Optimism is rampant with the declaration by the Supreme Court that the Affordable Healthcare Act meets Constitutional muster. However, the devil is in the details.
Those of us working in the medical field are all abuzz with “meaningful use” which translated means Federal dollars. At issue is having a method of health are delivery that actually works. Consider laboratory data as an example. A value from a laboratory in Denver may or may not be equivalent to another measurement done in a San Francisco lab. There are a myriad of reasons for discrepancies. The simplest being units of measure. The Denver lab might report the test in milligrams per milliliter while the San Francisco operation uses grams per liter. Other possible differences include that one lab will analyze whole blood while another uses plasma (or serum) which is the liquid component of blood. Then differences are seen in testing done on various instruments from unique vendors or even different reagents. My life right now is applying a Rosetta Stone approach known as LOINC coding to lab data.
Perhaps even more important is patient identification and confidentiality. We all need to have control of our own personal medical records and be able to share them with professionals who are treating us. In May 2008 HoU member Lauren Florence, MD introduced us to HIIU (Healthcare Information Initiative of Utah) an organization dedicated to patient focused Health Care Reform. Dr. Jim McGauley is one the driving forces of this organization. He recently produced a document detailing how to handle the privacy and confidential issues that are so important. Here are some excerpts:
The establishment of a uniform national healthcare information system that produces a Coordinated Medical Record for every patient in the country will do more to improve the quality and decrease the cost of healthcare than any other initiative.
A uniform information system is a single system that is used by every healthcare provider in the country. This uniform system will produce a Coordinated Medical Record for every patient. A Coordinated Medical Record is a single record that contains all of a patient’s clinical and financial healthcare information across space and time.
Skeptics will say this is an unattainable goal. However, for the sake of argument, if this is our goal, how would we go about establishing this national Coordinated Medical Record system.
CREDIT CARD SYSTEM MODEL
The industry model for a national Coordinated Medical Record system already exists. It is the credit card system.
The credit card system captures information from numerous disparate sites, merges and organizes the information in a coordinated record, keeps the information safe, and distributes it efficiently and cost effectively. This is exactly what the healthcare industry needs.
There are four basic principles that make the credit card system work: (1) the standard identification of every cardholder and merchant, (2) a uniform system for capturing information at every merchant site, (3) a first-tier data processing center for merging and organizing every cardholders’ data, and (4) the automated distribution of data throughout the system.
These same principles can be used to establish a uniform national healthcare information system that produces a privacy-protected Coordinated Medical Record for every person in the country.
A NEW ENTITY IN THE HEALTHCARE INDUSTRY
A Coordinated Medical Record system will be an entirely new entity in the healthcare industry. Considering the power and the sensitivity of the information in the system, the organization that establishes and maintains the system must be completely neutral with regard to all of the players in the healthcare industry, controlled by none and beholden to none.
The sole focus of the organization will be to appropriately manage the flow of information throughout the healthcare industry, across all institutional boundaries.
The primary beneficiaries of the Coordinated Medical Record system will be patients and physicians, neither of whom have ever had access to comprehensive coordinated records.
Those who pay for healthcare, including patients, employers and government agencies, will see a documentable decrease in healthcare costs, with a concomitant documentable increase in the quality of care. This documentation will be provided by the neutral entity that establishes and maintains the system. The system will be ideal for newly forming Accountable Care Organizations.
Healthcare institutions that want to hold on to a fragmented legacy system will not benefit. However, if they participate in the Coordinated Medical Record system they will appreciate a significant decrease in their own operating expenses.
Insurance companies will no longer serve as care managers, resulting in a significant decrease in healthcare premiums. The Coordinated Medical Record system will automatically generate much better care management information than is currently available anywhere in the industry.
The difficulty of establishing a national Coordinated Medical Record system cannot be underestimated. However, it is hard for anyone to stand up and say that such a system is a bad idea. And, it can be demonstrated that such a system will actually do more to both improve the quality and decrease the cost of healthcare than any other initiative.
As you can see, there is still much to be done to reform our healthcare delivery system!
—Jim McGauley, MD
This month our community members answer: “What is one of the big issues facing humanists in our country for the near future?”
- The thing that worries me most is the volume of public discourse. When everyone SHOUTS it becomes impossible to hear what anyone says. The need for respectful discourse has never been greater.
- One of the biggest issues facing humanists is that we sometimes have so much compassion that we do not speak up or stand up, because we are worried we might offend someone or hurt their feelings. If we would take a moment we would not necessarily respond with a “personal” attack, like some of the situations we are placed in.
- A recent article in The Nation reveals that this county still has about 46% of the population who are “creationists” when it comes to understanding the principles of evolution, and this figure has not changed in decades. This shows a basic failure in our educational system to instill even the basic ideas of the scientific method and critical thinking in students. We cannot begin to solve the problems of environmental degradation and sustainability that the world faces if we don’t instill basic facts in our students, who will become our future leaders. Humanists need to actively support public education and ensure that critical information is provided to all students and not watered down with unnecessary clutter and false ideologies (such as creationism) which have crept into education due to the influence of religious dogma.
- A recent public survey revealed that an atheist is the least likely person to win a presidential election in the United States. This fact says to me that our biggest challenge is developing a public relations program that will change the perception of Humanism. Militant Atheism will not win the hearts and minds of anyone. Concern for improving the human condition in every aspect of life is the best strategy for changing the perception of humanism. We need to promote the ideals of relief from fear, the attainment of happiness, healthiness, and knowledge. Positive goals will gain more friends for Humanism than simply shouting “there is no god.”
- There are so many issues it will be hard to pick just one. I’ll pick separation between church and state. A faith in the new scientific method, a respect for learning and hope for a better life in the future were some of the things that characterized our 19th century forbearers. The failure of our education system, a renaissance of superstition and fuzzy thinking and a senseless paranoia about our future threaten to return us to a medieval sensibility characterized by suspicion, fear and ultimately the worst kind of intolerance for Atheism, Agnosticism and free thinking.
- Acceptance of humanism as a philosophy of reason and as an alternative to faith-based religion. The more people who adopt a scientific (evidence and reason) approach to life instead of a religious (faith and prayer) approach, the better our society will be in terms of virtually everything. Rational decisions based on the evidence! Now there’s a novel approach.
- The thing gnawing at me lately is how so many of the gains we’ve made for a more equitable and healthy society are being threatened and endangered by the religious right and/or GOP. I have a sense of needing to dig in and fight just to hold onto things we’ve already fought for. Of course, this is not a new thing in the world.
Thanks everyone! I’m so proud to be a fellow humanist with you. The world needs you.
At the June Humanists of Utah Board meeting, I put forth the notion that our chapter needs a makeover. I think we need to become more relevant to the times, to young people, and a bit more activist. To start with we can upgrade our website and get more connected to the internet world and to likeminded groups. I also suggest that we do away with our summer recess and get involved with the Pride festivities. The Pride Festival is a win-win situation for us in that we can work for a cause we believe in (human rights issues) and make our chapter better known to the public at the same time. I also think that we should have another social in the summer inviting members of the Utah Coalition of Reason, which Humanists of Utah belongs to, together for a Freethinkers event.
We should also keep our involvement with the Homeless Youth Resource Center as one of our activist/charitable causes.
There were a lot of good ideas discussed at the board meeting and we will continue to sort through them in the months to come. The board of directors would also like to hear from the membership of Humanists of Utah as to what kind of events you prefer. We’re hopeful that we can find a good mix of desirable activities throughout the year. I am confident that we can achieve these goals of improving the chapter to make our schedule more appealing to all.
However, not everything is being changed. The schedule will still include our February Darwin Day celebration, our August BBQ, our December social, and a few speakers.
In my years on the board and as president we have always struggled with attracting new and especially younger people to get involved and become members. We have also struggled with making the chapter more “visible” to the public in general.
I believe that fostering and assisting the Utah Coalition of Reason to accomplish the goal to bring free thought groups together for common causes and socialization is one of the best ways to increase our visibility. The Utah Coalition of Reason exists because of the awareness that freethinker groups are diverse and somewhat fragmented and thus we should use UCoR to help us coordinate activities and share resources.
Well, enough about changes, I hope your summer is going well. Yesterday was the first day with measurable rain in 38 days, so the rain was welcome and refreshing and helped with the fires raging around the state. The rain was great for my garden and I’ll soon be enjoying the freshest tomatoes you can’t buy. But my zucchini plants have already taken over. If I don’t check and harvest then for a couple days the little things turn into torpedoes. Anybody need a Zucchini or two?