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Wednesday, August 12th, 2009
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9:00 pm - What I think about American Health Insurance
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Could someone PLEASE mention in the news and discussion that not all health insurance companies are for profit? Kaiser Permanente is not, and Blue Cross/Blue Shield companies are not. That doesn't mean they don't try to end up in the black. They need money to pay interest on their loans, and to maintain their I.T. and other overhead. Because I work in healthcare I.T., very close to insurance, several people have asked me what I would like to happen with American Health insurance and 'Obama's Health Care Proposal'. I remind them that is is not his; he left it to the U.S. Congress to draft and refine it.
I would like to see an end to insurance companies terminating a person's policy. In order to do that, there must be a greater pool of people who pay in and don't take out, to cover the expenses of those who do take out a lot because of expensive medical treatments. An important part of the proposals try to answer that question: Do we replace all insurance premiums with taxes? Do we demand the equivalent of premiums from those who have chosen not to purchase (or couldn't afford) insurance?
When HCHP started (like Kaiser, only in Boston), their casemix of subscribers was only employed people and their families. They started to include people who were on Medicaid as a trade off to remove them from their homes in order to acquire land for their clinics and hospitals. It was a whole different ballgame when the casemix included people who used more resources than Medicaid could cover.
There is a lot of pressure on physicians to conform to standard practice for diagnostics and treatment. On the other hand there is research. Do we want research to stop? On the other hand there are people who (quite reasonably) say "if they had done more testing, they might have found the cause and cure..."
There was an article in the SF Chronicle recently about medical errors, and how CPOE (Computerized Provider Order Entry) could reduce errors. The software is there, but the setup is expensive and labor intensive. It would be like hand writing a medical dictionary, because sets of orders have to be designed and built and maintained. It is a multi-million dollar commitment for a hospital system to make, and a major cultural shift.
There will always be human error. Every day I handle human error in the use of the Electronic Medical Record, including documenting medication administration. Usually the humans know that they have done the wrong thing, and they use human communication to make sure the other people managing the patient do not rely on the EMR for that information until the error has been cleaned up.
We want 100% perfect diagnoses and treatments and cures. I certainly would if it involved myself or my family or other loved ones. Medical care mostly succeeds. I hate the sensationalism of journalism that does stupid things with statistics, such as listing the hospitals where largest number or % of people die. If they were to factor in the risk level of that hospital's casemix, they would find that the comparisons are much more mundane. Trauma Centers and Teaching (read research) hospitals take in higher risk patients.
OK, I'm done for now.
Responses are welcome. I will not take any comments personally.
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[What other people think 4 What do you think?]
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| Wednesday, July 1st, 2009
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10:00 pm - the_Ogre is sick. no trip to SoCal this weekend
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He's got infection in his sinuses and lungs. He can barely speak from exhaustion. I canceled the hotel and got his mother a train ticket to go home tomorrow. Tomorrow Adam and & will go grocery shopping, and collect the cat.
One vacation day at a time.
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[What other people think 4 What do you think?]
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| Wednesday, June 10th, 2009
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6:22 am - San Francisco Free Folk Festival
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Schedule is Here
June 13-14, 2009, noon-10pm
The 33rd annual San Francisco Free Folk Festival Presidio Middle School 450 30th Ave, San Francisco (@ Geary) Parking $8 per day
Two days of free music & dance: Performers representing traditions from around the world will be involved in the two-day event, which is staged completely free of charge. All Bay Area lovers of music and dance are encouraged to participate. Nationally and internationally acclaimed performers, as well as gifted local musicians, singers, dancers, and storytellers will offer concerts and workshops throughout the festival. Family-oriented activities will include crafts and special music performances.
Festival details: for those who want to be hands- (and feet-) on, a sampling of workshops to be offered includes: • Instrumental music: concertina, Cajun jam, acoustic bass, tin whistle, mandolin, Contra dance band, 1950s blues… • Singing workshops: sea shanties, ballads, barbershop harmony, song circles - and songs of love, lust and seduction! • Dance workshops: Scottish country dance, tap, waltz, Lindy hop swing, salsa, tango, and English ceilidh. • Children’s and all-family activities: crafts, music & movement, storytelling, songwriting and beginning guitar • Evening dance parties: International folk dancing, vintage Ballroom, Contra dance - and much more.
Contra Dancing: Modern American Contra and Square Dance: flowing and fun moves, danced to Early American and Celtic live music. No partner needed. All dances taught and prompted. All experience levels welcome.
Sunday 5:00 PM to 6:00 PM South Gymnasium Gender-Free Contra Dancing
Sunday 6:30 to 9:30 PM North Gymnasium Contra Dance
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[What do you think?]
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| Wednesday, April 29th, 2009
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10:31 pm - It's not a game anymore
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I work in a real hospital. Except about 2 miles away in a building full of desks and computers. There haven't been any swine flu cases there yet, but the Emergency Department has taken over some other departments because it needs more beds. We have gotten several bulletin updates per day about what to do and what supplies are available.
For me it's not so much about a disease that might make a lot of people sick. Its more about watching the public health social aspect evolve. Schools closing, people can't go to work because their kids are at home, the anxiety factor. That's contagious.
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[What other people think 8 What do you think?]
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| Sunday, April 19th, 2009
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2:24 pm - That Icon Meme
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| Tuesday, February 3rd, 2009
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8:17 pm - I must admit
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Since Obama became President, I'm willing to listen to the news on the radio. It has been a while.
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[What other people think 1 What do you think?]
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| Sunday, January 18th, 2009
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11:23 pm - Now it's our turn again
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9:21 pm - I wonder if they met any real California Morris Dancers
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| Thursday, November 13th, 2008
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10:17 am - not so busy at work
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The internal network is down at work, so no hospital computer system, no email, no problem ticket application. I'm the only person around here with a broadband card, so I get to look at email and one of the fixers has borrowed my computer for a bit. Hospitals have "downtime procedures", which means switch to paper and backload later.
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[What do you think?]
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| Tuesday, October 28th, 2008
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4:06 pm - Kiros is better
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He has been eating since last night, with no vomiting. Still on supportive IV nutrition. Plan: home tomorrow afternoon, unless he takes another turn. The_Ogre can pick him up after work, so he gets first hugs. Yay!!
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[What other people think 9 What do you think?]
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| Tuesday, September 30th, 2008
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6:54 pm - Educate Sarah Palin about the USSC
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Most recently featured several people's LJ. Let's teach Sarah Palin about the Supreme Court! Everyone's probably heard by now of Sarah Palin, the Republican candidate for Vice President. What you may not have heard yet is that she is, as of this moment, unable to name any Supreme Court Case other than Roe v. Wade, as evidenced by Katie Couric. Seeing as how this woman could very well be our NEXT VICE PRESIDENT, I say we, the People, should take an active role in our government and teach her about this hallowed institution.
Rules: Post info about ONE Supreme Court decision, modern or historic, to your LJ. Any decision, long as it's not Roe v. Wade. (She knows that one already!)
I sent this to governor@gov.state.ak.us, to comply with the spirit of "educating" her.
Loving v. Virginia, 388 U.S. 1 (1967), was a landmark civil rights case in which the United States Supreme Court declared Virginia's anti-miscegenation statute, the "Racial Integrity Act of 1924", unconstitutional, thereby overturning Pace v. Alabama (1883) and ending all race-based legal restrictions on marriage in the United States. The U.S. Supreme Court overturned the convictions in a unanimous decision, dismissing the Commonwealth of Virginia's argument that a law forbidding both white and black persons from marrying persons of another race, and providing identical penalties to white and black violators, could not be construed as racially discriminatory. The court ruled that Virginia's anti-miscegenation statute violated both the Due Process Clause and the Equal Protection Clause of the Fourteenth Amendment. In its decision, the court wrote: “Marriage is one of the "basic civil rights of man," fundamental to our very existence and survival.... To deny this fundamental freedom on so unsupportable a basis as the racial classifications embodied in these statutes, classifications so directly subversive of the principle of equality at the heart of the Fourteenth Amendment, is surely to deprive all the State's citizens of liberty without due process of law. The Fourteenth Amendment requires that the freedom of choice to marry not be restricted by invidious racial discrimination. Under our Constitution, the freedom to marry, or not marry, a person of another race resides with the individual and cannot be infringed by the State.” The Supreme Court concluded that anti-miscegenation laws were racist and had been enacted to perpetuate white supremacy: “There is patently no legitimate overriding purpose independent of invidious racial discrimination which justifies this classification. The fact that Virginia prohibits only interracial marriages involving white persons demonstrates that the racial classifications must stand on their own justification, as measures designed to maintain White Supremacy.” Despite this Supreme Court ruling, such laws remained on the books, although unenforced, in several states until 2000, when Alabama became the last state to repeal its law against mixed-race marriage. ****** Automated reply to the email message:
Thank you for writing to Alaska Governor Sarah Palin. The concerns, opinions,
and/or information you have sent are important and valuable to the Governor.
Although she is unable to respond to each and every email herself, your message has
been received and is being reviewed by the appropriate staff person in this office
who can best address your need, suggestion, or comment.
Please do not reply to this email. If you would like to contact the Governor in the
future, please address correspondence to governor@alaska.gov.
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[What other people think 3 What do you think?]
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| Saturday, September 27th, 2008
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5:02 pm - busy as usual
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I've continued my work pattern of [wake at 4 AM] - [leave for work at 6 AM] - [try to study for certification exams 7-9 AM {25% successfully}] - [work 9-6 usually eating lunch from home at my desk] - [go home] - [go to sleep by 9 PM]. Yes, 11 hour workdays counting as 8.
I work at an application support desk; not receiving the original calls, but calling back the users and imitating their setup to see their problem or explain how to do something in the Electronic Medical Record. Occasionally I get to do requested projects, which involve slight screen changes. A typical example would be on a Medication screen, adding a medication to the drop-down list that was not available to select. Hence the term Clinical Documentation or ClinDoc for my specialty. It is the set of administrative tools used to design the data entry and display screens. Almost all issues are assigned to my team by the Help Desk, and we have to figure out what team should really work on it: Security, OpTime (Surgery Scheduling), Ambulatory, Pharmacy, ADT (Admission Discharge Transfer), or others. Since ClinDoc is not an application in itself, any screen or data problem is directed to us by the primary help desk, who have not been trained in any of the applications. Also, as one would expect, the user reporting the issue might not explain it very well the first time.
I have been on-call a few times. Twice during the week, and once on the weekend. It means that every issue reported to the HELP Desk goes to my pager, and for the ones of highest severity we gather a posse to get it resolved ASAP. The only 'Severity-2' issues that have been on my watch were things that would have been explained and fixed (or educated) within 5 minutes, if I had more knowledge of things the data entry screens do (or prevent doing) under certain circumstances. I was disappointed to find that my Team Lead, the first person I have to call, does not know the application, and the vendor off-hours help person assigned to the issues is as green as I am. I learned that being on-call on the weekend means that I could get a call at any time, which is not conducive to a relaxing period of sensual distraction.
This coming week I go to Madison again, for the final installment of my application training. I will finally learn the tools of ClinDoc,after being trained in what it is used for (first training) and how users are set up to see the screens in different ways for their workflows (Nurse vs. Physician) (second training). I will fly out on Tuesday, have class Wed-Fri noon, and fly home Friday evening.
My typical weekend: Friday night - go to bed at 8:30 PM Saturday + Sunday - catch up on home things: finances, other bureaucratic stuff, grocery shopping, sometimes laundry. I usually see WAB for a block of time on the weekend. When my husband is at home, we might watch a movie or just enjoy being together while doing separate activities.
I have gone to some parties and dinner events recently. I am feeling comfortable socially, I just don't have much time and have to get up early for work.
I feel respected and liked by people at work. I have gotten several compliments in writing from the director of the Change Management Board, for the way I explained issues and their resolution. I feel that I am still in the right job.
I chew gum a lot. When I am at the computer at home, Kiros is often sleeping on his half of the desk. He likes to type with his butt.
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[What other people think 2 What do you think?]
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| Monday, August 11th, 2008
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5:55 pm - In Madison this week for Epic training
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My pal from Kaiser is here (she lives in Chicago), so I am a happy camper! I slept well on the big pillows. I like learning new things.
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[What other people think 2 What do you think?]
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| Tuesday, August 5th, 2008
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9:01 pm - Ivory Chopsticks
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Scene: Upscale Chinese restaurant chain, in Monterey Time: end of dinner
Me: could I take the chopsticks? we are taking leftovers to our hotel room. Waitress (mid 20's): No, I'm sorry. People ask me that a lot. We can't let them go because they are special, made from elephant tusks. Me: Ivory from elephants has been banned from the market for several years. Waitress: I guess that changed. We got these about 2 weeks ago.
Note: the chopsticks were plastic. They were not dense enough to be Ivory.
I think she did not even know she was talking about ivory, and that it is illegal to trade now. I let it go, but there are several comments I could have made:
1) Oh dear, your employer is lying to you 2) I will have to tell my friends not to patronize your chain, if you are involved in poaching
Any other clever comments one might have made?
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[What other people think 3 What do you think?]
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| Thursday, July 17th, 2008
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2:16 am - Philosophy Quiz
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What philosophy do you follow? (v1.03) created with QuizFarm.com |
| You scored as Justice (Fairness) Your life is guided by the concept of Fair Justice: Everyone, yourself included, should be rewarded and punished according to the help or harm they cause.
"He who does not punish evil commands it to be done."
--Leonardo da Vinci
"Though force can protect in emergency, only justice, fairness, consideration and cooperation can finally lead men to the dawn of eternal peace."
--Dwight D. Eisenhower
More info at Arocoun's Wikipedia User Page...
Justice (Fairness) |
| 60% | Hedonism |
| 55% | Strong Egoism |
| 55% | Existentialism |
| 55% | Utilitarianism |
| 45% | Kantianism |
| 35% | Apathy |
| 35% | Divine Command |
| 15% | Nihilism |
| 5% |
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[What do you think?]
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| Sunday, June 22nd, 2008
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11:30 pm - We're home, and so far we are safe from the Brisbane fire
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We saw the fire from the airplane, and our landing was delayed because of it. We can see the fire from the mountain road above our house. I'm adding wake up alarms to my cell phone, in case we lose power and the usual alarm clock goes down.
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[What do you think?]
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| Sunday, May 25th, 2008
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4:33 am
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| Tuesday, May 20th, 2008
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9:31 am - We are a family. We are a team.
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Happy Anniversary, my Ogre dearest!! 15 years together, 13 years married.
We share our love with others, but it has not diminished our love and commitment to our marriage.
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[What other people think 8 What do you think?]
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| Tuesday, May 6th, 2008
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5:48 pm - Oh, and for those visiting our house
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Unless the contractor is a no show, we will have major dental surgery on our driveway tomorrow. All of the bushes and terraces will be replaced by concrete, so we can have 2 cars off the street and room to roll a motorbike in and out of the garage. Soft concrete for several days. We will be able to put the cars on it next Tuesday for street cleaning.
Wish us luck.
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[What do you think?]
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| Monday, April 7th, 2008
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11:17 pm - Farewell Noel
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My Uncle Noel died today. He was about 80, on dialysis, so his bones were fragile. Classic elderly situation: fell at home, broke a hip, died during surgery. He was the reason I wanted to visit Toronto. I liked him a lot. He was my dear father's baby brother, and always a rebel. He was a former Ontario Ministry of Education officer and French teacher. He was born on Christmas. Is name is the reverse of his older brother, my father Leon.
Rest In Peace
current mood: mourning
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[What other people think 9 What do you think?]
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