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There's not really any substance in this article and this person doesn't have enough insight into the healthcare industry. I disagree with the premise that the
by stevebmark 6y ago
There's not really any substance in this article and this person doesn't have enough insight into the healthcare industry.
I disagree with the premise that the issue lies in accurate diagnoses from inaccurate data. There is value in second opinions and maybe some very specifically applied machine learning, but modern medicine is far too primitive benefit from large amounts of data per patient. The bigger issue is the complete corruption of American healthcare. The whole system's gotta go.
The only good thing in the current system is that HIPAA allows you as a patient to access every single of your medical records from any provider you go to. You won't be able to do much with these records, but it's still nice.
Problem: EHR companies like Epic have corrupt leadership and are purely profit driven and intentionally make it harder to share data between provider networks. The Epic CEO Judith Faulkner is evil and directly profits from this. Same with Cerner and Brent Shafer. They have no desire to make data easier to share.
Problem: Same for hospitals, many of which are corrupt and make millions despite maintaining non profit statuses. They have an incentive to make it harder for doctors not in the hospital network to access their records. Forget about record sharing and easy healthcare data access.
Problem: Most hospitals only care about profits, not patient outcomes and efficiency. This runs deep and leads to inefficient hospitals, including reduced doctor availability. Hospitals also profit from things like billing errors or intentionally sloppy billing. Optimizing for outcomes is irrelevant to hospitals.
Problem: Doctors have conflicting evidence of what to do for health outcomes. For example, some doctors still incorrectly think lowering cholesterol will improve cardiovascular disease, and think people with high cholesterol should be on statins. Giving them more data isn't going to help fix their poor training.
Problem: There's corruption among doctors who care more about profit motives than patient outcomes. They have figured out how to game the system (there are many ways).
Problem: No one in America wants to see a doctor because of cost. And doctors and hospitals and everyone else in healthcare has gamed the system to make everything as expensive as possible, so the desire not to see doctors is more than warranted. You probably know health insurance companies are totally corrupt and the cause of this, but it's also doctors, hospitals (the biggest enemy), the government, medical device manufacturers, non profit health awareness groups, consulting groups like Deloitte, physical therapists, there is corruption at every level of healthcare.
- nradov 6y agoThose criticisms of Epic and Cerner are rather unfair. Both companies participate actively in HL7 interoperability standards development and expose fairly complete APIs for accessing patient charts. https://open.epic.com/ https://open.epic.com/ https://code.cerner.com/ https://code.cerner.com/
- sk5t 6y agoIME these efforts towards interop are rather superficial. They may still be implemented in wildly incompatible fashion, and you will need to open up the ol' wallet wide even to get access to figure out whether it is feasible to build something--anything--to work with Epic.
- lotsofpulp 6y ago> You probably know health insurance companies are totally corrupt and the cause of this, but it's also doctors, hospitals (the biggest enemy) How are health insurance companies the cause of this when I can’t get any healthcare provider (aka doctors) to spit out how much they will charge me? No one is stopping doctors from telling me they will charge me $100 per 15 min, or give me the codes they are going to charge. Yet when I call various doctors offices to schedule a routine procedure such as an ultrasound or a physical or X-ray, they all tell me to sign a blank check. I can figure out how much I need to charge to develop real estate, but a doctor can’t tell me how much (or what codes they are going to bill) for a physical? And if you so happen to start talking about something, you might be charged a different charge code that costs you hundreds extra?
- stevebmark 6y agoDoctors who don't run their own practices usually don't know how much their services will cost, because those prices are determined by private negotiations between practices/hospitals and health insurance companies. The rates vary depending on location, provider, insurance carrier and other factors. Health insurance companies pay their executive staff huge salaries while working as hard as they can to deny medical claims to patients. And the ACA mandating the minimum medical loss ratio for insurance companies had the unintended side effect of incentivizing health insurance companies to pay more expensive medical bills, because they can only pay their exec staff a fixed % of what they spend on health claims. The more they spend on claims, the more they can pay their executive staff. Doctors can be corrupt in many ways, but not being transparent about what they'll bill isn't an important one.