How did the reasonable idea of digital medical records turn into a giant clusterfuck?
Electronic health records were supposed to do a lot: make medicine safer, bring higher-quality care, empower patients, and yes, even save money. Boosters heralded an age when researchers could harness the big data within to reveal the most effective treatments for disease and sharply reduce medical errors. Patients, in turn, would have truly portable health records, being able to share their medical histories in a flash with doctors and hospitals anywhere in the country--essential when life-and-death decisions are being made in the ER.
But 10 years after President Barack Obama signed a law to accelerate the digitization of medical records--with the federal government, so far, sinking $36 billion into the effort--America has little to show for its investment.
Instead of reducing costs, many say EHRs, which were originally optimized for billing rather than for patient care, have instead made it easier to engage in "upcoding" or bill inflation (though some say the systems also make such fraud easier to catch).
More gravely still, a months-long joint investigation by KHN and Fortune has found that instead of streamlining medicine, the government's EHR initiative has created a host of largely unacknowledged patient safety risks. Our investigation found that alarming reports of patient deaths, serious injuries, and near misses--thousands of them--tied to software glitches, user errors, or other flaws have piled up, largely unseen, in various government-funded and private repositories.
Compounding the problem are entrenched secrecy policies that continue to keep software failures out of public view. EHR vendors often impose contractual "gag clauses" that discourage buyers from speaking out about safety issues and disastrous software installations--though some customers have taken to the courts to air their grievances. Plaintiffs, moreover, say hospitals often fight to withhold records from injured patients or their families. Indeed, two doctors who spoke candidly about the problems they faced with EHRs later asked that their names not be used, adding that they were forbidden by their health care organizations to talk. Says Assistant U.S. Attorney Foster, the EHR vendors "are protected by a shield of silence."
This is like the baseline level of problems and dysfunctionality in this country. We had our hands full with this kind of shit before we compounded it by putting Trump & co in charge.
I guess it's time for a Mueller thread?
(prediction: Barr won't release anything, this will take the most anticlimactic path possible, everything is the worst, etc.)
I have two idle questions:
1. Do you worry about the effect of smartphones on mental health? Like the constant distractions/never having down time/whatever it is that people fret about.
I tend to think that people underestimate how boring lots of parts of our lives were. I used to spend a lot of time and energy securing ways to keep from being bored during ordinary parts of every day! And I think that there's been a bit of hedonic adaptation when we complain about our smartphones taking over our brains. But there's probably some truth to it as well. (I recently read something about depression in teenagers being linked to smartphones, which seems impossible to measure but maybe there's something there.)
2. Do you have any TV recommendations that I'd enjoy watching with my kids, ages 4-10?
Guest Post - Gospel of Mark
Nick S. writes: I am surprisingly fascinated by Andrew Rilstone beginning to blog the Gospel of Mark. I'm almost completely irreligious, so it is easy for me to read it as if I've never read the story before. But it feels like an excellent match of style and task. The slightly off-kilter tone of his writing is well suited to the attempt to revel in the strangeness of the biblical text.
I'd be very curious to know how the post reads to somebody who has more familiarity with the story (which would be almost anyone).
And John was clothed with camel's hair,
and with a girdle of a skin about his loins;
and he did eat locusts and wild honey.
Everyone in the whole country is plunging into a river. And the one thing we are asked to pay attention to is John's clothes. Is this merely corroborative detail? "All sounds a bit unlikely? But if you don't believe me, I can tell you exactly what this John fella was wearing..."
Or is it part of a holy crossword clue? Are we supposed to say: "Aha: and you know who else was an hairy man, girt with a girdle of leather about his loins? The prophet Elijah, that's who!" One of the Prophets who talks about making straight roads through the wilderness for the Lord to walk down also says that Elijah is going to come back to earth in advance of the Great and Terrible Day of YHWH. It's the very last words of the book we call the Old Testament. So perhaps we are supposed to infer that camels hair and loin-cloths is the standard dress-code for a Forerunner?
Or is the point simply that John is a wild man from the wilderness, oh-so-different from those coach parties pouring in from Jerusalem?
I personally can't shake off the irreverent idea that Mark is simply saying "Yes, of course, they took their clothes off before getting into the river, but don't worry, they kept enough on to stay with in the bounds of decency." Greeks and Romans didn't have a problem with communal bathing facilities, but I think Jews did.
Heebie's take: Also never read the Gospel of Mark, and lack familiarity with any of the Bible that can't be absorbed through mainstream culture.
But you should click through: the writing style is very charming and engaging.
I recently ditched auto-correct on my phone, and I couldn't be happier. My main errors are typing "tge" instead of "the" and sometimes hitting the period instead of space bar, but those pale next to the number of manual-correcting-auto-corrections I was doing. The learning algorithm is really dismal, isn't it? Nothing made my blood boil more than when it introduces errors into an already correct word or phrase. Anyway, using html tags for italics is now positively a pleasure.
(I still have the word-suggest feature turned on, it just won't replace anything on its own.)
This seems properly scathing:
Most of us in New York City will never have the opportunity to live, work, shop and play within this provincial, hermetic, artificially constructed bubble of wealth that is now grafted on to the side of Manhattan. Hudson Yards is urban glamping. It provides you the skyline of NYC with none of the street. It is always a little sad to see what the people rich enough to have everything actually want.
Also, the name "Hudson Yards" sounds like a knock-off perfume for men. Wouldn't you like to smell like the locker room for the Harvard crew team?
(via one of you elsewhere)
Guest Post - Conservative Thinkers
Nworb Wendra writes: Have I got this straight? A man who call himself Bubba the Love Sponge filmed his then-wife having sex with Hulk Hogan. All parties were at the time happy with this arrangement. Later, they were not. Now, Mr Sponge appears on the Wall Street Journal's Opinion pages defending Tucker Carlson's record as an intellectual. Or perhaps, when Mr Sponge sued to stop the tape being published, he was defending his record as a private, rather than a public intellectual.
Heebie's take: From the first link:
Hulk has apparently warned his ex-wife Linda, son Nick and daughter Brooke - who now works with him on 'TNA IMPACT Wrestling' - to brace themselves for another onslaught.
A source close to the 59-year-old star told RadarOnline.com: 'Hulk is very concerned a new sex tape could emerge.
'After the first video was leaked he warned Linda, Brooke and Nick that he could have been caught on camera in the past.
'The family is absolutely mortified their name has been sullied in such a tacky way. They never imagined that Hulk could drag them into such an embarrassing situation.'
Seems a failure of imagination.