If You Like EMRs and EHRs, You’ll Love PHRs

I‘m still not clear on the difference between EMRs (electronic medical records) and EHRs (electronic health records), but now we have PHRs (personal health records). At least PHRs I think I understand.

Back to the first two: I’ve read where there’s no difference between EMRs and EHRs except that EHR is designed to be more marketing friendly for some reason. I’ve also read where EMRs are patients’ electronic records maintained at one location while EHRs are shared electronic records available across a network.

Whatever the case may be, the stimulus package from our lawmakers includes a bundle of dough to implement EMRs and/or EHRs. (Could this be like Betamax v. VHS or Blu-Ray v. HD-DVD?)

However the stimulus package implementation turns out, and we won’t know for years, PHRs are available right now on both Google and MSN. A personal health record is something that the individual chooses to create on one of those providers (I think WebMD offers PHRs as well).

Security issues aside, people have expressed fears that these providers might sell your data to pharmaceutical and other health marketing companies. Google denies this, if you trust what Google says.

Still, this is pretty exciting when you factor in IBM’s development of Continua-compatible software, which you can use to upload your vital data to your PHR, where your physician can access it and make recommendations. Already, a pulse oximeter is available (whatever that is), and future devices will measure blood pressure, glucose levels, temperature, weight and so on. In other words, instead of going in for a physical, you can update your data and have your doctor analyze it.

Now, the question is–will physicians go along with this since they can’t charge for an office consultation if you don’t come in person? I doubt it unless the rules are changed so they can charge for e-visits.

Wouldn’t it be great to sit at work, take your uploadable blood pressure, and sit back and wait for your doctor to call and say, “I think we need to change your Lisinopril level.” Sure beats taking a morning off and waiting around two hours for your doctor to get to you.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Mandatory Sick Leave an Employer Burden?

Businesses in Milwaukee are fighting a referendum that mandates up to nine days of paid sick leave for all employees working within the city. Voters overwhelmingly approved the referendum this past November, but last week a coalition of business owners got a court to slap a restraining order on its implementation. The measure will be debated in the court in detail beginning in May.

Meanwhile, the “Agenda” section of WhiteHouse.gov says that “Barack Obama and Joe Biden will require that employers provide seven paid sick days per year.” That’s a pretty clear signal.

Change like this–the government’s mandating employers to provide paid sick leave–may take awhile to implement given the worrisome nature of the economy, but my guess is that it won’t be long before paid leave is the law of the land.

The thought may freak out some business owners, but a survey of world policy toward paid leave shows that the U.S. is way, way, way behind most nations of the world, even ones where one might attach the “third world” moniker.

Take the issue of maternity/paternity leave, the paid variety. Gabon offers 14 weeks of 100-percent-of-salary paid leave to the mother, with job protection. Mexico offers 12 weeks at 100 percent, Peru 90 days at full salary. China tenders 90 days at 100 percent, but Japan–the world’s second largest economy behind ours–offers 14 weeks but at just 60 percent of wages.

Take a trip across the pond to our neighbors in Europe, and you’ll find some really generous packages: All working parents in Sweden are entitled to 16 months paid leave per child, the cost being shared between employer and state. France has a sliding scale starting at 14 weeks and rising in length as the number of children in the family increases.

Five countries in the world do not offer some form of paid parental leave: Australia, the United States, Liberia, Swaziland, and Papua New Guinea. However, most employees in Australia are entitled to at least 12 months’ unpaid leave for the primary caregiver, and new parents are able to receive a Baby Bonus of A$5000.

At least no one in Washington is proposing Sweden-like benefits. Yet.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Watch What You Say, Young Man!

The International Longevity Center and Aging Services of California have issued a media guide for writing about older people, which lists acceptable (PC) words and unacceptable (non-PC) terms.

However, it really depends on the audience reading what’s written to define acceptable. Readers in their 20s or 30s said in a survey they would take no offense at reading “senior citizen,” for example. In fact, “senior citizen” is viewed as a neutral term by those under 54 but offensive by those 55 and older. Hmmmm….

Likewise, “retiree” is okay with those 54 and under, but disliked by those 55 and older. “Veteran” is acceptable to both groups, but that would seem to apply only to people who’ve served in the military, not generally to old coots. Oops, that’s a no-no that never should be used. My bad (even though I do qualify as an old coot).

Some terms to be avoided at all costs include “golden years,” “feisty,” “spry,” “feeble,” “eccentric,” “senile” and “grandmotherly.”

This is useful information for the workplace as well, so as to avoid EEOC and DOL inquiries and potential legal disputes over ageism or hostile environments.

Get your copy of Media Takes: On Aging.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Mark Cuban Offers to Fund Your Start-Up

A bunch of restrictions are included, including a 90-day make-it-profitable provision, but Mark Cuban is offering to fund your start-up. You can read all about it on his blog.

I read through a bunch of business proposals pitched to him in the comments section, and I must say, there are a lot of daydreamers with lousy ideas out there.

Anyway, hats off to Mr. Cuban (multiple-multiple-millionaire owner of the Dallas Mavericks) for pitching in to help revive the spirit of entrepeneurship amid a sinking economy. (I guess he didn’t invest with Bernie Madoff, so his fortune is intact.)


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Stimulus Plan: $798B, But Just 18.5 Percent* for Jobs

I just went through the list of items covered in the final version of the stimulus plan (so called) and added up all the sums that were targeted at projects that could actually lead to jobs. I came up with $146.2 billion, which figures out to be 18.5 percent of the whole pie. The rest goes to what could be called the welfare state.

The implication here is pretty obvious: The Democrats decided to expand their favorite federal programs (some implemented by the states with fed dollars) while masquerading the whole thing as a “job-creating” stimulus package.

The question remains whether the targeted projects will “create or save” three million jobs (I also heard that Obama had raised that promised figure to four million). I’ve got a feeling that the $146.2 will just go to support unionized workers who are already working. At any rate, how does one prove that something “saves” four million jobs?

Here are the areas where money will be spent on job-creating or -saving projects: 1) Create a new “smart” power grid (to replace our current “dumb” one, I guess), $30 billion; 2) Repair and make energy efficient public housing, $6.3 billion; 3) Extend broadband services, $7 billion (again, does this create or save jobs?); 4) Implement electronic health records (EHRs), $19 billion; 5) Modernize roads and bridges, $29 billion; 6) Improve public transit and rail, $16.4 billion; 7) Restore lean water and modernize flood control, $18 billion; and 8 and last) Modernize federal and public buildings, $9.5 billion (again, already-existing union workers who will now get triple-time).

I guess that’s why White House Chief of Staff Rahm Emanuel warned early on that “this is no time to waste a good crisis.”

*N.B.: I loosely included the health IT’s portion, $19 billion, but as I further thought about it, this really doesn’t create any jobs; it just goes to buy equipment and services that are already available. If I delete this sum, the total going to “jobs” is reduced to $127.2, or 16 percent.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Doctors Warn Offspring: Don’t Go into Medicine, Kids

My headline is a little misleading. What I’m referring to is a survey showing that 39 percent of physicians would not encourage their children to pursue the same profession. When you factor in other health care professionals, however, the figure drops to 20 percent, according to a survey by HealthLeader Media.

Reasons for not recommending health care ranged from “uncertain future” to “broken system” to “too much regulation, interference” to “poor compensation, reimbursement.” (Guess which group favored the latter reason? Right–physicians!)

Since the majority of health care professionals in general and physicians in particular would recommend their careers to their children, the question was posed as to why. And the answer came back: 41 percent said it’s because health care is a practical choice with good long-term demand, while 40 percent noted that a healthcare career is rewarding personally or professionally and mentioned the value of doing good work and serving others.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Tom Daschle Lives On in the Stimulus Package

Those who were fretting that the extinction of Tom Daschle as potential secretary of Health and Human Services might delay health care reform needn’t worry.

The inclusion of several stealth provisions in the stimulus package now sailing through Congress will implement, mostly unnoticed, provisions from Daschle’s government-heavy idea of reform in his book, Critical: What We Can Do About the Health-Care Crisis.

His idea to prescribe which treatments and medications can and cannot be used by individual doctors lives on through the electronic health records (EHRs) initiative, which would be overseen by a National Coordinator of Health Care Technology. This latter person/office would monitor everything going on in the EHRs to make sure every doctor is following government guidelines and giving cost-effective care. And every doctor means your doctor.

Not only that, but the stimulus package includes the creation of a Federal Coordinating Council for Comparative Effectiveness Research to define and dictate cost-effective care: What physicians and hospitals can and cannot do.

In other words, this is the stealth implementation of Daschle’s plan to create a board similar to the one in Great Britain that dictates every medicine and every procedure for every known medical problem so that they are both efficient and cost-effective (but most of all cheap). Now, on the surface, this sounds reasonable until you face the actual results as a patient.

The British agency Daschle fell in love with (with the totally disingenuous acronym of NICE) has done things like, well, forbidding treatment of macular degeneration because the medicine was too expensive until the patient went blind in one eye. (This policy was reversed finally after three years of public outrage.)

Betsy McCaughey, former lieutenant governor of New York and now an adjunct senior fellow at the Hudson Institute, calls this “Ruin Your Health With the Stimulus Plan.” She explains:

The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.

There’s little wonder, then, that President Obama continually and frantically insists that the stimulus package be hurried through Congress–he doesn’t want anyone actually reading it. As his chief of staff quipped, this is “no time to waste a good crisis.”

As these pages have been predicting since the git-go, the only way anybody in government–using government solutions–can make health care both “accessible and affordable” is by restricting and rationing what’s available.

Hey, if you successfully lower health care expectations, maybe enough people will start kicking off before they reach 65, and the government won’t have to pay Social Security or Medicare.

Nice plan.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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A ‘Dead Pool’ for Companies About to Go Under

You’ve no doubt heard of, or even participated in, the so-called online “dead pools,” where odds are placed on which celebrity will be the next to meet the Grim Reaper.

That’s a bit too morbid for me, but when it comes to business, I don’t mind participating in some death watches since it’s instructive to see how others can screw up a good thing.

I’ve been of the opinion for some time now that not only will it go, but Chrysler should go to cut down the glut in Detroit. Mind you, that’s 50,000 or more layoffs, but capitalism is either creative destruction or it becomes socialism, where government picks the winners and losers. And let’s hope our current president doesn’t become this nation’s Hugo Chavez.

Back to Chrysler: I came across a Yahoo Finance article about “15 Companies That Might Not Survive 2009,” and sure enough, there was Chrysler’s name right near the top.

Others on this dead pool include Krispy Kreme donuts and Rite Aid pharmacies, both of which I watched expand much too rapidly for their markets beginning back in the 1990s. (I don’t think Starbucks will bite the bullet, and it’s not on the list, but that coffee purveyor also got way too ambitious in its expansion plans.)

The name Trump, as in Donald, also appears on the list, but it’s just one of the The Donald’s holdings, specifically his casinos. It’s “deja vu all over again” here as his Atlantic City holdings were near bankruptcy and forcibly restructured during the last great recession in the early 1990s.

So, if you work for one of these 15 (or anywhere else where things are shaky), polish up your resumes and be prepared for an “interesting” 2009, as in the Chinese curse, “May you live in interesting times.”


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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The Skyscraper Index: Believe It If You Choose

A theory from 1999 is resurfacing as the world plunges deeper into its current economic woes: The theory that the building of skyscrapers predates economic doom. This tidy bit of logic was conceived by Andrew Lawrence, at one time a researcher for Deutsche Bank.

Here are the “facts”:

The Chrysler Building in 1929 and the Empire State Building in 1930 gave way to the Great Depression. The Sears Tower and World Trade Center of the 1970s yielded a decade of stagflation. For the Asian crash of 1997, the Petronas Twin Towers of Kuala Lumpur, Malaysia, proved the culprit.

More currently, last year’s construction of ten (ten!) sky-highers at an average height of more than 1,000 feet took the world’s economy down as they went up. Finally, this year the Burj Dubai skyscraper, at 800 meters, or more than 2,500 feet, will become the world’s tallest building by a factor approaching two, but will it lead to the world’s greatest depression?

Stay tuned, and we’ll all find out, like it or not.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Do Rats Have Free Speech Rights? This Court Says Yes!

ratsThe New Jersey Supreme Court, which earlier this year ruled that striking nurses qualify for unemployment benefits, yesterday came out in favor of free speech rights–for rats!

Actually, for one rat–an inflatable, 10-foot-high rat bandied about by the International Brotherhood of Electrical Workers in Lawrence Township in 2005. The rat was being used outside a Dunkin’ Donuts to protest low wages being paid by an out-of-state contractor when, lo and behold, local authorities swooped in and fined the union for breaking a law against using banners or inflatables at events other than grand openings.

The union paid $100 in fines and $33 in court costs.

Flush with money, however, the union struck back in favor of its rat, and the issue went to the state’s highest court on Thursday, Feb. 5. At issue was the rat’s protection under the First Amendment’s guarantee of free speech.

The Supreme Court, overturning an appeals court decision, ruled that the township couldn’t have it both ways–banning inflatables at most events while allowing them just at grand openings.

Local officials vowed to do “some tweaking” of the law “immediately.”


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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