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View Diary: F**k you, Governor Brownback (90 comments)

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  •  kck, I agree that electronic data can be a godsend (3+ / 0-)

    in many settings.  For an example, a few of the many specialists involved with my child's medical care have been using this methodology for years (as opposed to paper charting).  Each staff member has a notebook/laptop that they input info from the beginning of the office visit.  A report can be generated on the spot or electronically sent to other specialists/docs if needed.  Which is cool beans!

    What I find troublesome is the range of community service provider rules that are typically set by a state entity and pertinent state depts.  Then coupled with any applicable federal "rules".  Further coupled with the fiscal considerations beit regular insurance, medicaid, medicare, SSI/Disability, state budgets.

    And then have the service provision outsourced to another entity-beit non profit or private-with their own set of rules or interpetations.

    As a hypothetical example: An adult with MR still living  at home requires community supports for activities of daily living, rec, transportation, job skills training or on the job assist.

    Each of these needs require evals, written plans, data collection, coordination of services, reviews and mandated annual redeterminations.  

    To further complicate matters, there can be (and are) pre-determined "units" allocated based on say SIS evals, state budget, whether needed services are available, whether there is a wait list and whether services are self directed

    It is entirely possible that multiple entities are involved-each with their own record keeping criteria and staff.

    Add to the scenerio something as simple sounding as respite or sudden need for enhanced home health services & you've got even more layers.

    To add further to the rabbit hole, any state & fed requirements must be met or the individual can lose benefits.   So it is in the best interests of the individual to have thorough documentation on monies spent & units utilized.  This is a completely different aspect to consider-one of the consumer not of the service provider.

    I am not familiar with the drug/alcohol/mental health/ elder community service programs but I have little doubt that they differ much from MR programs.  Each state seems to have their own criteria without portability of services.  So a program in CA will not resemble one in GA.
    (Hell, a program in another county in the same state won't necessarily resemble each other)

    So while I am excited & see great potential about electronic records in the medical setting, I have my qualms about their use in the community provider setting until there are universal methodologies with checks & balances in place.  Not likely, IMHO, with for profit entities involved.

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