to langelgjm's point, my nest connects to my furnace with 2 wires. one is red, the other is white. if you connect the wires, the furnace turns on. if you disconnect them, it turns off. this is not rocket science people.

i agree with all of your points.
connecting your EHR to your lab system, to your HIE, to your practice systems, etc is a mess. HL7 stinks. So things do indeed get missed.
of course, with deliberate, thoughtful deployments, these are solvable problems. it takes time and patience.

and don't get me started on end users. :-) but i do believe they are trying, they are busy, and they didn't go to medical school to deal with systems, but to help people.

Obamacare or ACA did not mandate the use of EHR. This was in legislation long before ACA, it was part of the American Recovery and Reinvestment Act (ARRA). It was specifically called Meaningful Use. it mandates a series of electronic use requirements over three phases with initially payments for use and later penalties by CMS. The vast majority of MU certified vendors were producing EHRs long before ARRA and have reasonable security in place. Clearly though some vendors, and hospitals need some shoring up though.

i have filled a few of the earlier generation garmin watches
the latest i haven't had an issue with by the previous two eventually filled up

first off, the protections for debit cards are much weaker than for a credit card. see http://www.bbb.org/blog/2013/11/do-debit-cards-and-credit-cards-hav-the-same-protection/
second, as someone below points out, with a debit card you have to maintain a constant float. not with a CC.

the CC is simple. charge everything. pay it off at end of month. very, very simple.
debit cards are a poor idea.

There are a number of running training schedules and approaches that use fairly exact HR thresholds for various runs. The more serious you are with your training, the more likely these gadgets help. for example, one popular use is as a better gauge of recovery between intervals. instead of the old, walk half the distance or walk the same amt of time, using a HR monitor can tell you when recovered more accurately.
here is a nice article from pete pfitzinger (famous as 2 time US marathon olympian and author of eternally popular Advanced Marathoning - and thus someone with more credentials than itzly ) http://www.runnersworld.com/race-training/heart-matter

i for one love my garmin. the combination of GPS, timer/watch and HR monitor is great.

for everyone knocking these devices, i would love to see your event placings. be it running, biking, whatever you do. how did you do in your last race? i'll put my number against yours anyday.

i think that was a apple ][gs

if it is a piece of cake for you, run faster. until it is not a piece of cake.
a 5k lolly gaggy is a piece of cake, until you run it hard and its not.

that is not how world records are set. look at the splits for the world records. they aren't positive or negative splits grossly, they are flat. consistent running is fastest.

VO2max is more important for short races. Lactate Threashold is the greatest indicator of marathon race performance. read Advanced Marathoning by Pete Pfitzinger for more on this. chapter 1 covers the effects of LT, V02Max, running economy and more. great book. the bible.....

you have clearly never run a marathon. yes, using rabbits is a somewhat controversial issue but it is non the less impressive.
a sub 2hr marathon is crazy fast. to make this happen will require every angle, every subtle increase you can possibly imagine.
run one, maybe two marathons and then you can talk about what is lame.
not to mention running is and has always been a numbers game.
read any running literature and you see runners are always running against the clock. Once a Runner (widely considered the best running book ever makes it very clear runners run against the clock).

race times in boston do NOT count as a world record. as was evidenced in 2011. it was a wonderful day that day, cool, tailwind, awesome.

this holds true across the board for hotels.
cheap hotels give free breakfast, nice hotels charge a small fortune
cheap hotels give free parking, nice hotels charge a small fortune
nicer hotels (like the gaylord mentioned) charge a resort fee of $25 per day for basically no services at all.
cheap hotels though are competing on stuff like free wifi, free breakfast, etc
where the nicer hotels are competing on location, beautiful facility, etc.

i still don't understand though the $1k fee. i have stayed at that gaylord many times. its not a $1k fee for internet, ever. more like $20 per day (unless your marriott gold or platinum, then its free).

The Meaningful Use (MU) requirements that are alluded to in the original post are pushing Continuity of Care Records (CCD) for this type of data exchange. And all the major EMRs and Practice system support some flavor of CCD. Just how much is the question. As it is XML, the CCD is finally a healthcare standard thats useful, in contrast to the not so standard standard of HL7. Epic is bad though about sharing data. Many others are much better.

posted by AC, shock!