Use taxes have been around forever -- in fact they usually predate or come up along side of sales tax. Sales tax is just the state requiring businesses in the state to collect your use tax. For instance, in CA the first use tax was passed at the same time as the first sales tax -- 1954.

http://www.boe.ca.gov/sutax/taxrateshist.htm

in the public domain. VISTA is the Veteran Administration's EMR which has generally gotten very good reviews by physicians. However, it is an unbelievably archaic on the back-end (uses M, predates relational databases, etc.). In addition there is no emphasis on charge capture, so it often is useless for billing purposes.

Very unlikely to happen in the US. The administration hasn't even submitted it to congress for ratification yet. Also, remember treaties need 2/3 support of the senate, and there are an easy 34 senators that oppose this.

Yes and no...

Their special advantage is active directory integration, and ownership of office. No one else has anything that even comes close at this point in time. The question is whether they can leverage it correctly.

I've implemented and consulted with many physicians on EMR systems for almost 10 years -- and I generally agree with you.

EMR's can be unbelievably useful, especially when the entire community is on the same database. For instance in one rural area I work with, there is only one hospital, and almost every physician in the community (including those in private practice) is integrated into the system.

No more consult notes faxed over, the ED can access the EKG done in the primary care office, primary care can access every drug prescribed for the last year by any physician (essentially) in a 20 mile radius, previous studies and xrays, hospital records, labs, etc.

The one issue is security, and I'm not sure I completely agree with their methods -- although its still fairly good. The security is very fine grained for non-physician staff, for instance a medical assistant can only access patients who their physician is treating, and only notes generated by their office, floor nurses can only access notes from the current visit for patients on their floor, etc. That being said, any physician (not NP or PA) can access any record in the system.

The only non-electronic notes in the community are the nursing / progress notes from behavioral health, but even then prescriptions, diagnosis, visit dates, and consult and admitting / discharge summaries are available.

It also is very good for public health and at implementing disease management protocols. Vaccines are almost never missed, diabetic's are prompted for foot care, cholesterol, HgA1C if needed, etc. (Physicians can design their own templates or the hospital will pay for someone else to do it according to their protocols).

As you mentioned the big problem is entering data, and that is a challenge esp. for free form notes. There are anatomical diagrams available, as well as voice recognition and other modes of entry. But a lot of physicians still do dictation (although they dictate to the note and its routed to the transcriptionist). Most of them have tablets, and in addition their are laptops on carts all over the place.

You can????

No, you cannot order corporations to destroy records they create on transactions with you, pictures they take in a public place, etc.

Sorry if I wasn't clear.

I was replying the the parent thread which indicates you can throw away everything away in 8 years.

Digitizing is not a problem at all, and I never meant to indicate it was.

although some paper work can be eliminated after 4 years, other needs to be retained much, much longer. Supporting documents for tax returns -- especially those not reported by third parties to the irs -- should be kept for a minimum of 3 years AFTER you file the return. Six years if you have under-reported or taken aggressive deductions that may reduce your taxes due by more than 25%.

In addition you should retain every receipt for the purchase and capital improvements to your house until (see above) years after you sell the house -- this includes new roofs, AC, appliances, remodeling expenses, etc.

Stock records should be kept as above.

Contracts (esp. big ones) should be kept until the contract is completed, and at least until the statue of limitations runs out.

This doesn't even get into business property -- where you can be audited on a desk you purchased up to 14 years later (in theory). Property related to assets (vs. expenses) should almost be retained indefinitely.

Senator's who have TS clearance do go through a background check. The House Armed Services Committee & Intelligence committee's require background checks on member's. The difference is that the Senate can decide to appoint someone to a committee regardless of the results as its up to the political process. That being said, I would be highly surprised if they did.

Cabinet Secretaries also go through background checks (usually) as part of their confirmation process. Although in theory the Senate could confirm w/o one, they do require them before hearings even take place.

The president / vice-president are the only ones who truly go through no official background check. However, the publicity and media surrounding a campaign almost guarantee's that everything will come up. If the people decide (regardless) that they don't have a problem, then its not the FBI's (or anyone else's) place to tell them no.

This really depends on the state. In Mississippi for instance the medical records are considered physician work product and state law explicitly states they are owned by the physician. This doesn't change the fact that the patient must have access to them in most cases (but not all).

Lab's and outside reports (radiology, etc.) are even more problematic.

is available usually very cheaply. That would meet the insurance requirement.

GE's EMR is highly advanced, is microsoft centric, and one of the few working solutions in the world at the system's / enterprise level.

The problem is that the last time I looked, it was 50-100K / physician.

This is targeted at small and mid-sized businesses....

SARBOX only applies to publicly traded companies, of which very few in this market are, and even those few will be big enough to have professional IT resources.

Yep....

A $100 license from apple to deploy enterprise apps w/o going through their app store is so expensive for a company looking for custom applications...

Linux has hardware support for things 20 years old that almost no one needs on a modern computer. Windows 7/Vista has support for almost every piece of hardware being sold today -- Linux does not.