Netizen

Wednesday, July 10, 2013

Ingress: Swatting Houseflies On The COMM

The COMM is the least well thought through element of the Ingress gaming app. It is just raw.

My top request right now with Niantic is to enable a Block User feature for the COMM. Minus that the COMM has a tendency to degenerate to the lowest common denominator kind of talk.

Also just having an All COMM and a secure COMM for faction chat is not enough. There is room for one more section, one called private COMM: there you only see people you allow.

There are only two global teams possible in the game and that is the way it should be. But every city in the world has at least one local team on each side. And the idea of making it possible to form many, many local teams is not an aside. Making that possible is central to bringing about complexities in the game.

The game has to be kept simple in its basics like it is now. But most of the new complexities and challenges will come from enabling easy creation of new teams. Just like you graduate from building portals to building entire farms the ultimate act in the game is when you build your own team. You don't have to, and most people will not, but that is the ultimate act in the game.

I have a global team in mind. I am going to build the top Resistance team in New York City. And in doing that I am going to build a blueprint with which to build a global team.

The number one thing that has been hindering my team building efforts is a sheer lack of portals in the city. I need my 1,000 portal submissions to go through before serious team building can start. There are people who have been astounded by how prolific I have been at submitting portals, and their reaction is to the 60 or so portals of mine that have gone live. Well, to them I say, wait until I start recruiting people. My portal submissions will pale in comparison to the team building I will do.

In the mean time I get to go on faction chat around 5 PM and swat houseflies. There are about five members of timtomhuze who like nothing better than to pull the conversation on faction chat to the lowest possible denominator. Like I said, I am new to Ingress, but I am not new to political warfare.

Tuesday, July 09, 2013

Ingress: Unity Portals: Elmhurst

Meaningful Use

The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States. ....... eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.

EHR Incentive Programs

The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program........ Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program

Meaningful Use Stage 2
Debate over meaningful use carries on, as does support

.... we formally and strongly recommend a one-year extension to Stage 2 before progressing to Stage 3 of Meaningful Use. ... there is general consensus that the meaningful use program should not be halted.

Editorial: Meaningful Use Incentive Program's Timeline Too Ambitious

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments. ..... substantive change can be made to requirements so meaningful use of EHRs really does mean better and more efficient care, and not just lots of meaningless data entry and technological frustration." ..... The editorial states that while Stage 1 of the meaningful use program "has succeeded in pushing doctors to adopt EHRs," several "flaws in the system have emerged," such as the lack of interoperability and concerns about usability. In addition, "the program is very primary care-centric, with specialties having to collect information that is of little use to them to meet requirements under the later stages," it states. .... adjusting the meaningful use schedule to take the time to conduct an independent evaluation of Stage 1 "would help to ensure that EHRs reach their best potential, not become one more rightfully resented bureaucratic hassle"

Electronic Health Record Incentive Program (“Meaningful Use”)

The Health Information Technology for Economic and Clinical Health Act (HITECH) provides financial incentives to encourage the use of electronic health records (EHR). The U.S. Centers for Medicare and Medicaid Services (CMS) are implementing incentive programs for eligible health care professionals, eligible hospitals and critical access hospitals to adopt, implement or demonstrate meaningful use of certified EHR technology. ...... Both Medicare and Medicaid offer financial incentives to providers and hospitals who implement or enhance EHR systems and meet criteria to demonstrate their meaningful use. ..... Stage 1 includes a set of core objectives to demonstrate meaningful use of EHR, as well as a menu set. Providers must meet all the core objectives as well as five items from the menu set, including at least one of the public health-related objectives.

Make A Difference (And Some Money) With The Meaningful Use Incentives Program!

With a big incentives check in hand each year, more providers than ever can afford cost-cutting and life-saving EHR technology. In fact, with checks as large as $21K in 2011 and the potential to earn more than $63K by 2015, many providers can't afford not to apply for Meaningful Use incentives! ...... Physicians, dentists, and even nurse practitioners who see Medicare or Medicaid patients can qualify for Meaningful Use incentives by demonstrating "meaningful use" of electronic health records. The Centers for Medicaid and Medicare provide 25 objectives to be met, some of which are optional. If practices can demonstrate they meet 20 out of 25 of these objectives with certified electronic health records technology – they qualify for an incentives check. .......... you can only apply for either Medicaid or Medicare incentives, even if you treat patients from both programs. Incentives are based on a percentage of what you bill (Medicaid), or of your allowables (Medicare). Here's how these incentives can bring big money to your practice:
Medicare: up to $18K in 2011; up to $44K by 2015
Medicaid: up to $21K in 2011; up to $63K by 2015
... your practice should have plenty left over in your very first Meaningful Use incentives check.

More physicians awarded meaningful use money

For the first time, physicians and other health professionals received more cash in Medicare meaningful use bonuses than hospitals got in a single month. However, Medicare Payment Advisory Commission data show that the vast majority of physicians have yet to collect a dime of government incentives for their use of electronic health records. ..... In February, the latest data available, 12,365 physicians and other “eligible professionals” received $222.6 million in Medicare meaningful use incentives, compared with 84 hospitals getting $129.9 million ..... Doctors qualifying for Medicare meaningful use incentives in stages over five years can earn up to $44,000 per physician. Hospitals’ incentive terms can vary, but they start with a $2 million base payment. ..... Physicians began receiving Medicare meaningful use bonuses in May 2011. The bonuses were created by a provision in the 2009 economic stimulus package. ..... more physicians and eligible professionals were collecting Medicaid meaningful use bonuses, but at smaller numbers than the Medicare program. ..... Medicaid incentive payments were first available in January 2011 ...... For Medicaid, physicians can receive as much as $63,750 over six years ..... Hospitals, but not physicians, can participate in both the Medicaid and Medicare programs. The Medicaid meaningful use program, like Medicaid itself, is offered by the states ..... Doctors must adopt EHRs and achieve meaningful use criteria by October 2014, or else they would see reduced Medicare or Medicaid payments in 2015. ...... Overall, only 35,341 physicians and eligible professionals have collected Medicare meaningful use bonuses, totaling $636.2 million. The CMS report said 796 hospitals have received $1.4 billion in bonuses. In the Medicaid program, 24,332 physicians and eligible professionals have collected $510.8 million in meaningful uses bonuses, and 1,559 hospitals have received $1.3 billion. ..... those who received money accounted for 16% of hospitals and 6% of eligible professionals, including physicians, nurse practitioners, dentists and chiropractors who are not employed by a hospital. ..... I’m somewhat disappointed by the participation both by the hospitals and the physicians, especially when we have the carrot and the stick approach,” said Ronald D. Castellanos, MD, a MedPAC commissioner. ..... 66% of hospitals and 25% of eligible professionals in the U.S. have signed up to participate.

EHR Incentive Programs

The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program. ...... Registering does not commit you to participating in the program, so register early! .... An electronic health record (EHR)—sometimes called an electronic medical record (EMR)—allows healthcare providers to record patient information electronically instead of using paper records. However, EHRs are often capable of doing much more than just recording information. The EHR Incentive Program asks providers to use the capabilities of their EHRs to achieve benchmarks that can lead to improved patient care. ...... Although most hospitals will be able to receive a payment from both programs, eligible professionals must choose which program they want to participate in. The two programs are similar in many ways, but there are some important differences between them. ....
Incentive payments for eligible professionals are based on individual practitioners.
If you are part of a practice, each eligible professional may qualify for an incentive payment if each eligible professional successfully demonstrates meaningful use of certified EHR technology.
Each eligible professional is only eligible for one incentive payment per year, regardless of how many practices or locations at which he or she provides services.

Clinical Quality Measures

Eligible Professionals (EPs) will continue to report from the 44 measures finalized for Stage 1 and
Eligible Hospitals (EHs) and and Critical Access Hospitals (CAHs) will continue to report from the 15 measures finalized for Stage 1.
In 2013, there are two reporting methods available for reporting the Stage 1 measures:
Attestation
eReporting Pilots: (Physician Quality Reporting System EHR Incentive Program Pilot for EPs eReporting Pilot for EHs and CAHs)

Physicians Continue to Say Yes to Electronic Health Records

72 percent of office-based physicians were using an EHR system in 2012, compared to only 48 percent in 2009. Physicians have also increased their EHR functionality, with 80 percent having EHRs with computerized provider order entry for medication orders in 2012, compared to 65 percent in 2011, and 67 percent having EHRs with drug interaction checks, compared to 51 percent in 2011. ...... Through April 2013, ONC said over 291,000 health care professionals (representing over half of eligible professionals) and over 3,800 hospitals (representing roughly 80 percent of eligible hospitals) have received payments under the Medicare and Medicaid EHR Incentive Program. The EHR Incentive Program offers a financial reward to providers for adopting and making meaningful use of an EHR system. CMS has made nearly $15 billion in EHR incentive payments as of June.

More than Half of Doctors Now Use Electronic Health Records Thanks to Administration Policies

Until the President made investments in health information technology by signing the American Recovery and Reinvestment Act, our health care system ran largely on paper. In 2008, only 17 percent of physicians were using advanced electronic health records and just 9 percent of hospitals had adopted electronic health records. Information is the lifeblood of modern medicine, but information can’t get where it needs to go when it’s on paper. ...... That means doctors didn’t have the best information at their fingertips when making diagnosis and treatment decisions; that patients didn’t have easy access to their medical records; and that information is dropped when patients leaving a hospital transition to a nursing home or home care.

Now a majority of doctors use electronic health records — what does this mean for you?

The market for EHRs is now estimated at between $6 billion and $10 billion. For this reason, noted investor Peter Thiel recently referred to this technology as revolutionizing “our interactions with the medical community, just as Facebook did for social networking.” ..... In 2009, congress passed the Health Information Technology for Economic and Clinical Health Act. This offered health care providers reluctant to make the shift to digital systems “meaningful use” incentives — and if that didn’t work, a threat of punitive action. ....... more than 50 percent of doctors and 80 percent of hospitals have received enhanced federal funding for achieving “meaningful use” of digital records..... Some of the most frustrating challenges include interoperability between different systems and a lack of integration with medical devices..... entrenched behavior is a bigger factor than we realize. Doctors aren’t Luddites, but many have learned to “absorb” uncertainty rather than trying to minimize it through technology..... Just like any technology trend — we have the early adopters on board, but it’s not easy to change behavior...... with information about your tests, results, procedures and gaps in care stuffed into manila folders in doctors’ offices and hospitals, and not turned into electronic records, it has proven difficult to improve patient outcomes...... When thousands fled Hurricane Katrina, many of their paper-based medical records were ruined by water or blown to the winds. Proponents of EHRs say that the technology will stand firm in the wake of natural disasters...... the U.S. has 200,000 avoidable deaths a year because “data is simply not shared.” ..... “There’s a lot of money to be made making health care less expensive.” ..... electronic health records will drastically lower administration costs in the long-term ...... savings of about $80 billion a year for the health care sector when it moves toward paperless medical records.

What is an electronic health record (EHR)?

An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. ...... An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care.

Benefits of Electronic Health Records (EHRs)

Medicine is an information-rich enterprise. A greater and more seamless flow of information within a digital health care infrastructure, created by electronic health records (EHRs), encompasses and leverages digital progress and can transform the way care is delivered and compensated. With EHRs, information is available whenever and wherever it is needed..... As of August 2012, 54 percent of the Medicare- and Medicaid-eligible professionals had registered for the meaningful use incentive program.

Electronic health record - Wikipedia

An electronic health record (EHR) is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations. It is a record in digital format that is theoretically capable of being shared across different health care settings. In some cases this sharing can occur by way of network-connected enterprise-wide information systems and other information networks or exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.