GlusterFS / NFS mount havoc

If running on a GlusterFS backed NFS mount (in my case, setting up Concrete5) make sure your nlm (lock daemon) is accessible on your client, or else your server won't be able to tell you to break and retry the file connections. This causes Concrete5 to spin forever waiting for a file to become available.

Doctoring the words In The Age Of Obamacare

So my revered state representative, Lee Terry, posted this on Facebook recently as -proof- of evil Obamacare failings. A woe is me story from an endocrinologist: Doctoring In The Age Of Obamacare

 Dr Sklar laments,

When I tried this I found that typing in the data was disruptive to the patient visit. My eyes were focused on the keyboard and the lack of direct contact kept patients from opening up and discussing their medical and personal problems. I soon returned to my old method of dictating notes and pasting a print-out of the dictation into the electronic record.

Guess what? I have an Endocrinologist. And while I don't know her intimately, I do know that she doesn't make me uncomfortable by typing during our session, but she still manages to get the now required checklist printed out by the time I leave each visit. As an IT professional, I wonder if Dr. Sklar put any time into actually assessing the software packages or simply picked the first one he found.

In addition to my endocrinologist being able to keep pace with our quaint visits, I also utilize a pediatrics doctor for our children. He has these neat tablets that have pens attached. No more cut and paste editing. He can scribble to his hearts content and everybody is digitally satisfied. They also manage to print out the documentation before we leave.

 Dr. Sklar continues with tales of having to track down his patients by phone to make sure everything is ship-shape. I truly would like to know, show of hands out there, how often are you contacted by your doctor for reasons not having to do with scheduling reminders or those lovely collections calls that usually precede your insurance company adjustments for some reason.

To prevent physicians from prescribing more costly medications and tests on patients, insurers are increasingly requiring physicians to obtain pre-authorizations. This involves calling a telephone number, often being rerouted several times and then waiting on hold for a representative. The process is demeaning and can take 30-45 minutes.

Well god forbid anybody except a patient having to experience a non-productive phone call. I don't deny that political and bureaucratic road blocks abound, but here's the thing: You can't blame IT for not doing what you want it to or being effective if you don't take the time to assess your software package for off the shelf solutions, or go through a discovery process with your software/hardware vendor.

Don't tell a patient that a refill could 48-hours because you were forced to switch to electronic. (personal experience) They know that is BS and you are reflecting poorly by complaining in this way.
It is possible with extra paperwork, that you may have to hire some clerical health workers. Welcome to 2014.

In Dr. Sklar's case, I am not even sure why having your note transcribed straight into the medical record by staff would be any less work that transcribing them to a document first.

Something we can agree on. Pharamacy costs are out of control. The cost differential to other countries is astronomical and cannot wholly be placed on R&D and Quality Control.

ICD-10CM is the system with 'over 70,000 codes'. However, saying that an endocrinologist needs to be versed in all of them is similar to saying that a Ford employee should be able to identify the VIN for a 1991 Nissan Maxima with premium package and premium motor. Are there too many codes? Maybe, but a correctly designed software package should all but hide the codes and bits from the end health care user.

Don't resist the tech too strongly, you are only hurting your self. We can all agree that the design by federal committee is always a bit heavy handed, but lets not get carried away.