Governments seem to be suckers for computer salesmen who tell them that computerizing their operations will save them money and allow them to operate more efficiently.
It doesn’t happen. The one certainty is that the process will cost way more than budgeted and the big uncertainty is whether it will work at all. I could give innumerable examples but the one that stands out is Britain’s experience of linking all their government hospitals into one network with all the records of all the patients in the country on it. The Brits spent over 12 BILLION pounds over a period of about a decade on it. It never worked and has just recently been scrapped
Unbelievably in the circumstances, computerization is one of the far-fetched dreams of Obamacare. You would think the British experience would have engendered caution but it has not.
One of my readers is an anesthesiologist who is a computer enthusiast and an instructor for Electronic Hospital Records. He reports below one of the more successful uses of computerization in hospitals.
Its limited degree of success stems largely from the fact that a “tried and true” system was bought “off the shelf”. It is when governments order an entirely new system for themselves that the woes often become insurmountable:
We just installed Electronic Hospital Records here Nov 6. Amusing how the State Government can’t seem to do anything right – any claim that Government can do medicine “more efficiently” is laughable.
Gettling into the game late is an advantage – the EPIC system has been used successfully in U T hospitals in Texas and many other places – successfully.
So using a product that has been made better by several generations should be an advantage – but think again when State Government interferes.
Problem # 1
HER was funded by Medicare Stimulus, with a deadline; much was done in haste to meet mandated deadline, Nov 6.
Instead of using a product “as is”, each of multiple State Hospitals just “had to have” “custom features” that simply were not on the original system.
As I know (wife was a programmer for many years) people just can’t wish for “custom programming” and get what they want in a reasonable period of time. Multiple delays.
Problem # 3
Anesthesia machine and monitor vendors were NOT informed that EHR was planned until several months ago. Modules for the machine and monitor to “talk” to computers was ordered late; this kind of hardware must be custom ordered; it isn't sold in Radio Shack or Best Buy. When we went “live”, many modules were not yet available, so data had to be entered manually.
Problem # 4
By the “grapevine”, our system was a “low budget” version, with low level support; when a problem occurs (like computer won’t boot etc..), it may be hours before a support person shows up in the operating room; and often, personnel don’t know what’s happening because the system is so specialized. Likely support package was low budget as well.
Problem # 5.
No surprises here since, in the past, institutions have lost tons of money when new computer systems fail at billing:
ALL my records from the last 3 weeks are listed as “not closed” (records are “closed” when all signatures are checked by myself, and listed as “complete”).
Although records are listed as “closed” in my workspace, on the central system they are listed as “open”; billing cannot occur electronically with open records.
So now entire anesthetic records are printed, and searched by hand for completeness before paper records are submitted for billing; rumor has it that this system will not work properly until local software is upgraded.
EHR is better medicine – looking up patient records online is fast, no paper must be searched for and manually delivered; and paper records are often “lost” because multiple people are using them, often without the record people knowing who has the record at the moment; worst time is days post op, when records are being used by business managers for billing; to dictate reports etc. With HER, we simply search patient’s name or numbers.
But PLEASE – anyone saying EHR saves money is a fool; besides hardware, a system of IT support is needed; on top of this, the system charges a fee.
More on Breivik's "symptoms"
It is a symptom of madness if one takes a close interest in politics and history? Oh boy! I am stark raving at that rate! And if wearing a face-mask to avoid germs is mad, there sure are a lot of crazy Japanese. See the picture of Japanese students in a lecture hall above
The Norwegian mass murderer Anders Behring Breivik showed signs of paranoid delusions as early as 2006, his mother has admitted in a tearful interview with forensic psychiatrists.
"He must have been insane, he became so different," Wenche Behring was quoted as saying in the psychiatric evaluation report submitted to the Oslo court. "It is hard to believe that these things happened. It's still hard to believe."
According to the report, leaked to Norway's Verdens Gang newspaper, Mrs Behring said that soon after the 32-year-old moved back in with her five years ago, he began to behave in an erratic way.
In interviews, Mrs Behring described to two psychiatrists how her son became obsessed with politics and history. "He was totally beyond reason and believed all the nonsense he said," she said.
In July, Mr Breivik killed 77 people in shootings on the island of Utoya and a bomb attack in Oslo.
By April, when he was planning the attacks, Mr Breivik had taken to wearing a face mask inside the house, fearing his mother would infect him. He often refused her cooking.
Mr Breivik was brought up by his mother, who had divorced her diplomat husband when her son was one.
New Gun Company Advertisement Compares Obama to Hitler, Stalin
I am sure that the Left would like to shriek about this but after all the Bush=Hitler placards they would have a cheek to do so. I think the alarm below is overblown. Obama obviously has contempt for "bitter, clinging" gun owners but he would have to do an end-run around Congress to introduce new restrictions: Not impossible but unlikely
A gun company advertisement that warns of impending gun control compares President Obama to Adolf Hitler and Joseph Stalin.
The USAAmmo ad shows side-by-side pictures of Obama with Hitler, Stalin and other dictators who committed atrocities across the world. The ad, which is also accompanied by a video, warns that gun control is imminent and foreshadows that the U.S. could face millions in casualties if they are not allowed to defend themselves.
USAAmmo states that “tyranny is knocking down the doors of American cities daily” and that Obama, Attorney General Eric Holder and other gun control advocates “are secretly conspiring American Citizens of the right to bear arms.”
Trace Williams, director of operations for USAAmmo, defended the ad that was emailed Monday. He told CBS Washington that “Obama and his various czars are infringing on the rights of Americans to own guns.”
“He’s anti-gun and he’s obviously a socialist cramming health care down American’s throats,” Williams said. “That is exactly how those people in that ad rose to power.”
Williams told CBS Washington that he doesn’t regret comparing Obama to those dictators and that his company has received “unbelievable support” since the ad was put out.
“Just look at history. Obama’s socialist agenda is geared toward depriving American citizens of their God-given rights.” He also added that sales have gone “through the roof.”
Obama promised stricter gun control laws following the January Tucson shooting where Rep. Gabby Giffords was seriously injured and six others were killed.
Incentives are life and death
By economist Dr Oliver Marc Hartwich
If there was one word to sum up the whole body of economic theory, it would have to be ‘incentives.’ People act on incentives. As William Stanley Jevons (1835–82), one of the founding fathers of neoclassical economics, put it, the whole economy is ‘a calculus of pleasure and pain.’ Greece is playing out a most macabre application of incentives.
Greece may be the madhouse of the world economy, but there is method in its madness. According to a report in The Lancet, the number of HIV infections in Greece has skyrocketed. The increase was partly due to the termination of drug rehabilitation and street-work programs as a result of government austerity measures. But there was a more chilling explanation.
Drug addicts – acting on incentives – are injecting themselves with the deadly virus to qualify for ‘benefits of €700 per month and faster admission onto drug substitution programmes.’ The incentive to get higher welfare benefits plus access to medical treatment obviously is a strong one – particularly for people who have little left to lose.
It is not the first time economic research has revealed the strange consequences of people acting on incentives. One of the classic economic papers, ‘Dying to save taxes,’ was about how some people in the United States were successfully prolonging their lives by a few days to reduce the estate-tax liability of their heirs.
Australian economists Joshua Gans and Andrew Leigh came to a similar conclusion after studying the effects of the abolition of federal inheritance taxes in 1979: ‘in the very short run the death rate is highly elastic with respect to the inheritance tax rate.’ In other words, people managed to live a bit longer to beat the tax office.
Tax incentives certainly are a matter of life and death, as was confirmed by Germany’s introduction of parental benefits from 1 January 2007. Research by the University of Bolzano showed how German mothers delayed giving birth by a few days to qualify for the benefits.
Incentives matter. If policymakers kept this basic insight in mind, they would design better policies. It might also save the Greek government money it would otherwise spend on AIDS treatment.
The "Spring" that wasn't
At first glance, the Arab uprisings of this year looked to be advances for people often trapped by clerics and tyrants who have used Islam to enslave, torture and kill their people so that they can live in opulent grandeur among some of the planet's poorest populations.
Iran might appear to be the odd man out. For a start its people prefer to fashion themselves as Persians, but it has a significant Arab core. Its supreme leader seems to shun the indulgences that define the lifestyles of his neighbouring leaders, but he and his president, Mahmoud Ahmadinejad, are still the two of the most dangerous men on earth. Ahmadinejad is mad. Barking. And soon to be nuclear armed.
This year saw movements for freedom in Egypt, Tunisia, Yemen, Bahrain, Morocco, Iran, Syria, Jordan and even Saudi Arabia.
The tyrannical states that enjoy Western support - Bahrain and Saudi Arabia - have largely survived, although Egypt fell quickly. Those who alienated the West, or threatened it, or attacked it, are gone. By the hand of their own people.
A Libyan shot dead Colonel Gaddafi, even if his convoy was trapped in Sirte by NATO airstrikes.
But the next chapter in the lives of these states is unlikely to include anything like democracy.
A greater danger is that the threatening Muslim Brotherhood will overtly or otherwise control their destinies.
A year ago I wrote that we'd do well to remember the name Sayyid Qutb, and suggested that despite being dead for almost 50 years he could yet be the most influential man of this century, in the manner that Karl Marx was the most influential man of the last century while not living to see it. The Koran-quoting assassins of the Muslim Brotherhood work to Qutb's manifesto In The Shade of The Koran.
They are bad news for honest, secular Arabs who made such sacrifices this year in the hopes of liberalism and progress that might change their destiny.
The Brotherhood plans changes, too. First they'd turn the clock back to the sixth century, and introduce sharia law; Muslim women and girls could forget about equality. Next they'd start planning for the destruction of the state of Israel.
They are well organised for today's election in Egypt and the military's bloody crackdown on protesters last week plays directly in to their hands. The poll results will give us an indication of the Brotherhood's real strength there. It can hardly be a coincidence that Cairo will also be the venue for a meeting on December 22 between the Palestinian Fatah and Hamas movements as they strike a unity deal after recent talks on "the question of a truce ... with Israel and the question of popular resistance".
They can't have been long talks: Hamas demands the destruction of Israel.
If the Palestinians put down their weapons, there'd be peace. If the Israelis put down their weapons, there'd be genocide.
Meanwhile, in Yemen, the vacuum left by departing President Saleh also doesn't mean freedom for his people. Jockeying for power there are his son and some tribal chiefs, with various factions of the military.
In Moroccan elections at the weekend so-called "moderate" Islamists appear to have taken the lead, as they did in Tunisia a few weeks back, but secularists failed.
And then there's Libya. Run by a murderous lunatic and his sons - one of them the captured Saif, best mate of Prince Andrew, whose mum is Australia's head of state - after 40 years the people revolted and the era of fear, torture and murder was ended.
Already the new regime is talking of sharia law. Welcome the new barbarians.
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The Big Lie of the late 20th century was that Nazism was Rightist. It was in fact typical of the Leftism of its day. It was only to the Right of Stalin's Communism. The very word "Nazi" is a German abbreviation for "National Socialist" (Nationalsozialist) and the full name of Hitler's political party (translated) was "The National Socialist German Workers' Party" (In German: Nationalsozialistische Deutsche Arbeiterpartei)