who the heck knows anything, anyway

Wednesday, August 25, 2010

More Reasons to Improve Healthcare: For the Sake of the Internet

I think I may increasingly be a fan of Federal Government (Sorry, T-Jeff).
This may sound odd, because I have never been a fan of The Man, and federal government is about as Man-ful as it gets. However, I love organization and, though I'm sure it's drowning in its own bureaucratic nonsense, I imagine the consistency offered by it (at its most ideal, mind you) would make jobs like the one I currently have MUCH easier.
Before the days of the internet, I would probably be a Power to the States girl. But the internet has proven to me that the Texas Medical Board has it way more together than the Oregon Medical Board, and this is disheartening. There goes my state pride. But if EVERY state had to meet certain searchable board requirements, I would be The Happiest. Because I am researching on medical boards across the country all day long, and it is a headache and a half to try to find a license for an emergency transportation organization in about 46/50 states.
(this is Thomas Jefferson, in case you hate history)

The issue is consistency. Oregon, for example, breaks out each medical specialty into its own board (leaving MDs, PAs, and DOs together, fortunately). Looking up a nurse? Nursing Board. Chiropractor? LCSW? Physical Therapist? All on their own boards. This is nice as far as additional information is concerned, but the licensing lookup should be centralized. Additionally, each lookup should consist of:
   1. license number
   2. original effective date of said license
   3. license renewal/expiration date
   4. Board actions
Some states even appear to fund their state department in part by charging people to access this information. I am not okay with charging for public information, no matter how broke your state is. That's ridiculous.
There's a larger argument hidden in here. About communication between people who essentially dictate the outcome of other people’s lives—i.e. there is none. I had a conversation with one of my coworkers about it this afternoon, and she was describing how inconsistent keeping charts can be from doctor’s office to doctor’s office. And here’s an interesting story: Health Insurance providers (like the one I work for) can get a bad rep for denying non-formulary prescriptions. Many require prior-authorization from a doctor’s office. So it gets bounced back to the doctor who is supposed to contact the health plan. Health plans turn over prior auths within 24 hours. However, if your doc forgets about it for a few days, and then we take another 24 hours, and then the doc doesn’t call you back right away, you might be prescription-less for a while. Which is awful, considering the point of prescriptions. It’s an absolute miracle anything gets done, ever. And, yes, everyone thinks healthcare needs an overhaul, but honestly, you can’t blame President Obama for not being able to single-handedly make healthcare affordable AND streamline it, when you have to crack down on everything from provider education to medical boards using the same (or at the very least compatible) software*.
I see no immediate solution for this insanity other than actually scrapping EVERYTHING and starting from square one. I love being a citizen of the United States (especially of the Pacific NW persuasion), but it’s almost too big to handle itself.
Ah, capitalism. I kind of hate you.

*you see the problem here. All of a sudden you’re fighting big, fat Insurance monsters AND big, fat software companies, AND doctors who don’t want to change how they’ve been conducting business since forever, etc.