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ColdWetDog: good insight. As you said, smaller organizations have a difficult time implementing EHR systems. But much of that is because they dont have good communication between their clinical staff and their technical staff. The IT staff usually has little clinical background, and gets left out of discussions where they really need to be included.

  In a large organization, often times the IT staff has a clinical background as well, such as former nurses, etc.

-As a side note, how is an organization supposed to make an informed desicion about an EHR vendor?

Vendor 1: We do everything! Watch our slick presentation! See how easy it is!
Vendor 2: We do everything! Watch our slick presentation! See how easy it is!
Vendor 3: We do everything! Watch our slick presentation! See how easy it is!

What they dont tell you is that the large vendors have been around for a long time have a bunch of ancient, bloated, buggy code. (Epic, Cerner)

Thats just bullshit.

Meaningful Use is NOT a requirement. It is NOT Obamacare.
It is an incentive that actually gives money to organizations to help them implement EHR infrastructure.
In order to qualify, and to make sure that money is NOT WASTED, there are a number of requirements that must be met. Stage 1 MU is bone-headedly simple, and Stage 2 is pretty straight-forward. Stage 3 is not even written yet, but is likely to include reporting to show how it affects patient outcomes.

The idea of it all is to actively manage your patient population and to use analytics to improve patient outcomes. -And by doing so, you can actually reduce the total cost of healthcare.

The problems are 1: blood-sucking EHR vendors that charge millions and provide crap products. 2: dumbass healthcare administrators who are so involved with political back-stabbing that they totally fail to even attempt to get the free money available from MU

I've worked for a number of healthcare organizations over the last 10 years, and I've seen organizations both large and small not only succeed in MU funding, but thrive as well. (I've also witnessed others utterly fail)

I'm lucky to be part of one of the good organizations right now. yay!

"Take a look at vaccine adjuvants. Doctors are not scientists, they are business people, and use a lot of hocus-pocus for financial and other reasons."

Dumbass! If doctors were just business people, they wouldnt care at all about vaccines. They dont get paid didly squat for them. I agree that there are some docutors who are greedy, but that is not the majority of them. Nor are most of them "activists" or "community leaders". Most of them just want to make a living. They will help you with your problems the best they can -if you come to them. "Pushing" vaccenes that you take once or twice in your lifetime is not going to make them rich!

" For a large part doctors and biologists have no clue what they are really doing."

Are you really that fucking stupid!? Next time you have a broken leg or appendicitice, who ya gonna call? Ghost busters?

"No holistic/philosopical objections here, just pure science."

-Quite obviously you do have objections, and they have nothing to do with science. Few people in developed countries have witnessed things like polio or pertussis. Maybe you think they are folklore like bedbugs (which are real btw).
   

I much prefer a larger single monitor to dual widescreen monitors. That way, I can have two applications side-by-side and have enough room for each. So at least a 24" monitor and maybe up to 30".

At my previous job, all the IT people were to be given dual 19" widescreen monitors. But a 19" widescreen monitor only has the vertical size of a 15" regular monitor. So for me it was a step backwards. And I agree that the extra space on the side did not help at all. Especially in Microsoft Word that limits the page width to a certain size on the screen. And when browsing or writing code that doesnt take up all 255 characters.

"I doubt they're going to try and end the war on [insert everything here] or roll back IRS harassment powers or end civil forfeiture or rein in the NSA or anything else that I'd really like the government to stop doing."

-Actually, thats exactly what they should do, expecting it all to be veto'd by the president. Then they can say say they are all for progress, but that we need a republican president to do it.

-Then when there is a republican president, and the republicans will have the opportunity to do whatever they want, they will line their pockets with money.

Adhoc tag: The future is not hard to see, but it takes balls to do something about it. -Me

How do you feel being around things that were living when our culture was just at it infancy?
Or knowing that the aspens may have been a shelter for early humans (just guessing).

Do you feel a spiritual connection or more of a scientific respect?

Are there any precausions you must take to ensure you do not harm the organisms?

Photography is often thought of as a non-destuctive process. But as a nature photographer myself, I know that equipment like tripods, lighting units, and sometimes just being there can be harmful to wildlife.

"Dark Magma" -really? no i didnt read tfa but "Dark Magma"!?

Dont you think the term "Dark ???" is being overused now?
Hey! theres something we dont know what it is.. lets call it "Dark... Meatcake!"

Actually, i would say that HR and Recruiters are at opposite ends of the same coin.

It is extremely difficult to get through the HR recruiting process.
Sending resumes to HR may as well send them into black holes (the information destroying ones)
The online application process is horrible and is only eclipsed by the paper application process.
Many IT departments, in order to justify their salaries, list 20 years experience in XYZ application-specific programming language which is not taught anywhere. But then HR departments include that in their screening process and come back with ZERO candidates.

And even with a large amount of technical experience, the reality is that half of everything you do is going to require business-specific knowlege that you wont learn in school. And 40% of what you are doing will be application-specific or environment-specific. So really only 10% of what you will be doing in any technical postition is relative to your previous experience or education!

So again, just getting an interview with HR is a major barrier to many otherwise qualified candidates.

-And really, how is HR going to verify ANY of what someone says on their resume? Do you really think they are going to call china or india to validate the diploma from a worker who studied abroad?

The candidates that finally make it through the HR screening process are either lying through their teeth, or the candiate will be asking 5x your entry-level salary anyway.

So I welcome the recruiters! Let them send me some warm bodies and I will decide in the interview whether I think they qualify.

"Kazeem was obviously less than worthy"

"proprietary, secretive, incompatible "
Hmm this sounds like manager-speak. Lets try google translate to engineer speak.

"Unmanaged, undocumented, badly designed"

Lefty-Loosey

Hey if we slip into being a 3rd world country, we can call ourselves a 'developing nation' and ignore the kyoto protocol like china does.

Seriously, "China is running roughshod over us " is not accurate. WE are running roughshod over ourselves.
WE want our cheap stuff and our own companies are happy to invest in factories in China, Myanmar, Malyasia, etc. WE have financed their industrial growth. WE have voted on laws and politicians that enable 'free trade' with countries that cannot afford our own products.

If you want to say you think the US is going in the wrong direction, fine. But follow that up with REAL solutions. How do you suggest we reduce greenhouse gasses? -Gee-wiz, Mr. Keqiang, can you please stop using those coal-powered factories that we paid you to build? Ya, thats going to go real well.