Is the NHS Computer System Crash in Scotland a Harbinger of what is to come with Obamacare?

Posted by PITHOCRATES - October 5th, 2013

Week in Review

One of the keys to making health care better under Obamacare is by digitizing our medical records.  To allow the swift sharing of our personal information with medical providers.  A one-stop-shop, if you will.  Where everything you would ever want to know about someone (income, Social Security number, home address, names of family members, embarrassing medical conditions, etc.) is but a click away.  All sitting nice and tidy in one massive database.

Hmmm, wait a tic.  Isn’t that kind of dangerous?  I mean, is there anything more frustrating when you can’t get your balance at the bank because the computer is down?  But that’s only a banking system.  I’m sure that would never happen with a national computer system for Obamacare that is guarding our most private and personal information (see NHS IT staff hopeful about fix for Glasgow health board area posted 10/3/2013 on BBC News Glascow & West Scotland).

Scotland’s largest health board has said its IT system is working again after a two-day crash saw hundreds of appointments and procedures cancelled.

NHS Greater Glasgow and Clyde said it still does not know what caused the problem which affected 11 hospitals.

The health board said no patient information had been lost and data gathered during the crash would be manually added to update the system…

Mr Calderwood said the “unprecedented” systems crash related to the health board’s computer network and the way staff connected to clinical and administrative systems.

“The situation is that as users log on they go through a system called Microsoft Active Directory, a router system which recognises users and allows individual access to our clinical and administrative support systems,” he explained.

“This was corrupted over the weekend which became apparent when staff logged on to the system on Tuesday after the holiday weekend.”

Although the problem has been resolved, NHS GGC still does not know what caused it.

“You know, Mrs. Smith, I’m not happy with the grade you gave me for my paper.  That could hurt my scholarship chances for college.  So let’s make a deal.  You fix my grade and I won’t tell anyone about your HPV and your vaginal warts that you contracted when you were in high school, you filthy whore.”

In this day and age do we really want to make it easier for people to steal our identities or extort us?  They said no patient information was lost but how much was copied?  Which is a rhetorical question as they could never know.  Something happened.  But they have no idea what.  But there is nothing to worry about they insist.   Just because kids can hack into some of the most secured computer networks in the world what are the chances that someone hacked into theirs to steal most private and personal information we have in our lives?

Obamacare did not get off to an impressive start.  With the whole system going offline for repairs within the first week.  It would be sad if we remember these as the good days of Obamacare.  Before hackers began stealing our most private and personal information.

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Near Accidental Harvesting of Organs from Not Quite Dead Patient a View into Obamacare?

Posted by PITHOCRATES - July 13th, 2013

Week in Review

President Obama has delayed the employer mandate of Obamacare.  As there was so much confusion in implementing Obamacare that despite having 3 years to put this massive bureaucracy into motion the government is still not ready.  Or it could be because of the immense unpopularity of the program that they want to push back some of the more unpleasant parts of it to after the 2014 midterm elections.  So Democrats up for reelection don’t have to face an angry electorate while campaigning.  Like so many did in the 2010 midterm elections.  And lost.

The Obama administration is beefing up the IRS to enforce Obamacare.  Expanding their reach into our private lives.  And into our medical records.  To see who qualifies for a subsidy.  And who is not paying their fair share.  Who, when identified, they will descend upon them with all the joy and pleasure of an IRS rectal exam.  I mean, audit.

The real scary part of all this is that the agency now responsible for our very health is the one that recently persecuted some Americans for their political beliefs.  The vast majority of the policy-makers at the IRS donated to President Obama’s reelection campaign.  Which makes the persecution of Tea Party groups and their donors the more frightening.  For where will it end?  This abuse of federal power (see Patient awoke to doctors mistakenly preparing to remove her organs by Eric Pfeiffer posted 7/9/2013 on Yahoo! News)?

The Post-Standard reports that in October 2009, Colleen S. Burns was taken to the emergency room at St. Joseph’s Hospital Center, suffering from a drug overdose. Although a nurse told doctors that Burns was recovering from her overdose, those same doctors pronounced her dead.

A call was placed to her family informing them that Burns had passed away, and the family subsequently agreed to have her removed from life support and gave the hospital clearance to harvest her organs.

But Burns was not dead. In fact, a number of signs clearly pointed to her being alive. When a nurse performed a mandatory reflex test on Burns, her toes curled downward. She appeared to be breathing independently of a hospital respirator, and her lips and tongue were said to have moved moments before doctors prepared to remove her organs.

Nonetheless, the nurse then followed instructions to give Burns a powerful sedative, a seemingly unnecessary move if the patient were actually dead.

Thankfully, Burns awoke moments before doctors were going to cut her open to remove the organs from her presumed-dead body.

Imagine the future world of Obamacare.  With an expanded IRS acting like the secret police.  And a state official at each hospital responsible for the enforcement of Obamacare policies.  Big Brother, if you will.  Making sure everyone is Obamacare obedient.  And reporting back to their superiors in Washington of problem personnel.  This official having direct access to the standardized digital medical records of every patient.  Now imagine a patient near death who is either a political enemy of the state.  Like the Tea Party and their donors were to the IRS.  Or someone that their Obamacare computer programming flags as a potential match to someone in the inner party in need of an organ transplant.  And they unexpectedly take a turn for the worse and die.

That will never happen, some will say.  Those who believe government is an instrument of good.  And maybe this scenario will never happen.  But it could happen.  That’s the scary part.  Because the pieces are all there now.  All it will take is someone to make it happen.

In the movie V for Vendetta V said, “People shouldn’t be afraid of their government. Governments should be afraid of their people.”  The United States became a nation based on that principle.  The U.S. Constitution enshrines that principle.  But things have changed since the Founding.  And people are now afraid of their government.  And the IRS.  Just ask those Tea Party groups.  And their donors.  They can tell you a thing or two about abuses of federal power.  And now these people are going to be in charge of our health care.  Where they can do anything they want to us.  Force us to pay a higher premium.  Make us wait a longer time for treatment.  Even deny us treatment.  Giving us a pill to take instead to manage our pain until we die.  Or they could even hasten our deaths.  To cut costs.  And to, perhaps, harvest our organs.  For someone more important in the inner party.  All it will take is someone to make it happen.  Just as someone chose to make that IRS persecution of political enemies happen.

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Can we trust Obamacare when the NHS loses 1.8 Million Confidential Patient Records in a Single Year?

Posted by PITHOCRATES - October 28th, 2012

Week in Review

One of the ways Obamacare is supposed to reduce costs is by digitizing our medical records.  So any of our doctors can pull them up from anywhere.  So that every doctor will always have the most up to date file on us.  The problem is, it just may not be our doctors accessing our records from anywhere.  So some are asking if we should trust the government to protect our confidential information.  For they can look across the Atlantic and see that trusting the government with our confidential information was not a wise thing to do (see NHS lost track of 1.8m patient records in a year with sensitive information found in public bin and for sale on the internet by Jack Doyle posted 10/28/2012 on the Daily Mail).

The NHS lost track of 1.8million confidential patient records in a single year, the Daily Mail can reveal.

In worrying lapses in data security, sensitive paper records have been dumped in public bins and electronic records found for sale on an internet auction site.

The worst cases include details of terminally ill patients being faxed to the wrong number, and patient records being stolen and posted on to the internet.

The total is the equivalent of nearly 5,000 records going missing every day. But the real figure is likely to be much higher because in some incidents it was not known exactly how many records were lost…

The Information Commissioner, Christopher Graham, has levied fines totalling nearly £1million on NHS bodies in the last six months…

Trespassers gained access to the site and copies of records – which dated from the 1950s – were posted on the internet…

The worst breach involved a CD containing 1.6million patient records, including personal details, belonging to Eastern and Coastal Kent PCT. The CD was lost when a filing cabinet went missing during an office move.

The trust was not fined, but signed an undertaking with the ICO not to repeat the error.

The worst breach of patient privacy is punished by a promise not to do that again?  Well, problem solved.  For promises are serious things.  I mean, who has ever broken a promise?

The NHS is taxpayer funded.  So how does that work?  The government fining the government?  Do they reduce the amount of money they spend on health care services?  Does the government then reimburse the NHS Trust?  Or does it simply let more people go without health care?

This is the problem when government provides services.  And the oversight.  The government provides oversight on themselves.  They set the standards.  And they measure if they meet those standards.  Which probably explains why they fix problems with promises.

So is it any wonder that they’ve lost over a million confidential patient records?  No.  Will it be any wonder when Obamacare loses over a million confidential patient records?  Probably not.  Because bureaucrats are bureaucrats.  So digitizing our medical records is probably not a good idea.  For that matter, neither is Obamacare.  Based on the real world example provided by the NHS.

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Thieves are Stealing Medical Equipment and Personal Information from the NHS

Posted by PITHOCRATES - September 29th, 2012

Week in Review

Thomas Jefferson did not like having money and government get too close.  Because history is strewn with examples of corruption whenever money and government come together.  From padding the federal payroll to spending money to buying votes to outright graft.  Which is why Thomas Jefferson would have opposed Obamacare.  For he would have thought it was not the federal government’s business to provide health care.  And he definitely would not have wanted the federal government spending that kind of tax money.

We spend a lot on health care.  About $2.6 trillion today.  And another bad thing about spending that kind of money?  Government bureaucrats just aren’t that good at it.  So you know Obamacare won’t be as good as the health care provided by the private sector.  Just look at what’s happening in the UK to see the future of Obamacare when the government takes responsibility for $2.6 trillion in health care spending (see The great hospital robbery: Defibrillators, baby heart monitors, even beds – thieves are walking out of NHS wards with vital equipment by John Naish posted 9/24/2012 on Mail Online).

The great hospital robbery: Defibrillators, baby heart monitors, even beds – thieves are walking out of NHS wards with vital equipment…

Experts suggest they are spiriting it abroad, to Eastern Europe or even as far afield as Iraq and Afghanistan.

And, shockingly, NHS staff are sometimes involved, acting as an ‘inside man’.

But if such thefts are not scandalous enough in themselves, NHS chiefs appear to be so blasé about the losses they don’t even have a national picture of how much equipment is being stolen, let alone a comprehensive anti-theft strategy…

To make matters worse, NHS trusts can’t claim for the stolen property, says Sarah Bailey of the Association of British Insurers.

‘The NHS does not tend to take out commercial insurance policies. Instead, it “self-insures”, which means it absorbs the cost of its losses, rather than taking out policies that could be expensive.’

As she points out: ‘Ultimately, it could be the taxpayer who funds those losses.’

Of course government bureaucrats aren’t going to get excited about theft.  Why should they care?  It’s not their money.  And it’s not their job.  Besides the losses won’t come out of anyone’s pay.  They’ll just pass the losses on to the taxpayers.  Something they can’t do in the private sector.  Which is why they take loss prevention a bit more seriously in the private sector.  Because there is accountability in the private sector.  And profits.  So they put people in places to minimize anything that will reduce those profits.  Like theft.  Something the NHS appears to be not overly concerned about.  Pity.  For they are stealing more than just medical equipment.

Laptops used by hospital staff are the most frequent target of hospital thieves, which could mean millions of people’s personal details and medical records have fallen into the hands of criminals.

In June last year, for example, NHS North Central London admitted that an apparently unencrypted laptop, containing details of more than eight million patients, was one of 20 machines reported stolen from a storeroom.

When computer thefts result in the loss of sensitive information on patients, this has to be reported to the Information Commissioner’s Office (ICO), the independent public authority set up to uphold information rights.

Figures from the ICO show that the NHS is the top sector for such losses, with significantly more incidents than the whole of the private sector put together…

And this is the future under Obamacare.  Greater inefficiencies because of theft.  And greater theft of personal information.  Which there will be a lot of available to steal as Obamacare digitizes all our medical records.  So as we move to national health care it will cost more and we will get less.  As they spend a lot of our tax dollars to replace stolen equipment thanks to the lackadaisical attitude of the government bureaucrats in charge of Obamacare.  While we spend more to replace what others steal from us thanks to their lackadaisical attitude about securing our personal information.

Sure, some say Obamacare will do better than the NHS.  But to them I say the NHS probably does national health care better than most.  And after doing it since 1948 they’ll be able to do it better than the Americans will be able to do it just starting out.  Only it will be a lot harder than it was in 1948.  Thanks to an aging population raising the cost of health care.  And the sophistication of the bad guys in stealing from the system.  No.  Obamacare will be a far cry from the NHS.  So as bad as anything is in the NHS just remember that Obamacare will probably never be that good.

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Computerized Medical Records open the Door to Fraud and Give Glimpse of Health Care under Obamacare

Posted by PITHOCRATES - September 29th, 2012

Week in Review

One of the ways to improve efficiency and cut costs in health care is to digitize medical records.  President Obama and the Democrats kept talking about that as they pushed Obamacare through a Democrat-controlled House and Senate.  This simple fact was going to fix so much that was wrong with health care in the U.S.  Putting all our personal information online is just common sense.  Because it makes it so much easier for health care providers to look up our personal information no matter where they are.  And as it turns out, it makes it easier for others to pull up that personal information (see Feds warn hospitals over Medicare fraud by Associated Press posted 9/24/2012 on CBS NEWS).

Computerized medical records were supposed to cut costs. Now the Obama administration is warning hospitals that might be tempted to use the technology for gaming the system.

Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder issued the warning Monday in a letter to hospital trade associations, following media reports of alleged irregularities.

The letter said there were indications that some providers were using computerized records technology to possibly obtain payments to which they were not entitled. It raised the threat of prosecution.

Among the practices under scrutiny is what’s called “upcoding” — or raising the severity of a patient’s condition to get more money.

The U.S. spends about $770 billion annually on Medicare based on a recent CBO projection.  Imagine the fraud in the system when the government takes over all $2.6 trillion of health care spending.  If the spending increases by 238% one can assume the fraud will increase by 238%.  Fraud made easier by the digitizing of our health care system.  Unless, of course, the U.S. will have the best cyber security in place like they do for Medicare.

Hospitals say part of the problem is that Medicare has lagged in updating billing guidelines for emergency room and clinic visits.

Getting the billing guidelines in place is probably the easier part of a computerized billing system.  Probably a lot easier than securing that system from cyber attacks.  So it doesn’t give one a strong sense of confidence that our personal information will be safe online.  Especially when the government goes from processing $770 billion annually to processing $2.6 trillion annually.

Obamacare may make it easier for doctors to access all our personal information.  But it will also make it easier for everyone else to access our personal information.  Including those we don’t want seeing our personal information.  Those who want our social security number.  Address.  Phone numbers.  Addresses and phone numbers of our family members.  As well as our personal medical history.  All of which will be one click away for those who would really like to have it.  Makes you yearn for the old days.  When only your family doctor had that information.  On a paper file.  In his or her file cabinet.  Safe and secure.  Even if it was not the most efficient system in the world it was one you didn’t have to worry about.

Sadly, those days are long gone.  For Obamacare will put your health care experience on the public stage.  Where little will be secure from prying and persistent eyes.  Where the same people will be responsible for your personal information that can’t stop Medicare fraud.

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Australia’s First Attempt at digitizing Health Records off to a Poor Start

Posted by PITHOCRATES - August 18th, 2012

Week in Review

For a glimpse into the world of Obamacare consider the digitizing of health records in Australia (see Cool response to online health record scheme by Fran Molloy posted 8/14/2012 on The Sydney Morning Herald).

Despite more than 15,000 patients having consented to a shared e-health record in one Brisbane test area alone, only 5000 people have registered with the federal government’s eHealth scheme nationally…

The Queensland initiative was one of three national wave sites trialling the new health record system since February 2011.

Australians attempting to register online have met with a cumbersome process, which requires several clicks and a redirection to the Australia.gov.au website before the registration process can begin…

Sydney IT worker Garry Stevens last week detailed his experience in a letter to the Health Minister, in which he called the registration site a masterpiece of incompetence with interface issues including browser incompatibility, punctuation problems and irritating time-outs.

How many times did the Obama administration say that digital medical records would solve most of the problems in the health care industry?  I don’t have the exact number but it was somewhere around a lot.  And it’s a big part of Obamacare.  There is only one problem.  The organization trying to bring the health care industry into the modern era is the same organization that has left it in the old era.  Somehow trusting the people who have done such a poor job of maintaining records to modernize these same records doesn’t fill one with a whole lot of confidence.  Which is why a lot of Australians are not signing up for this program.

And then there’s the matter of security.  I mean, how many people are going to trust these people with putting their most private and sensitive information on line when they can’t get the little things right?  Like punctuation?  Or browser compatibility?  You just know that there is some kid out there that will be able to easily hack their system.  Or some political operative trying to dig up some dirt on a political opponent.  Worse, they’ll probably not even know if they were hacked.  Well, a politician will know when his or her sexually transmitted disease becomes public.  Should they have one.

And what do we gain from this?  Not much.  Other than a more impersonalized health care system.  Where doctors will spend less time with their patients.  As they use their computer systems to process more patients per hour.  To improve efficiency.  And cut costs.  Because time is money.  And talking to patients just wastes time.

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NHS Doctors compromise Patient Privacy by Accidentally Clicking on ‘cc’ Instead of ‘bcc’ when Emailing

Posted by PITHOCRATES - June 3rd, 2012

Week in Review

One of my favorite Winter Olympics were the 1992 games in Albertville, France.  In part to that montage at the end accompanied by a couple pieces from Carl Orff’s Carmina Burana.  And Charles Kuralt.  Who gave us charming slices of life in the Tarentaise Valley.  Farmers eating a breakfast of cheese and wine after finishing their early chores…before the sun had risen.  And people waiting for freshly baked baguettes in the crisp predawn hours.  Made by bakers the way bakers had baked bread hundreds of years earlier.  Because as Charles said, sometimes the old ways are the better ways.  It turns out that’s true in more ways than one (see Doctors ‘risking email privacy breaches’ by Caroline Parkinson posted 6/1/2012 on BBC News Health).

As the email whizzes off into the ether, dread strikes. It’s gone to the wrong person.

Normally, the worst that can happen is a little embarrassment.

But a medical advice body is warning that while trying to use modern technology to contact patients, doctors are sometimes revealing confidential information…

In one case a practice sent patients an email reminder for a flu vaccination clinic, but mistakenly pasted the email addresses into the “To” rather than the “Bcc” – blind copies – box…

The MDU is issuing advice to doctors about how to send out group emails, and what to do if it goes wrong.

“These are breaches of confidence. It shows those in the email group that other individuals are part of that practice, and part of that particular group.

“And, while you may not be directly releasing clinical information, it can be possible for people to make assumptions, especially in small communities.

“For example, on a flu jab reminder list, you may be on there because you are immunosuppressed, because you have cancer or HIV – or other reasons you don’t want people to know about.”

In the old days there were family doctors.  Who we knew all our lives.  And we paid them for the services they rendered.  In the days before heath insurance became an employee benefit.   And life was good.  Charming.  Folksy.  But now health care has grown into a great bureaucracy.  Where doctors have to spend more of their time being bureaucrats than doctors.  With the advent of employer provided health insurance there were no longer free market forces to determine health care prices.  Because someone else was paying the bill.  Then came the lawyers.  And the malpractice suits.  Changing medicine into a defensive action against frivolous lawsuits.  Further increasing health care costs.  And pulling health care providers further away from practicing medicine.  Instead spending their time managing risk. 

Now Obamacare wants to change this further.  By digitizing medical records.  Turning health care into production line care.  To process more people per hour to reduce costs.  Transforming the doctor-patient relationship to a patient-random government bureaucrat relationship.  Relying on the data in our records more than personal knowledge of a patient like in those folksy old days.  Which can really speed up treatment.  As long as an overworked, underpaid bureaucrat inputs all of the data correctly.  And no hacker breaks into the system to mess with people’s data.  Or steal it.  For it will be one large repository of names, addresses, phone numbers and social security numbers.  As well as intimate medical information.  Which people could use for whole sorts of reasons.  The mind shudders to think what may happen when this information is in the hands of the wrong people.  Especially when health care providers begin emailing each other.  With attachments.  Or their patients.  Like in Britain.  Accidents happen.  Especially when the technology makes it so easy for accidents to happen. 

Doctors are at risk of being in breach of both the Data Protection Act 1998 and the Privacy and Electronic Communications regulations 2003 – and the Information Commissioner would have to be informed.

A spokesman for the Information Commissioner’s office said GP practices, like hospital trusts and local councils had a responsibility to take care of the data they hold.

He added: “Bcc and group emails are a concern. If we find a breach related to Bcc, and particularly if that’s caused damage or distress, we would take enforcement action.”

As if doctors didn’t have enough to worry about in their busy day.  Being both bureaucrat.  And part-time doctor.  Now they have to worry about breaking the law when they accidentally click ‘cc’ instead of ‘bcc’ after a long, sleep-deprived day.

And this is a glimpse into the future of Obamacare.  Where we can only hope it will be as good as the NHS.  For as national health care systems go, it’s one of the best.  But it still doesn’t beat the good old days.  When we had warm familial relationships with our family doctors.  Who knew us better than we knew ourselves.  Who didn’t need digital records or emails.  And not only were we able to pay for our own health care but we liked our health care.

It’s like Charles said.  Sometimes the old ways are the better ways.

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The Form-Based Efficiency of the NHS fails to Save a Baby from Chicken Pox

Posted by PITHOCRATES - May 5th, 2012

Week in Review

A baby dies despite the efficient use of forms in national health care (see Baby boy died from chicken pox after doctors sent him home THREE times – and all he needed was simple antibiotics by Paul Sims posted 5/3/2012 on the Daily Mail).

Hospital staff missed three vital opportunities to save a toddler with chicken pox and he would be alive today if they had acted, a coroner said yesterday.

Lewis Mullins was seen by doctors three times in three days after his mother became convinced his condition was deteriorating rapidly.

But on each occasion she was given painkillers to make her son more comfortable and sent home…

Rotherham coroner Nicola Munday said Lewis would have almost certainly have survived the infection had staff ‘heeded’ the warning signs, carried out routine tests and treated him…

She rushed her son to Rotherham’s NHS walk-in centre on Wednesday, March 30 last year and was told he had infected chickenpox.

But a questionnaire filled in by a nurse, which detailed Lewis’s pain, rash, high temperature, shaking episodes and breathing problems, was not passed to the GP who later saw him.

As a result the GP thought he was treating him for chickenpox and nothing more…

This is medicine on a grand scale.  National health care.  And what Obamacare will be like.  Where the focus will be on cost cutting and greater efficiencies.  Digitizing medical records.  Using forms and checklist discipline to process as many human inputs into the system as possible.  To make those limited health care resources stretch as far as possible.  Instead of old time medicine.  Where you have a family doctor.  And your family doctor knows you and your family.  Your family history.  A doctor that sees your children growing up.  A doctor that knows your child.  And his or her brothers and sisters.  Knowing them as children.  And not as checklists.  But we can’t have that with national health care.  And we won’t have that with Obamacare.  Because that will take too many doctors.  And too much time.  So our doctors will become strangers.  Strangers who peruse a checklist.  Then goes on and processes the next human input into the health care machine.

This would probably not have happened in the United States.  For even though health care there is still not nationalized most children receive a chicken pox immunization.

Miss Conlay is now calling for a national immunisation programme for chicken pox. Vaccination is routinely available in the United States and Canada, but it is not offered to children in the UK…

Of course one can only assume the reason why the UK doesn’t is for the same reason that directs every decision in the NHS.  Cost.  Currently immunization clearly isn’t cost-effective.

It’s not the people in the NHS.  It’s the NHS.  The system.  Which is asking them to do the impossible.  For with their aging population and rising budget deficits they have little choice but to cut costs and pursue greater efficiencies.  And even though there is this great example of a large national health care system struggling to deal with an aging population and rising deficits the United States is heading down this same road.  Only with more human inputs to the health care machine.  That is struggling to deal with an aging population and rising deficits as well.  Who likes to hold up the model of Medicare as a success story.  Even though they project Medicare to go bankrupt in a decade or two.  So enjoy your health care in America while you can.  For if Obamacare isn’t repealed these are the kind of stories we’ll be reading about.  Only on a grander scale.

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