From: boron_elgar@hotmail.com   
      
   On Sat, 16 Jan 2021 19:11:32 +0000 (UTC), Howard    
   wrote:   
      
   >Boron Elgar  wrote   
   >   
   >> The system just had   
   >> to figure out how to properly monetize it all.   
   >   
   >It seems possible that's a big driver.   
   >   
   >I was really bothered to find out that probably the biggest reason   
   >behind problems with shifting the medical system to electronic record   
   >keeping and data sharing was the insurance side of it. Having doctors   
   >record their diagnoses, collect test results, issue prescriptions, and   
   >all of that wasn't a huge challenge. For the hardcore anti-tech   
   >oldtimers, that stuff can generally be handled by handing notes and   
   >recordings off to third parties.   
      
   It can be problematic even for younger, computer savvy docs, my own   
   and her partner as prime examples. When the Feds first mandated the   
   changeover to computerized record keeping, they immediately contracted   
   with a recommended company specializing in it. It cost them a lot of   
   money, and even with the small rebates, the training for their own   
   plus staff use was impressive. Then the company got bought out by   
   another med record company and that required a lot of upgrading and   
   re-training. And then a third company ate that one- this is not   
   unusual in a new and evolving industry- but the 3rd company decided   
   not to support the previous software and bang, the docs were out more   
   money and back to square one.   
      
   The docs gave up. It got to the point that they sold their practice to   
   one of the large hospital corporations that provided all of the   
   computerized patient and billing and lab work properties. They still   
   practice, but as part of a corporation now.   
      
   The computerized requirements are so time consuming, that many   
   practices use what are known as scribes to sit in on examinations to   
   do all the recording while the doc just interacts with the patient. In   
   fact, all but one of my docs has that sort of thing in place now.   
      
   >   
   >It wasn't even the privacy issues -- it was the fact that the   
   >documentation had to conform to billing specs in order to justify   
   >decisions that needed insurance reimbursement.   
   >   
   >Digitizing the patient-provider and provider-provider sides were   
   >challenging but manageable, but the patient-insurer and especially the   
   >provider-insurer parts were (and still are) a nightmare.   
      
   And they are not going to emerge from it easily or quickly. Lots of   
   patient burden, too. The practices and labs now have patient portals   
   and more of those larger groups do not share patient data across   
   companies. I have my doc's hospital group and two other hospital   
   groups and a two separate lab and diagnostic companies that have   
   separate portals. Lots of record keeping for me, too.   
      
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