Thursday, December 18, 2008



The National Health Information Network and the Social Security Administration

When I first started hearing about this, I thought "oh brother, talk to me in 20 years when they have this thing in place for real". How long will it take? Who knows. But, increasingly, I find discussion of the NHIN more interesting.

Here's the gist of it all: The social security administration would like to streamline the social security disability application process by getting records faster. The hope is that a national health information network, where records can be accessed electronically, will be the ticket.

Sound far-fetched? By definition, I think it is far-fetched, as in "it will take a long time for this network to come into being. Reason? Cost. It will take a lot of money, and therefore a lot of time, to get everyone (medical treatment providers) onto this new "grid".

Here's why I think so. I went to my doctor yesterday and he took a fair amount of time explaining to me how his new medical record data system works (He knows I blog online and assume that I must, therefore, understand everything that involves a computer). Basically, he dictates his notes on a computer or PDA and they go straight into the database. If he writes a prescription using his data management system, it automatically goes right over to the pharmacy electronically. If he gives someone an ekg or a treadmill test (for suspected coronary artery problems), that information is also recorded and sent into the patient's "chart" in the database. All in all, its a wonderful system.

It was also very expensive. And, as he said, he doesn't know of a single other practice in our metro area that has it. Probably due to A) the cost and B) the extreme hassle it would take to set the system up and learn how to navigate within it.

I found his new data management system really neat. But...what about backing up data? What if it crashes and you can't access a patient's chart? what if it gets corrupted by a virus? What if, what if, what if? And I'm sure this is whats many medical practices think of when some sales guy tries to sell them this system. And then there's that nasty issue of cost. Contrary to popular myth, most family doctors don't make a ton of money. They do well enough, of course, but they don't make half of what medical specialists make. And they have a ton of overhead.

This new national health information network will not really come into being into all the thousands of medical practices in the country upgrade their internal systems of medical record keeping. And how long that will take is anyone's guess.

Having said that, though, once the NHIN comes into existence, social security disability claims and SSI disability claims may move a lot faster in the system. As a disability examiner, it was very clear to me that the major holdup on a disability application or a request for reconsideration was...the ridiculous amount of time spent waiting for medical records that had been requested (sometimes SEVERAL TIMES and sometimes months earlier).

For more info on the NHIN, read the following article (with at least one grain of salt) -

NHIN will debut at Social Security Administration



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Other Posts

How long does it take to get a hearing for disability ?
Social Security Disability Requirements
How does Social Security Disability use your Work History?
Appealing a denial of Social Security Disability Benefits
Social Security Disability SSI Tips Advice Answers to Questions
Denial on a disability application - What comes next?

2 Comments:

Blogger martin said...

tim, I just found your blog, and have spent the entire afternoon and evening reading it. I completly agree with a lot of your comments, and have learned a lot. i'm in my 18th month, and still have a year before i have my hearing. I worked in State Law Enforcement (Corrections) for 28 years. for 25 of those years i had issues of passing out when i cough, don't mean black-outs, but hitting the floor types. Just 3 months prior, i had spoken to my doctor about it, and it was noted in my chart.It progressed to the point that i had a incident at work in front of my supervisors, while i was in a secure area with no access to help me. It was well documented. it was strongly encouraged that i retire. I did so not long afterwards. Well, i applied for SSDI, and obtained lawyer in the same day. as always, I was turned down. since I never know when these spells will happen, I was instructed not to drive, be supervised outside, etc, etc. In addition to this incident, I have COPD, OSA, Hearing only in 1 ear, and the loss in it is >90. I o to the doctor every month, have been to the mayo clinic seeking treatment, is no treatment/cure. While at the clinic, they found that i had radia tunnel s.. in my left arm. from a incident (fight/fights) at work a few years ago. and this to is may not be treatable other than wearing a cast at night to ease the stress on the arm. the treatment for my arm is to operate, but only 20% postive outcome, and 80% chance of more damage. Not going to happen. Was advised that as time went on, my arm would go to sleep due to the nerve damage and not wake up. Everything is well documented, to include listing of my phyical/mental duties from my past employer. RFC's by all 3 members of my medical team. well, so far the response from SSDI has been that i can work, and lift up to 50 pounds. So, if i can work, does that mean I can drive a bus, taxi, carry my weapon again?. i think not. but if I did and something happened, would SS be liable for it due to the determination that i could work any job that did not require lifting over 50 lbs. I think not. And for even a better short story.. since i retired from the state, I can't get any additional help from the state. And because i was able to pay off my house, own a rv and 2 cars free and clear and gross 2500.00 a month, but only clear 1500.00 because of the cost of my health insurance, but then, add another 6000.00 dollars for out of pocket medical co-pays, and medication. but I retired from the state, thus i don't need anytype of help according to ssdi and food stamp assistance program...thanks for letting me vent a little

10:13 PM  
Blogger Disability Blogger said...

Martin,

Feel free to vent. You have a lot on you. From what you said about your monetary situation, I couldn't help but think about my in-laws and a number of claimants I've spoken with over the years. In the case of my mother-in-law and father-in-law, they're both retired and have redundant health insurance, but they get eaten alive with co-pays and the cost of medications that are not covered. Something is absolutely going to HAVE TO HAPPEN with reform of our health insurance system here, in addition to what's wrong with the SSA disability system. You also sound like you have a huge monthly insurance premium. I would say its shocking, but I've spoken to others in the same situation. I know a lot of people are against a national health care plan, but I honestly don't see any way around it. Too many people go uninsured and even those who are insured get hammered on the cost of premiums and out-of-pocket expenses. Regarding what you said about 50 lbs ("so far the response from SSDI has been that i can work, and lift up to 50 pounds"), it seems they're basically saying you have a medium exertion RFC. Here's my opinion on medium RFC ratings. They are usually a joke. I once came up with an idea to partially reform the disability evaluation process by making each and every single doctor at DDS (disability determination services, and the doctors are known as medical consultants) keep a 50 pound dumbbell beside their desk. My requirement would be that they have to pick that sucker up once a day and see what 50 pounds really feels like. I've lifted weights my entire adult life and I don't think these guys have any clue what 50 lbs is. But none is surprising: there are reasons why these doctors are not in private practice and instead work for state government making far less. Basically, as I and many examiners have often said, we would never go to one of these doctors for treatment of any kind.

7:30 AM  

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