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Cash Strapped States Tapping Into Philanthropy For Help With Both Interpreting Healthcare Laws & IT Infrastructure to Comply Wit

Posted Jun 06 2011 12:45am

When the President took office a couple years ago, saw this coming as I said to run HHS it required an individual with some actual “hands on” Health IT Infrastructure” experience and not just a figure head who relies image on everyone else’s research in order to make decisions.  This is partly the reason the word “algorithm” and it’s meaning sits center stage on this blog.  I’m just a tiny fish in the sea but folks who write code and deal with data bases and know what is possible see it before it gets here, I did.  As you see in the news every day we are so very “complicated” today and without some “hands on” experience from those who are at the top of the ladder this is what you get, a lot more money spend on studies and huge expenditures.  Sure some of this would be there anyway as technology continues to throw us a new left curve every day, but for those who don’t have “code logic” engrained, the job is much tougher. 

Look at Bill Gates if you will for a perfect example, he sees it and started giving his money away a few years ago as he knows how algorithmic formulas can either be beneficial for all or done for profit only and leave those who are not at this level, which a great majority of us, left to fend a battle they know nothing about, in other image words it’s a mathematical battle that shift money today.  Mr. Gates has spent many years testifying to deaf ears in Congress with trying to share his knowledge and nobody would listen.  Pay attention to the Bill Gates, Steve Jobs, Larry Ellisons of the world as they see technology and the moving and evolution of code way before the rest of us as well as being the town criers to help us prepare. 

You have to look no further than Wall Street.  It is what it is with algorithmic formulas.  About a year and a half ago I did an interview and both the reporter and myself I think were ahead of our times as she was pursuing the same topic as a freelance writer for Proto, the magazine for UMASS hospital.  We didn’t get published but we discussed what she referred to as “rogue” algorithms and they are out there.

I say the same thing a lot, there are algorithms written that give accurate results and those that are written for “desired” results and sadly the two are not always the same as you would think they should be.  It’s also easy enough to snow others who are “non participants”with software and technology and tell a story, IT folks do it every day to try to translate in a way that layman can understand and most I feel do a good job but some flat out lie and go about their business of instructing their developers to write for profit, no matter who ends up on the losing end.  Again, look no further than Wall Street for some blaring examples. 

I live out here in California, where we have probably some of the most sophisticated CIOs in public office who do a darn good job but with budget cuts and the ability to upgrade and only do so much, they reach a point to where their hands are tied.  Actually California has a “Digital Literacy” campaign to increase consumer awareness that was put in place by executive order from Governor Arnold back in November of 2010.  Put his personal issues aside for the moment here and he was great leader with digital technology and always kept us up to date with Tweetcasts and since he has left office it has all died. 

One item that is being terribly overlooked at the Congressional level is the amount of time it takes to implement IT infrastructures to run programs as they all have one today or need upgrades.  This comes largely from digital illiteracy in Congress with so many being the “non participants” when it comes to consumer IT literacy at least and since they are responsible for making laws they should be required to go beyond as that’s what’s needed today.  They seem to think that the staff is supposed to do everything and they are just the figure heads but we are seeing some pretty sad ones today out there. 

As a comparison, look at doctors, they have continuing education required to continue to practice and is there any such stipulation for those in Congress?  I’m not aware of any but they should have requirements just like doctors do or else we end up with what we have today with soap operas and stupid issues like “Weinergate” that take up the time on the news and distract and disrupt members of Congress from what they were hired to do.  I get tired of it and so does everyone else and we look less than intelligent as the rest of the world views us. 

When you dig down into this article it is interestingly pointed out that Blue Shield distances itself from some of the activity and instead calls for more studies when the State of California asks for help.  I guess this way it looks like they are doing something with all the legal snags and issues with having a study done but again that takes time so we have a whole lot of nothing going on at times.   The California HealthCare Foundation has donate money and hired consultants and I would guess these are both the Legal and IT type of companies and individuals as they word hand in hand today or at least they should.  Public CIOs are now openly stating that they are learning more about healthcare than they would have thought was necessary to know for their positions, even outside of healthcare. 

Healthcare Reform Putting Additional Pressure on Public and Medicaid CIOs-The Health IT Bubble Gets Closer As Money And Digital Literacy is Scarce

IT and the Legal infrastructures have changed and we are now aggregating data throughout many systems where this did not occur even as recent as 4-5 years ago and digital illiteracy with lawmakers with denial or not accepting or learning about this is making it impossible to breath and then it seems they jump back in to the 70s to discuss abortion control, something they feel they can control I think and it’s stupid and meanwhile the American public sits back and gets the side shows on the news at night and confidence with each episode drops lower and the folks in Congress can’t seem to figure out why their confidence levels are at an all time low, digital illiteracy I say or one big whopping case of denial.  I can make one more example of this illiteracy with a recent post made on a bill introduced to put “flawed” Medicare claim data on the web.  They have no clue on the cost, the amount of time and again just listen to what someone else tells them, and in this case it could be some lobbyists or the Dow Jones with their ridiculous lawsuit they filed basically just because they could and might be looking to drum up a few million dollars of business for some company.  Bills that are impossible to implement in the time frames they suggest are just wasted time, not to mention the millions it will cost.

These folks just seem to think that IT Infrastructure costs just grows on trees and the former administration was a big part of why we are at this cross road today as they were technology sleepers by all means, and that was proven when the Obama administration when they moved in, found many computers in the White House still running on Windows 98.  I will still never forget the day that Bush held up a tablet in Congress with a jpg image of an “e-budget” and he had clue about what he was talking about and he seemed to be well primed to hold up the tablet and point to the image. 

Do Some Think That Health IT Costs and Systems Grow On Trees-Certainly Starting To Give That Impression of Late

Our folks are not smart enough in Washington too see a valuable tool presented to them when they see it and I’ll reference IBM Watson server technology as one example as being it was on Jeopardy, I get this feeling they thought the technology was only good for games, sad.  I just attended the Israel Convention in Los Angeles this week and let me tell you they are all over “machine learning” in almost everything they are doing today and we are missing the boat here, not with technology companies but with digital illiteracy in Congress not being able to recognize the tools they need to do their jobs with creating laws.  One item I noticed that was a little different than what we do here was the mention of collaboration and putting the innovators in labs to work together, and again I have said that is a image big part of what is fouling up our healthcare system, innovation without collaboration. The link below gives a few of my observations and we were also treated to a presentation from Jonathon Miller, Chief Digital Officer, Chairman and CEO of the Digital Media Group for News Corporation.

Instead of collaborating and everyone seeing the same figures and data at once we still get this Ryan program which was created by one group without collaboration and there’s great white hope without collaboration.  In essence it’s just one more disruption that allows for the continued lack of collaboration by our members and the inability to work together. 

So here we go into the impossible storm with lawmakers at every level across the country behind the times.  With high powered technology and data mining they would be starting out at the 10 yard line with data they need in a usable fashion instead of the 40 yard line where they all seem to hang out today with their efforts of making a touchdown.  Thank goodness philanthropy is around to help out but again how far can they go is the question too and will they tire of helping those who refuse to help themselves while the rest of us as a country suffer?  It is what it is sadly today with impossible bills being created and little attention being paid to consumer issues and without some digital algorithmic centric laws we get flushed down the toilet.  I don’t mean to be pessimistic but what I see as the future scares the daylights out of me too as I can’t do anything but watch the circus continue while we sink. 

A while back too I was outspoken on what creates wealth and it’s not “social network algorithms”.  Sure social networks belong but not at the rate they are being promoted by banks as far as their value. 

When you bank on nothing but intangibles without tangibles in business attached, the bottom will fall in and all we have left is a bunch of algorithms without balance, so I thought this was important enough to mention once more.  Social networks are not going to cure me when I am ill, but a drug or device along with visiting a doctor will, and again more thoughts should perhaps be thinking in this direction as well. 

Back in the middle of 2009 I suggested perhaps a need for a Department of Algorithms or something right along that line and it sure looks like the need is growing and something needs to be created in that direction soon.  BD   

From August of 2009….

WASHINGTON _Short on cash and time, officials in California and at least a dozen other states have turned to philanthropies to help pay for the extra work required under the federal health law.

Nowhere do the ties between private health foundations and state government run deeper than in California, where Democratic Gov. Jerry Brown's administration is grappling with a projected $10.8 billion deficit in 2012, leaving little money for implementing the law. Three major foundations — the California HealthCare Foundation, the Blue Shield of California Foundation and the California Endowment — have stepped into the breach with money for actuaries, economists and other consultants.

The California HealthCare Foundation is funding two consultants to work on the state's application for federal funding for a health insurance exchange, a cornerstone of the law that will allow individuals and small businesses to shop for coverage in a new online marketplace. It must be in place by 2014, and though the state was the first to pass a law authorizing the exchange, last September, it has committed few resources to actually building it.

"It is a sign of the times," said Marian Mulkey, the California HealthCare Foundation's health reform director.

Budget problems — states' 2012-13 deficits are expected to total $150 billion — aren't the only reason why states are seeking foundation support. Lengthy procurement procedures mean it can take many months for states to hire experts, making it tough to meet health law deadlines, Howard said.

Peter Long, president of the Blue Shield of California Foundation, said his organization distances itself from potential conflicts. When the foundation receives requests for help from the state, it contracts with experts who can handle the work, then steps back, leaving the tough policy choices to public officials. "We're inspector No. 12," he said, referring to the calling cards anonymous quality checkers might leave in the pocket of a new garment.


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