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Comment Watered-down quality results? (Score 1) 398

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 :)

Comment Baloney (Score 2, Interesting) 398

I worked on an EHR procurement process for the last several years and, yes, there's a LOT of crapware out there, but I have seen systems deployed that were almost entirely reliant on the input of the actual front-line providers and they'd sooner saw off their own arms than go back to paper records.

"They should start working now to have all records be electronic, X-rays, MRIs, personal history, etc. should be in formats that can be directly shared between doctors."

They already do. It's called HL7. It's been around for twenty years. Teleradiology is nothing terribly new anymore either.

As for "having a doctor or nurse putting in billing codes," look, if they're worth half their salt, they can already rattle off the ICD9/10 codes with sufficient accuracy from memory that it's actually faster than scribbling the condition on paper.

Yes, even GOOD systems can fail if deployed poorly. ITFA they admitted "we sucked when we used paper, then we went to computers and lo-and-behold, we still sucked just as badly, almost precisely so, ergo, we're pretty sure it was the computer's fault." This is a typical case of bad management pointing the finger at the technology to cover their own incompetence. I'm sure when they were on paper they blamed the f'ing pencils.

Networking

Why Is Connectivity So Cheap In Stockholm? 443

lpress writes "Symmetric, 100 Mbps service in Stockholm, costs $11/month. Conditions in every city are different, but part of the explanation for the low cost is that the city owns a municipal fiber network reaching every block. They lease network access to anyone who would like to offer service. The ISPs, including incumbent telephone and cable companies, compete on an equal footing."

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