Saturday, March 25, 2017

Why Veterans Administration Medical Care is Better than Civilian

I know the material as I have lived it for years and I have no medical insurance so I would have been boxed years back without VA.  Army time was '70-'72 and experience those joy joy feelings one more time.  I would tell you my war stories ... but I have no war stories.

Why VA medical is better

Zero paperwork

When going to a civilian doctor for the first time, I will have to write "War and Peace" in the waiting room to describe everything in my checkered medical history.

There is zero writing while waiting with VA because all information, history and treatment, is managed on a centralized computer system in which all departments have access to it.  Physical access security controls appear to be excellent.

Centralization of that nature is dead center in the privacy contest in the real world.  At VA it works splendidly for minimizing fuck-ups due to confusions in moving from one department to another; it's impossible within VA to go doctor shopping to pile up prescriptions for pain pills and the like; the entire history is always available.

The huge benefits to this type of centralization are easy for people to visualize but it's also easy to create a vision of Medical Nazis with Evil Intent using that information for who knows what demented and malignant purpose.  This one is gigantic with many people in thinking I am so absolutely screwed if that information can be seen.

There doesn't need to be any other thing which shows VA is better than civilian since that one is enormous beyond description.  There's a calm which comes when you know there's not going to be any confusion such as, wow, were we taking out the left or the right kidney with this one.

Practically every patient at VA is already screwed but all know this is the best move we can make toward getting unscrewed, assuming that's even possible.

By way of contrast

We have today's visit to a civilian doctor's office which is rare but he does a custom cut so VA sent me to him although I had a choice of which cutter; this wasn't a forced march.

I noticed paper files all over the office and they were organized immaculately, using that color code they always seem to use in medical places, and I thought, holy hell, what century is this.  When the hell am I, Billy Pilgrim?  Where is the wagon train?

To make it priceless, the power went out.  I noticed the office computers were down and I asked if they have considered battery backups.  They said, oh, we have those.  I didn't say, well, it doesn't appear they work very well.

Welcome to the future, George Jetson.

The biggest VA liability

There's no emergency support so that's necessarily civilian where they do not have access to the records and now you're on a medical desert island but there's all kinds of high-tech machinery and lots of people with good intentions but they're blind for the history.  If you're needing a medical sinkhole, that's the one.

No need for a big spiel on that.  Once you're in-sync with VA it flows fairly well.  If not it can be somewhat bothersome (i.e. long delay) getting started into it.

The Beef

The beef in this one is the central part about security versus centralized management since a whole lot of people would like to throw that onto the fire.  My purpose in the article is to illustrate it's exactly the thing which is working with excellent success in VA.  If it's such a terrible thing then having every damn thing about me open to any of them then the consequence of that situation is something I should be seeing in some negative way but it's not there.

I've pumped gallons of blood at the donor center for three reasons:

- it's easy
- helps someone I probably don't even know
- I'm on the street in fifteen minutes feeling like a hero

That's good stuff for a kid and all of the sibs turned negative vampire like that as well with a whole lot of blood pumping.  I really don't know what started it but I kept with it as much as I could until they got so stringent they just didn't want it anymore.

Note:  my blood type is O- which is the universal donor and I can give blood to anyone but can only receive O- and, in transactional analysis, that means you're ok and I'm screwed.  (Many the visits to emergency rooms and hospitals but I never sprang a leak; it was always from broken bones so no transfusions)

Tip:  if you ride motorcycles, be better at it than I was.  I only found one bike I couldn't crash (Honda 500).

This is all with the background theme of the Theory of Propagated Goodness in which good things happen and are most likely when you do anything good without any idea of what good will ever come of it, just that something will, somewhere.

Centralized medical information is identical in concept to blood donation but vast in scope.  Yah, avaricious cave dwellers will find some way to yank it for money but much more noble people will see the finest database for medical research which ever existed.

Maybe you buy it that the scope of human thinking expanded specifically because of Google search.

Google became the low-speed storage for the human mind for the things we would like to remember if, you know, Every Damn Thing would fit.

How much do you suppose the scope of medical thinking will increase if their incarnation of Google search can review as much of the medical history of the human race as possible.

Y'all are scared of that but, dayum, think of it.  Carry it through and you'll know it's not rubbish.

Watson:  it's not rubbish about the avaricious cave dwellers either!

Fair enough ... but ... how much damage do you really believe they can do.  Understand the information isn't being secured by idiots.  Maybe you recall the hacker field day recently with baby cams which were easily compromised because the people who bought them never secured them.  Whammo, Baby Elmo is all over the web.

Connecting patient names with the medical data is likely the biggest horror since then maybe your stuff is known all over the Internet and people can read it as easily as your court history, always for only a nominal sum, said he as he twisted his dark, waxy mustache.

Before you're going to buy it, likely you have to be satisfied the storage of the information is done in a way which is rational and satisfactorily secure.  That, however, turns it into a democratic debate which means it dies on the House floor.

You have a hard game with this one but, lo, hear the angels and their trumpets, the evolution of medical care and advanced medical research awaits your move.

How about this for a closer since it seems the Doctor Kildares can cure it if they can see it and it's finding it which seems often the problem.  What if this search of a central human medical database helps them find things better and it reasonably should.

Take it away, George Jetson.  Make it happen, my brother.


Anonymous said...

Hospitals give you a Barcode on admission. It is scanned for everything going there after including all medicinest. Drs access through a laptop.
Very little paperwork. Mostly it is PCPs that won't spend the money to transcribe the old records. Mine have already moved to a paperless system.
But the VA would be among my last choices for health care I am glad that they are there for you but they are hardly state of the art.

Peas InOurThyme said...

There's a significant possibility Yevette's cancer would not have advanced as it has if not for the failure of a doctor to convey information to others. The non-VA approach hasn't been impressing me too much but everything looks like it is synced now.

There was some discussion of lawsuits but my pitch has been focus, focus, focus. Get better before thinking of such things.

Anonymous said...

Get all the records you can--right away so you have them on hand (or have a surrogate obtain them for you). There is one available--a friend of her mother. Let people give love and support (I know that they want to).

But yes, for now Yvette focus on getting better--and accept help--which I know is very hard to do.

I pray for you daily, and you are in my heart. You will beat this--I know you will!

Peas InOurThyme said...

She will and I will help. Thank you for being so excellent about it all and there's been some rallying as well from family she hasn't seen in a while. The team is behind her and she can see it. All have the same chant: you get better, girl.

The legal aspect is some of the Silas the Counselor bit and it goes just like you said. There's plenty of time for attorneys and right now the only thing that matters is to get well.