed up for a medical informatics course.As a doctor / tech geek myself, I believe any IT system should also cater to the doctor's and nurse's needs.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283682</id>
	<title>Re:The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259685120000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p><div class="quote"><p>Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training. "If you need a manual, then the system doesn't work. If you need training, the system doesn't work," he said.</p></div><p>This is true, but they should still have them. The true key to good software design is thorough documentation that effectively never gets used. Even better if it is integrated into a help feature.</p><p>I have thrown more OSS solutions away because of lack of/poor documentation because (I assume) the writer assumed everything to be intuitive, and maybe with the right background it is, but that doesn't excuse the lack.</p></div>
	</htmltext>
<tokenext>Programmers of the successful systems told Himmelstein that they did n't write manuals or offer training .
" If you need a manual , then the system does n't work .
If you need training , the system does n't work , " he said.This is true , but they should still have them .
The true key to good software design is thorough documentation that effectively never gets used .
Even better if it is integrated into a help feature.I have thrown more OSS solutions away because of lack of/poor documentation because ( I assume ) the writer assumed everything to be intuitive , and maybe with the right background it is , but that does n't excuse the lack .</tokentext>
<sentencetext>Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training.
"If you need a manual, then the system doesn't work.
If you need training, the system doesn't work," he said.This is true, but they should still have them.
The true key to good software design is thorough documentation that effectively never gets used.
Even better if it is integrated into a help feature.I have thrown more OSS solutions away because of lack of/poor documentation because (I assume) the writer assumed everything to be intuitive, and maybe with the right background it is, but that doesn't excuse the lack.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30299038</id>
	<title>Re:What about VISTA?</title>
	<author>Shane dot H</author>
	<datestamp>1259604720000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext>Not to mention its source is available as public domain code. Part of the problem is that the VA has different incentives than most hospitals. The VHA is an insurance company that owns the hospitals, the equipment, and pays the doctors a fixed salary. It keeps the same patients for decades, and has an incentive to get records right from the get-go, because they know they'll be paying for that patient's treatment down the line. In that sense, some of the benefits of the VA's electronic health records system aren't easily mimicked by the private sector, but it certainly is a good start.<br> <br>

In any case, I'm curious too as to how VistA fares compared to these other systems.</htmltext>
<tokenext>Not to mention its source is available as public domain code .
Part of the problem is that the VA has different incentives than most hospitals .
The VHA is an insurance company that owns the hospitals , the equipment , and pays the doctors a fixed salary .
It keeps the same patients for decades , and has an incentive to get records right from the get-go , because they know they 'll be paying for that patient 's treatment down the line .
In that sense , some of the benefits of the VA 's electronic health records system are n't easily mimicked by the private sector , but it certainly is a good start .
In any case , I 'm curious too as to how VistA fares compared to these other systems .</tokentext>
<sentencetext>Not to mention its source is available as public domain code.
Part of the problem is that the VA has different incentives than most hospitals.
The VHA is an insurance company that owns the hospitals, the equipment, and pays the doctors a fixed salary.
It keeps the same patients for decades, and has an incentive to get records right from the get-go, because they know they'll be paying for that patient's treatment down the line.
In that sense, some of the benefits of the VA's electronic health records system aren't easily mimicked by the private sector, but it certainly is a good start.
In any case, I'm curious too as to how VistA fares compared to these other systems.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280554</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280356</id>
	<title>Re:Well</title>
	<author>Sarten-X</author>
	<datestamp>1259700960000</datestamp>
	<modclass>Insightful</modclass>
	<modscore>2</modscore>
	<htmltext><p>...But it has to look pretty, or the folks with access to the bank account will never buy it! It also needs animated sliding panels, customizable positions for all controls, and must fit the graphical style of Windows 7, so the office staff don't get confused. When the programmers are done with those important goals, then they can work on the petty stuff like speed and usability.</p><p>Let's not forget, it also absolutely MUST interface with the mainframe they kept records on in the 80's, just in case they need that information (but there's no budget for migration), and according to the boss's nephew who "knows computers", the next big thing will be X, whatever that is, so the system must use X, to do whatever it is that X does.</p></htmltext>
<tokenext>...But it has to look pretty , or the folks with access to the bank account will never buy it !
It also needs animated sliding panels , customizable positions for all controls , and must fit the graphical style of Windows 7 , so the office staff do n't get confused .
When the programmers are done with those important goals , then they can work on the petty stuff like speed and usability.Let 's not forget , it also absolutely MUST interface with the mainframe they kept records on in the 80 's , just in case they need that information ( but there 's no budget for migration ) , and according to the boss 's nephew who " knows computers " , the next big thing will be X , whatever that is , so the system must use X , to do whatever it is that X does .</tokentext>
<sentencetext>...But it has to look pretty, or the folks with access to the bank account will never buy it!
It also needs animated sliding panels, customizable positions for all controls, and must fit the graphical style of Windows 7, so the office staff don't get confused.
When the programmers are done with those important goals, then they can work on the petty stuff like speed and usability.Let's not forget, it also absolutely MUST interface with the mainframe they kept records on in the 80's, just in case they need that information (but there's no budget for migration), and according to the boss's nephew who "knows computers", the next big thing will be X, whatever that is, so the system must use X, to do whatever it is that X does.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280254</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285590</id>
	<title>Manager-Centrism</title>
	<author>Tablizer</author>
	<datestamp>1259693280000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><blockquote><div><p>The study also showed most of the IT systems were aimed at improving efficiency for hospital management -- not doctors, nurses, and medical technicians.</p></div></blockquote><p>That's true in just about ANY industry. Managers are prima-donna's who think they are the center of the universe, and everything else is relegated to Pluto. If that happens, it's not the fault of "computers" per se, but of how they are used.</p></div>
	</htmltext>
<tokenext>The study also showed most of the IT systems were aimed at improving efficiency for hospital management -- not doctors , nurses , and medical technicians.That 's true in just about ANY industry .
Managers are prima-donna 's who think they are the center of the universe , and everything else is relegated to Pluto .
If that happens , it 's not the fault of " computers " per se , but of how they are used .</tokentext>
<sentencetext>The study also showed most of the IT systems were aimed at improving efficiency for hospital management -- not doctors, nurses, and medical technicians.That's true in just about ANY industry.
Managers are prima-donna's who think they are the center of the universe, and everything else is relegated to Pluto.
If that happens, it's not the fault of "computers" per se, but of how they are used.
	</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283788</id>
	<title>It doesn't shock annyone</title>
	<author>geekoid</author>
	<datestamp>1259685540000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>that management software doesn't work well.<br>The best way to get maximum possible benefit from management software is to write it in house.</p><p>Every company does management differently, and has specific business rules the go all the way to the center of their business.</p></htmltext>
<tokenext>that management software does n't work well.The best way to get maximum possible benefit from management software is to write it in house.Every company does management differently , and has specific business rules the go all the way to the center of their business .</tokentext>
<sentencetext>that management software doesn't work well.The best way to get maximum possible benefit from management software is to write it in house.Every company does management differently, and has specific business rules the go all the way to the center of their business.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</id>
	<title>The key being ...</title>
	<author>Anonymous</author>
	<datestamp>1259700180000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>5</modscore>
	<htmltext><p>"IT systems were aimed at improving efficiency for hospital management"</p><p>Doctors and other medical personnel do not typically hold much power<br>when it comes to IT.</p><p>Software vendors aim to please management, they are the ones who take<br>the purchasing decisions.</p><p>Your typical Lab software for example might not have a straightforward<br>way to cross-check isolates for emerging resistance trends,<br>run critical screens or automatically report to a global EPI database,<br>but it sure has 1,000 ways to generate Aging Reports and auto resubmit insurance claims.</p></htmltext>
<tokenext>" IT systems were aimed at improving efficiency for hospital management " Doctors and other medical personnel do not typically hold much powerwhen it comes to IT.Software vendors aim to please management , they are the ones who takethe purchasing decisions.Your typical Lab software for example might not have a straightforwardway to cross-check isolates for emerging resistance trends,run critical screens or automatically report to a global EPI database,but it sure has 1,000 ways to generate Aging Reports and auto resubmit insurance claims .</tokentext>
<sentencetext>"IT systems were aimed at improving efficiency for hospital management"Doctors and other medical personnel do not typically hold much powerwhen it comes to IT.Software vendors aim to please management, they are the ones who takethe purchasing decisions.Your typical Lab software for example might not have a straightforwardway to cross-check isolates for emerging resistance trends,run critical screens or automatically report to a global EPI database,but it sure has 1,000 ways to generate Aging Reports and auto resubmit insurance claims.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280240</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30288362</id>
	<title>It's all economics</title>
	<author>Henk Postma</author>
	<datestamp>1259659980000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>IT will only save you money if you can do the same work faster and/or more cheaply than the competition. If all hospitals implement similar systems, that is now the new standard and you don't have a competitive edge that allows you to lower your operating expenses as compared to other hospitals. This is basically one of Parkinson's laws, as mentioned below.

</p><p>Of course there may be problems with the IT systems in hospitals. So at some point in the future, one company will make a product that works really well and solves these problems. The first hospital to acquire the system will lower operating expenses, increase their efficiency. They can then attract more 'business' by lowering their price. Then the same company sells the system to all the other hospitals, and all their operating expenses will be reduced, efficiencies increased. Prices drop, new baseline reached. Lather, rinse, repeat.</p></htmltext>
<tokenext>IT will only save you money if you can do the same work faster and/or more cheaply than the competition .
If all hospitals implement similar systems , that is now the new standard and you do n't have a competitive edge that allows you to lower your operating expenses as compared to other hospitals .
This is basically one of Parkinson 's laws , as mentioned below .
Of course there may be problems with the IT systems in hospitals .
So at some point in the future , one company will make a product that works really well and solves these problems .
The first hospital to acquire the system will lower operating expenses , increase their efficiency .
They can then attract more 'business ' by lowering their price .
Then the same company sells the system to all the other hospitals , and all their operating expenses will be reduced , efficiencies increased .
Prices drop , new baseline reached .
Lather , rinse , repeat .</tokentext>
<sentencetext>IT will only save you money if you can do the same work faster and/or more cheaply than the competition.
If all hospitals implement similar systems, that is now the new standard and you don't have a competitive edge that allows you to lower your operating expenses as compared to other hospitals.
This is basically one of Parkinson's laws, as mentioned below.
Of course there may be problems with the IT systems in hospitals.
So at some point in the future, one company will make a product that works really well and solves these problems.
The first hospital to acquire the system will lower operating expenses, increase their efficiency.
They can then attract more 'business' by lowering their price.
Then the same company sells the system to all the other hospitals, and all their operating expenses will be reduced, efficiencies increased.
Prices drop, new baseline reached.
Lather, rinse, repeat.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</id>
	<title>Re:The key being ...</title>
	<author>martyros</author>
	<datestamp>1259666040000</datestamp>
	<modclass>Interestin</modclass>
	<modscore>4</modscore>
	<htmltext>Best quote from the article:<blockquote><div><p>Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency -- and those hospitals custom-built their systems after computer system architects conducted months of research.

</p><p>He pointed to Brigham and Women's Hospital in Boston, Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems. That's because they were intuitive and aimed at clinicians, not administrators.

</p><p>Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training. "If you need a manual, then the system doesn't work. If you need training, the system doesn't work," he said.</p></div>
</blockquote><p>In other words, computers are not a magic bullet.  They only work well when you actually invest the time to find out what you need them to do, and then make them do that.</p></div>
	</htmltext>
<tokenext>Best quote from the article : Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency -- and those hospitals custom-built their systems after computer system architects conducted months of research .
He pointed to Brigham and Women 's Hospital in Boston , Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems .
That 's because they were intuitive and aimed at clinicians , not administrators .
Programmers of the successful systems told Himmelstein that they did n't write manuals or offer training .
" If you need a manual , then the system does n't work .
If you need training , the system does n't work , " he said .
In other words , computers are not a magic bullet .
They only work well when you actually invest the time to find out what you need them to do , and then make them do that .</tokentext>
<sentencetext>Best quote from the article:Himmelstein said that only a handful of hospitals and clinics realized even modest savings and increased efficiency -- and those hospitals custom-built their systems after computer system architects conducted months of research.
He pointed to Brigham and Women's Hospital in Boston, Latter Day Saints Hospital in Salt Lake City and Regenstrief Institute in Indianapolis as facilities with some success in deploying efficient e-health systems.
That's because they were intuitive and aimed at clinicians, not administrators.
Programmers of the successful systems told Himmelstein that they didn't write manuals or offer training.
"If you need a manual, then the system doesn't work.
If you need training, the system doesn't work," he said.
In other words, computers are not a magic bullet.
They only work well when you actually invest the time to find out what you need them to do, and then make them do that.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280286</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280528</id>
	<title>okay, this really bothers me</title>
	<author>el\_tedward</author>
	<datestamp>1259659680000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>But I'm glad it says that these systems are targeted towards management. It sounds to me like a lot of the people running hospitals enjoy buying themselves fancy toys.</p><p>I work as a go-fer at a doctors office. There's two doctors there with roughly a dozen nurses. I wouldn't have a job if we didn't have the shit paper filing system we currently have. Several people who work there wouldn't have jobs if we didn't have the shit filing system we have there. It's a waste of my time that I could be spending at collage not doing homework. Is that a bad thing? No, I'm gana grow up to be a l33t computer hacker and get lots and lots of money. Those nurses that get fired when the office gets the electronic records keeping may go on to get licensed as hardcore full on RNs. There's plenty of room in the expanding healthcare system for more nurses. It's not going to kill jobs, but a system of server to server sharing (yeah, someone needs to find a way for this to work so doctor in california can find out about the STDs I got diagnosed with here in [place where the job market is bad]) mah patient info would eliminate errors when things are coded properly (I do get quite annoyed with myself when I find a file I put in the wrong place, but our file system has more room for error than you think it does. Files just take... a long time to find).</p><p>Also, we have an accountant who is going over all this stuff, so hopefully they read this article and not waste money on things the doctors really don't need. Like buying a sports car, a prius, and then a new battery prius to save the environment.. The doctors are currently in a legal battle of who has the biggest e-peen though, (50-50 share in the company, tee hee) so I really don't care that much about how things turn out at the office.</p><p>Also, I know all this stuff because I work for my mommy.</p></htmltext>
<tokenext>But I 'm glad it says that these systems are targeted towards management .
It sounds to me like a lot of the people running hospitals enjoy buying themselves fancy toys.I work as a go-fer at a doctors office .
There 's two doctors there with roughly a dozen nurses .
I would n't have a job if we did n't have the shit paper filing system we currently have .
Several people who work there would n't have jobs if we did n't have the shit filing system we have there .
It 's a waste of my time that I could be spending at collage not doing homework .
Is that a bad thing ?
No , I 'm gana grow up to be a l33t computer hacker and get lots and lots of money .
Those nurses that get fired when the office gets the electronic records keeping may go on to get licensed as hardcore full on RNs .
There 's plenty of room in the expanding healthcare system for more nurses .
It 's not going to kill jobs , but a system of server to server sharing ( yeah , someone needs to find a way for this to work so doctor in california can find out about the STDs I got diagnosed with here in [ place where the job market is bad ] ) mah patient info would eliminate errors when things are coded properly ( I do get quite annoyed with myself when I find a file I put in the wrong place , but our file system has more room for error than you think it does .
Files just take... a long time to find ) .Also , we have an accountant who is going over all this stuff , so hopefully they read this article and not waste money on things the doctors really do n't need .
Like buying a sports car , a prius , and then a new battery prius to save the environment.. The doctors are currently in a legal battle of who has the biggest e-peen though , ( 50-50 share in the company , tee hee ) so I really do n't care that much about how things turn out at the office.Also , I know all this stuff because I work for my mommy .</tokentext>
<sentencetext>But I'm glad it says that these systems are targeted towards management.
It sounds to me like a lot of the people running hospitals enjoy buying themselves fancy toys.I work as a go-fer at a doctors office.
There's two doctors there with roughly a dozen nurses.
I wouldn't have a job if we didn't have the shit paper filing system we currently have.
Several people who work there wouldn't have jobs if we didn't have the shit filing system we have there.
It's a waste of my time that I could be spending at collage not doing homework.
Is that a bad thing?
No, I'm gana grow up to be a l33t computer hacker and get lots and lots of money.
Those nurses that get fired when the office gets the electronic records keeping may go on to get licensed as hardcore full on RNs.
There's plenty of room in the expanding healthcare system for more nurses.
It's not going to kill jobs, but a system of server to server sharing (yeah, someone needs to find a way for this to work so doctor in california can find out about the STDs I got diagnosed with here in [place where the job market is bad]) mah patient info would eliminate errors when things are coded properly (I do get quite annoyed with myself when I find a file I put in the wrong place, but our file system has more room for error than you think it does.
Files just take... a long time to find).Also, we have an accountant who is going over all this stuff, so hopefully they read this article and not waste money on things the doctors really don't need.
Like buying a sports car, a prius, and then a new battery prius to save the environment.. The doctors are currently in a legal battle of who has the biggest e-peen though, (50-50 share in the company, tee hee) so I really don't care that much about how things turn out at the office.Also, I know all this stuff because I work for my mommy.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30285156</id>
	<title>Re:The key being ...</title>
	<author>ShakaUVM</author>
	<datestamp>1259691480000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>&gt;&gt;In other words, computers are not a magic bullet. They only work well when you actually invest the time to find out what you need them to do, and then make them do that.</p><p>Right, but there's actually quite a bit of research showing tremendous benefits for computer systems implemented well in hospitals. Without computers, doctors can spend as much as 75\% of their time away from patients, fucking around with paperwork.</p><p>At my wife's hospital, they don't have the best system in the world, but they have an electronic drug ordering system, automated drug vending machines on each floor for commonly used drugs which tie into the hospital-wide inventory database, have electronic files, etc. The thing goes down waay too often for something that is marketed toward hospitals, but at least the company provides 24 on-call support.</p></htmltext>
<tokenext>&gt; &gt; In other words , computers are not a magic bullet .
They only work well when you actually invest the time to find out what you need them to do , and then make them do that.Right , but there 's actually quite a bit of research showing tremendous benefits for computer systems implemented well in hospitals .
Without computers , doctors can spend as much as 75 \ % of their time away from patients , fucking around with paperwork.At my wife 's hospital , they do n't have the best system in the world , but they have an electronic drug ordering system , automated drug vending machines on each floor for commonly used drugs which tie into the hospital-wide inventory database , have electronic files , etc .
The thing goes down waay too often for something that is marketed toward hospitals , but at least the company provides 24 on-call support .</tokentext>
<sentencetext>&gt;&gt;In other words, computers are not a magic bullet.
They only work well when you actually invest the time to find out what you need them to do, and then make them do that.Right, but there's actually quite a bit of research showing tremendous benefits for computer systems implemented well in hospitals.
Without computers, doctors can spend as much as 75\% of their time away from patients, fucking around with paperwork.At my wife's hospital, they don't have the best system in the world, but they have an electronic drug ordering system, automated drug vending machines on each floor for commonly used drugs which tie into the hospital-wide inventory database, have electronic files, etc.
The thing goes down waay too often for something that is marketed toward hospitals, but at least the company provides 24 on-call support.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281170</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30289560</id>
	<title>Bumrungrad Hospital (Bangkok)</title>
	<author>aaarrrgggh</author>
	<datestamp>1259665020000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>If you want to see computers saving hospitals money, get a physical at Bumrungrad Hospital in Bangkok.  The system is multi-lingual, and you get results almost immediately.  I don't know that a legacy hospital can pull off the same things, but it is truly amazing to see.</p><p>Compared to my physician's scribbles on pre-printed form letters, it really does a lot to make it look like the doctor knows what they are doing and communicate effectively.</p></htmltext>
<tokenext>If you want to see computers saving hospitals money , get a physical at Bumrungrad Hospital in Bangkok .
The system is multi-lingual , and you get results almost immediately .
I do n't know that a legacy hospital can pull off the same things , but it is truly amazing to see.Compared to my physician 's scribbles on pre-printed form letters , it really does a lot to make it look like the doctor knows what they are doing and communicate effectively .</tokentext>
<sentencetext>If you want to see computers saving hospitals money, get a physical at Bumrungrad Hospital in Bangkok.
The system is multi-lingual, and you get results almost immediately.
I don't know that a legacy hospital can pull off the same things, but it is truly amazing to see.Compared to my physician's scribbles on pre-printed form letters, it really does a lot to make it look like the doctor knows what they are doing and communicate effectively.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281960</id>
	<title>Re:Designed for Entrepreneurs</title>
	<author>some-old-geek</author>
	<datestamp>1259675100000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p><div class="quote"><p>Computerized systems are not designed for the benefit of users. They are designed for the benefit of entrepreneurs.</p></div><p>Fixed that for you.</p></div>
	</htmltext>
<tokenext>Computerized systems are not designed for the benefit of users .
They are designed for the benefit of entrepreneurs.Fixed that for you .</tokentext>
<sentencetext>Computerized systems are not designed for the benefit of users.
They are designed for the benefit of entrepreneurs.Fixed that for you.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280532</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281914</id>
	<title>Hospital Systems DO SAVE MONEY</title>
	<author>Anonymous</author>
	<datestamp>1259674680000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>Let's start off with the basics.<br>Time = Money.<br>Mistakes = Money</p><p>There are actions that need to be complete and the longer actions take the more people are needed to perform these actions. Therefore... the longer actions take to complete the more money it costs the hospital. Think "Nurse what drugs has this patient been given?". Most hospitals keep digital records of all medications given which helps doctors make decisions. This simple task could take 5-10 minutes pouring through 200 pages of charts and possibly missing pages.</p><p>Think bad handwriting where the nurse AND the doctor can't read what it is. Get the idea?</p><p>Mistakes also cost money. One of the biggest benefits is that Doctors can quickly see what Jonny has been taking and don't accidentally prescribe something that will kill him when mixed with other things. It also helps the doctor quickly see trends and change their decisions quickly whereas with paper records they might not as easily notice.</p><p>This paper is written by someone who hates computer systems and doesn't take into account how medicine has changed in the last 20 years.</p><p>This is just coming from a guy who works at a Veterinary College... our patients are cats and dogs. Our system has been attributed to saving hundreds of lives because of how statistics can be generated on the fly. Comparing test results with a click of a button and seeing trends, easily, efficiently... without error. The ability for alerts to come up letting a doctor know that a drug they are prescribing may cause an allergic reaction with this patient.</p><p>I can easily say Dr. David Himmelstein has flawed research with far too many missing puzzle pieces and flawed logic. This system has saved our hospital MILLIONS in potential lawsuits alone.</p></htmltext>
<tokenext>Let 's start off with the basics.Time = Money.Mistakes = MoneyThere are actions that need to be complete and the longer actions take the more people are needed to perform these actions .
Therefore... the longer actions take to complete the more money it costs the hospital .
Think " Nurse what drugs has this patient been given ? " .
Most hospitals keep digital records of all medications given which helps doctors make decisions .
This simple task could take 5-10 minutes pouring through 200 pages of charts and possibly missing pages.Think bad handwriting where the nurse AND the doctor ca n't read what it is .
Get the idea ? Mistakes also cost money .
One of the biggest benefits is that Doctors can quickly see what Jonny has been taking and do n't accidentally prescribe something that will kill him when mixed with other things .
It also helps the doctor quickly see trends and change their decisions quickly whereas with paper records they might not as easily notice.This paper is written by someone who hates computer systems and does n't take into account how medicine has changed in the last 20 years.This is just coming from a guy who works at a Veterinary College... our patients are cats and dogs .
Our system has been attributed to saving hundreds of lives because of how statistics can be generated on the fly .
Comparing test results with a click of a button and seeing trends , easily , efficiently... without error .
The ability for alerts to come up letting a doctor know that a drug they are prescribing may cause an allergic reaction with this patient.I can easily say Dr. David Himmelstein has flawed research with far too many missing puzzle pieces and flawed logic .
This system has saved our hospital MILLIONS in potential lawsuits alone .</tokentext>
<sentencetext>Let's start off with the basics.Time = Money.Mistakes = MoneyThere are actions that need to be complete and the longer actions take the more people are needed to perform these actions.
Therefore... the longer actions take to complete the more money it costs the hospital.
Think "Nurse what drugs has this patient been given?".
Most hospitals keep digital records of all medications given which helps doctors make decisions.
This simple task could take 5-10 minutes pouring through 200 pages of charts and possibly missing pages.Think bad handwriting where the nurse AND the doctor can't read what it is.
Get the idea?Mistakes also cost money.
One of the biggest benefits is that Doctors can quickly see what Jonny has been taking and don't accidentally prescribe something that will kill him when mixed with other things.
It also helps the doctor quickly see trends and change their decisions quickly whereas with paper records they might not as easily notice.This paper is written by someone who hates computer systems and doesn't take into account how medicine has changed in the last 20 years.This is just coming from a guy who works at a Veterinary College... our patients are cats and dogs.
Our system has been attributed to saving hundreds of lives because of how statistics can be generated on the fly.
Comparing test results with a click of a button and seeing trends, easily, efficiently... without error.
The ability for alerts to come up letting a doctor know that a drug they are prescribing may cause an allergic reaction with this patient.I can easily say Dr. David Himmelstein has flawed research with far too many missing puzzle pieces and flawed logic.
This system has saved our hospital MILLIONS in potential lawsuits alone.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30286290</id>
	<title>Re:Designed for Entrepreneurs</title>
	<author>Anonymous</author>
	<datestamp>1259695740000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext>Should be  read in the narrators voice from "The Hitchhiker's Guide to the Galaxy"<p><div class="quote"><p>Of course, eventually there *will* be a company that succeeds (mostly by accident).  That company will run suspiciously like SAP where there will be a very complex set of computer programs designed to support an even more complex set of processes.  These processes in turn will have nothing to do with the underlying business of providing health care.  However senior management will be ecstatic that they finally have a unifying computer based process, and the only people who fully realize its true futility will be the people doing the work.  They, of course, will be ignored.</p></div></div>
	</htmltext>
<tokenext>Should be read in the narrators voice from " The Hitchhiker 's Guide to the Galaxy " Of course , eventually there * will * be a company that succeeds ( mostly by accident ) .
That company will run suspiciously like SAP where there will be a very complex set of computer programs designed to support an even more complex set of processes .
These processes in turn will have nothing to do with the underlying business of providing health care .
However senior management will be ecstatic that they finally have a unifying computer based process , and the only people who fully realize its true futility will be the people doing the work .
They , of course , will be ignored .</tokentext>
<sentencetext>Should be  read in the narrators voice from "The Hitchhiker's Guide to the Galaxy"Of course, eventually there *will* be a company that succeeds (mostly by accident).
That company will run suspiciously like SAP where there will be a very complex set of computer programs designed to support an even more complex set of processes.
These processes in turn will have nothing to do with the underlying business of providing health care.
However senior management will be ecstatic that they finally have a unifying computer based process, and the only people who fully realize its true futility will be the people doing the work.
They, of course, will be ignored.
	</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280532</parent>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30283914</id>
	<title>Who wrote the requirements?</title>
	<author>foniksonik</author>
	<datestamp>1259686080000</datestamp>
	<modclass>None</modclass>
	<modscore>1</modscore>
	<htmltext><p>Computers and machines in general just do what you tell them to do. So who wrote up the requirements? It's very likely that an administrator did... so no wonder the systems were designed to make administration more efficient. This means that the inputs and outputs were designed for good bookkeeping - not efficient medical practice. Doctors and nurses now have to learn to do things the 'administrative' way rather than the 'practitioner' way... and likely it is not very efficient for them.</p><p>A good fix for this would be to develop a new view of the system which is organized and designed for the doctors and nurses but translates to a view for administrators.</p><p>Unfortunately this will up the cost and now that the work is being done twice will likely swallow up the savings for the near term... so the hospital board is unlikely to approve it and simply insist on more 'training' for Doctors and Nurses.</p></htmltext>
<tokenext>Computers and machines in general just do what you tell them to do .
So who wrote up the requirements ?
It 's very likely that an administrator did... so no wonder the systems were designed to make administration more efficient .
This means that the inputs and outputs were designed for good bookkeeping - not efficient medical practice .
Doctors and nurses now have to learn to do things the 'administrative ' way rather than the 'practitioner ' way... and likely it is not very efficient for them.A good fix for this would be to develop a new view of the system which is organized and designed for the doctors and nurses but translates to a view for administrators.Unfortunately this will up the cost and now that the work is being done twice will likely swallow up the savings for the near term... so the hospital board is unlikely to approve it and simply insist on more 'training ' for Doctors and Nurses .</tokentext>
<sentencetext>Computers and machines in general just do what you tell them to do.
So who wrote up the requirements?
It's very likely that an administrator did... so no wonder the systems were designed to make administration more efficient.
This means that the inputs and outputs were designed for good bookkeeping - not efficient medical practice.
Doctors and nurses now have to learn to do things the 'administrative' way rather than the 'practitioner' way... and likely it is not very efficient for them.A good fix for this would be to develop a new view of the system which is organized and designed for the doctors and nurses but translates to a view for administrators.Unfortunately this will up the cost and now that the work is being done twice will likely swallow up the savings for the near term... so the hospital board is unlikely to approve it and simply insist on more 'training' for Doctors and Nurses.</sentencetext>
</comment>
<comment>
	<id>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30281702</id>
	<title>Re:Well</title>
	<author>Anonymous</author>
	<datestamp>1259672460000</datestamp>
	<modclass>None</modclass>
	<modscore>0</modscore>
	<htmltext><p>I can give insight on this particular facet of care by way of my medical school orientation dinner many years ago:</p><p>"The truth comes out as the white coats get longer."</p><p>which I'll amend from my personal experience with the prefix "More of..."</p><p>Many patients, for a host of reasons which also include very real human shame, pride, regret, are reluctant to give the full story. As they are slowly integrated into the clinical setting, the barriers almost invariably drop as they are further removed from the everyday: the waiting room chair gives way to an emergency room bed, street clothing is removed and a gown is put on. The actual nurse repeats the questions, and almost invariably the answers are more detailed than the tiage notes.</p><p>Enter the PA, with a short white coat.  At this point, the patient has been hooked up to the usual suite of automatic diagnostic equipment and the reality of the Emergency Dept has begun to sink in, with its smells, sounds and, of course, waiting.  Inhibitions falls, and the story may change completely.</p><p>Finally, someone enters the room with, 'I'm Dr.<nobr> <wbr></nobr>..." as the patient now has an IV established, lab draws taken, injuries fully exposed and, again, with plenty of time to think about what has happened, it real story only now begins to emerge.</p><p>I don't say this in any way to slight anyone, it would be impossibly inaccurate to claim the physician is the only person capable of getting the truth for as anyone who has done time in a hospital knows, the charge nurse, the janitorial staff and the on-call maintenance guy make or break the emergency department, but I do claim the repeated questioning is more necessary due to human, not technological, barriers.</p></htmltext>
<tokenext>I can give insight on this particular facet of care by way of my medical school orientation dinner many years ago : " The truth comes out as the white coats get longer .
" which I 'll amend from my personal experience with the prefix " More of... " Many patients , for a host of reasons which also include very real human shame , pride , regret , are reluctant to give the full story .
As they are slowly integrated into the clinical setting , the barriers almost invariably drop as they are further removed from the everyday : the waiting room chair gives way to an emergency room bed , street clothing is removed and a gown is put on .
The actual nurse repeats the questions , and almost invariably the answers are more detailed than the tiage notes.Enter the PA , with a short white coat .
At this point , the patient has been hooked up to the usual suite of automatic diagnostic equipment and the reality of the Emergency Dept has begun to sink in , with its smells , sounds and , of course , waiting .
Inhibitions falls , and the story may change completely.Finally , someone enters the room with , 'I 'm Dr. ... " as the patient now has an IV established , lab draws taken , injuries fully exposed and , again , with plenty of time to think about what has happened , it real story only now begins to emerge.I do n't say this in any way to slight anyone , it would be impossibly inaccurate to claim the physician is the only person capable of getting the truth for as anyone who has done time in a hospital knows , the charge nurse , the janitorial staff and the on-call maintenance guy make or break the emergency department , but I do claim the repeated questioning is more necessary due to human , not technological , barriers .</tokentext>
<sentencetext>I can give insight on this particular facet of care by way of my medical school orientation dinner many years ago:"The truth comes out as the white coats get longer.
"which I'll amend from my personal experience with the prefix "More of..."Many patients, for a host of reasons which also include very real human shame, pride, regret, are reluctant to give the full story.
As they are slowly integrated into the clinical setting, the barriers almost invariably drop as they are further removed from the everyday: the waiting room chair gives way to an emergency room bed, street clothing is removed and a gown is put on.
The actual nurse repeats the questions, and almost invariably the answers are more detailed than the tiage notes.Enter the PA, with a short white coat.
At this point, the patient has been hooked up to the usual suite of automatic diagnostic equipment and the reality of the Emergency Dept has begun to sink in, with its smells, sounds and, of course, waiting.
Inhibitions falls, and the story may change completely.Finally, someone enters the room with, 'I'm Dr. ..." as the patient now has an IV established, lab draws taken, injuries fully exposed and, again, with plenty of time to think about what has happened, it real story only now begins to emerge.I don't say this in any way to slight anyone, it would be impossibly inaccurate to claim the physician is the only person capable of getting the truth for as anyone who has done time in a hospital knows, the charge nurse, the janitorial staff and the on-call maintenance guy make or break the emergency department, but I do claim the repeated questioning is more necessary due to human, not technological, barriers.</sentencetext>
	<parent>http://www.semanticweb.org/ontologies/ConversationInstances.owl#comment09_12_01_0115246.30280428</parent>
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